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By Dr Nikhil Suresh Ghadyalpatil

A 52-year-old schoolteacher came to me with a persistent cough and mild breathlessness. She had never smoked a cigarette in her life. Her chest X-ray showed a shadow. Tests confirmed lung cancer. Her first words were, “But doctor, I don’t smoke.”

This captures the biggest misconception about lung cancer — that it only happens to smokers. While tobacco remains the leading cause, I am seeing a growing number of non-smokers, particularly women, being diagnosed in my practice. Air pollution, cooking fumes in poorly ventilated kitchens, occupational exposure to chemicals, and genetic factors all play a role.

Warning signs you should not ignore

If any of the following last more than two to three weeks, see a doctor. A cough that won’t go away or gets worse. Coughing up blood, even a small amount. Chest pain that worsens with deep breathing.

Unexplained breathlessness. Hoarseness of voice. Unexplained weight loss. Repeated chest infections that keep coming back.

These don’t always mean cancer. But they always deserve attention.

Screening can catch it early

This is something I feel strongly about. Lung cancer often causes no symptoms in its early stages, which is why most patients come to me late. But we now have a proven screening tool — the low-dose CT scan of the chest. For heavy smokers and long-term smokers above the age of 50, this simple, quick scan can detect cancers when they are tiny and still completely curable. Studies have shown that CT screening in high-risk smokers reduces lung cancer deaths significantly. I strongly urge anyone who has smoked heavily for years to talk to their doctor about getting screened. It could save your life.

Treatment has transformed

Lung cancer treatment today is nothing like what it was a decade ago. We now test every cancer for genetic mutations. In Indian patients, mutations like EGFR are quite common, and we have targeted tablets that can control the disease for years. Immunotherapy has been a game changer.
I will share something that would have been unheard of just ten or fifteen years ago — I have stage IV lung cancer patients in my practice who are living well and leading normal lives for five years and beyond. Stage IV, which was once considered a death sentence with survival measured in months, is now a disease many patients are living with, not dying from. That is how dramatically the treatment landscape has changed.

Note: If you smoke, stop. The risk drops the moment you quit. If you don’t smoke, don’t assume you are safe. Be aware of the symptoms, and act early. Lung cancer is no longer a hopeless diagnosis. But everything depends on catching it in time.

Dr Nikhil Ghadyalpatil is a medical oncologist at Apollo Hospitals, Hyderabad