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Dr Sabyasachi Bal
Lung cancer is often thought of as a disease of the elderly but it does occur in young patients. The death of Dana Reeve, best known as the wife of "Superman", from lung cancer at a young age has caught public attention. Not only was Dana a non-smoker, but was just 45 at the time of her death in 2006.
Is cancer of the lung increasing among the young?
At first glance, lung cancer in young people may seem uncommon. But considering that lung cancer is the leading cause of cancer deaths in men and women in the US, even a small percentage can translate into many people suffering from the disease. This applies equally to India with its vast population.
Although the incidence of lung cancer among the young is decreasing in developed countries, the truth may be different in India. It is true that at least half of these cancers occur in non or never smokers and there seem to be differences as compared to elderly patients in that cancers in younger patients are more advanced and therefore, have a poorer prognosis. Younger patients are likely to be non or never smokers, seem to have a genetic predisposition, have a different type of cancer called adenocarcinoma with different molecular charecteristics which can explain the occurrence of lung cancer in these young patients.
Pollution, a risk factor?
A recent report suggested that there may be a link between rising air pollution and lung cancer. The report said: “Pollution is contributing a lot to the rise in lung cancer cases. Industrial and vehicular emissions and stubble burning are some major reasons for lung cancer. People of younger age groups and women are victims of lung cancer mostly due to pollution.”
Research shows that tiny dust-like particles called ‘particulate matter’, or PM are an important part of air pollution. The smallest particles — less than 2.5 millionths of a metre across, known as PM2.5 – appear to be the main cause of lung cancers caused by pollution. The risk of developing lung cancer increases as the level of PM2.5 in the air increases.
Air pollution increases the risk of lung cancer. For each individual the increase in risk is small. But because everyone is exposed to some form of air pollution, when we think about big numbers of people, like the population of a country, air pollution has a much bigger effect.
Air pollution can be indoor or outdoor. In 2013, outdoor air pollution was identified as a cause of cancer by the International Agency for Research on Cancer (IARC). However, it’s responsible for far fewer cases of cancer than other risk factors such as smoking and obesity.
Indoor air pollution can have many sources, including fuels used to heat homes and cook with, and tobacco smoke. The most common type of indoor air pollution is second-hand smoke.
Currently, millions of people in the world are exposed to second-hand smoke. For children most of this exposure occurs in their homes. If you are a smoker, smoking outside can help reduce exposure for others in your home. And quitting will benefit you as well as your family.
And air pollution isn’t only linked to lung cancer, there is also sufficient evidence that it can increase the risk of other diseases — mainly respiratory-tract diseases and heart disease.
It is important that as individuals we play our part in reducing air pollution levels by trying to avoid creating more of it. Choosing ‘active travel’ options like walking and cycling, can help reduce pollution levels from transport besides offering several health benefits.
— The writer is HoD & director, thoracic surgery at Fortis Flt Lt Rajan Dhall Hospital, New Delhi
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