Doctors concerned over rising incidence of tobacco-linked lung diseases

Bengaluru: Medical specialists are sounding alarm bells over the rise in aggressive forms of lung cancer and chronic obstructive pulmonary disease (COPD) among younger populations due to tobacco exposure. 

At the state government-run SDS Tuberculosis Research Centre and Rajiv Gandhi Institute of Chest Diseases, more than 50 per cent of the patients seen daily are active or passive smokers. 

Dr C Nagaraja, director, noted that even passive smokers are presenting with COPD and increased risk of heart diseases, sleep disorders and cancer due to tobacco. "We see at least 260 patients each day in our outpatient unit. At least 150 of them have a history of smoking," he said. 

Dr Ravindra Mehta, pulmonologist and founder-director, Vaayu Chest and Sleep Specialists, noted that cancers are on the rise, especially in people aged 40-50 years who are generally not exposed to other risk factors. 

"Now, we are seeing women and younger men also develop lung cancer even without significant smoking. There is a pattern of accelerated progression and late detection leading to advanced cancer in younger age groups now," he said. 

Second hand or passive smoking is also leading to a rise in lung cancer, especially among women aged between 40-45 years. 

Dr Mohammed Naseer, consultant medical oncologist at HCG Hospital, noted that a majority of patients who show up with thoracic malignancies have some form of tobacco exposure. They are at risk of developing the rare but aggressive small-cell lung cancer, which has a poor prognosis. 

Besides risking the development of advanced lung cancers, tobacco use can also increase the risk of developing coronary artery disease, cerebrovascular accidents such as stroke, oral cancers, throat cancers, gut cancers, including that of the esophagus and stomach, and cancer of the urinary bladder. 

Dr Amit Rauthan, medical oncologist at Manipal Hospitals, explained that radiation therapy is commonly opted for only in locally advanced lung cancer. "In the early stages, surgery followed by chemoimmunotherapy is used, and as the stages progress, a combination of targeted drugs and chemo-immunotherapy is opted," he said. 

Specialists are pushing for better tobacco prevention and cessation initiatives. 

Dr Naseer pushed for low-dose computed tomography scans on patients displaying symptoms of lung disease to pick up early lesions. 

Dr Arvind Kasthuri, community medicine specialist and chief of medical services at St John's Medical College Hospital, emphasised on the need for policy changes, community engagement and multi-level prevention activities. This includes outreach activities involving schoolchildren to highlight the ill-effects of tobacco, messaging to stop tobacco use, early diagnosis and treatment of signs of lung disease and limiting the spread of lung disease. 

Signs to watch out for

* Persistent cough that does not settle

* Unexplained weight loss

* Coughing blood

* Wheezing and shortness of breath

* Chest pain

* Unexplained fatigue

* Any sores and inflammation in the oral cavity that won't heal

Expert advice

* Don't pick up smoking

* If started, quit as soon as possible

* Avoid passive smoking

* Mask up in polluted areas 

* Undergo periodic check-ups of the lungs