Lung cancer, second most common cancer in the valley: Dr Naveed

Dr Naveed Shah is the first J&K Pulmonologist, Professor and Head of Chest Medicine GMC Srinagar who played a leading role in handling the COVID 19 crisis in UT.

In an exclusive interview with Rising of Kashmir Special Correspondent Jahangir Sofi, he talks about lung cancer in Kashmir in relation to smoking.


Tell us something about lung cancers and what are its symptoms?

Our lungs are the spongy organs that help in gas exchange. The lungs are prone to a variety of diseases ranging from common respiratory infections to deadly lung cancers.

In the early stages of lung cancer, patients do not show any kind of signs and symptoms. Typical signs and symptoms of lung cancer develop in later stages of the disease, including shortness of breath, chronic cough that does not resolve with conventional treatment, blood in sputum, chest pain. Change of voice.

How does smoking play a role in disease progression?

People who smoke have a higher chance of developing lung cancer, although there are reports that lung cancer can develop in those who never smoke.

According to Kashmir valley hospital data, lung cancer was found to be the second most common cancer. Over the past few decades, the cancer catastrophe has wreaked havoc across the world, Kashmir has seen an increase in cases of lung and breast cancers.

According to Kashmir valley hospital data, men have higher incidence of lung cancer while women suffer from breast cancers.

There is a direct relationship between the duration of smoking and the number of cigarettes smoked per day. Even if smokers quit smoking, there are risks of developing cancer, but these risks decrease further.

How do you see smoking trends in the Valley?

In Kashmir, the number of people actively involved in cigarette smoking is increasing at an alarming rate, such as the National Family Health Survey (NFHS-4), 38.2% of men in Kashmir smoke and an international survey conducted by Global Adult Tobacco Survey (GATS) places Jammu and Kashmir on serial number 6 among all states and union territories in terms of smoking.

Due to its large portion of the population involved in smoking and the exponential increase in the population of smokers every year in the future, Jammu and Kashmir will be tagged as the smoking capital of India. Recently Indian Council of Medical Research published a report titled “Health of Nation States” according to this report J and K have highest incidence of Chronic Obstructive Pulmonary Disorder (COPD) and the same report attributed this to the increasing population of smokers in J and K. In addition to local brands of cigarettes, imported cigarettes have become a culture of decency and intelligence among young people.

Is there any research or studies on the harm caused by smoking?

Researchers working in this field posit that smoking being full of carcinogens causes drastic changes in the lining of the lungs and this change begins immediately when the cells lining the lungs are exposed to the carcinogens found in cigarette smoke.

In the early stages, our lungs are able to repair this damage, but chronic exposure leads to aberrant lung cell behavior that ultimately results in the development of lung cancer.

Pulmonologists divide lung cancers into two broad categories based on the types of cells involved in lung cancer progression; these include small cell lung cancer and non-small cell lung cancer.

Of these two types, small cell lung cancer is widely found in the population of heavy smokers and very rarely in the population of non-smokers. Recently, a study was conducted by SKIMS, and they reported that smoking-related cancers (lung cancers) have increased significantly in the summer capital Srinagar.

In 2014, the International Research Agency concluded that in addition to active smoking, passive smoking of carcinogens can also cause lung cancer.

Can passive smoke increase the risk of lung cancer?

Long-term passive exposure to cigarette smoke increases the risk of lung cancer and breast cancer, cigarette smoke has been reported to contain over 7,000 chemicals of which 70 have been reported to be highly carcinogenic .

Inhaling these chemicals damages the tiny air sacs in the lungs called the alveoli, and over time the cells that line these air sacs undergo DNA mutation and therefore the development of cancer.

How is the disease diagnosed and treated?

Diagnostic tools commonly used for the diagnosis of lung cancer include computed tomography, bronchoscopy, endobronchial ultrasound, and histology.

There are various treatment options available including surgery for early stages and chemo radiation therapy for advanced stages. Immunotherapy, also in eligible cases, has shown great promise in the treatment of inoperable cases.

In most cases, lung cancer is diagnosed when the disease is stage III or stage IV, so the prognosis for lung cancer is poor, but encouraging results have been reported in the treatment of lung cancer if the Diseases are detected early and treated with a multi-modality approach.

And electronic cigarettes?

It is an electronic device that mimics the sensation of smoking by producing mist and delivering nicotine.

These products are new to the market and the side effects associated with long-term use have yet to be established. At present it is unclear whether e-cigarettes are associated with lung cancer, but recently the American Cancer Society postulated that e-cigarettes also contain carcinogens but less in quality and quantity compared to conventional cigarettes.

A chemical called diacetyl used as a flavoring agent in e-cigarettes causes DNA damage that may be a prerequisite for the progression of lung cancer.

Additionally, very heavy metals such as lead and tin have been isolated from e-cigarette smoke, which are highly carcinogenic.

What are the other causes of lung cancer?

Nearly less than 15% of lung cancers are not associated with smoking. Clinicians have therefore identified the following other causes of lung cancer besides smoking.

These include genetic factors (family history), exposure to radioactive substances, the National Cancer Institute has identified asbestos in the progression of lung cancer, automobile exhaust (Centers for Disease Control and Prevention).

Recently, researchers have identified dietary factors for the progression of lung cancer. They reported that smokers who take increased levels of beta-carotene supplement have an increased risk of developing lung cancer.

What should be done for its prevention?

At the hospital level, screening programs can be useful for the early detection of lung cancer. At the community level, action to improve air quality must be taken, at the individual level, efforts are warranted to reduce active and passive smoking.

It’s never late to quit smoking, when we quit smoking our body is equipped with a wide range of physiological processes that can repair the damage caused by smoking.

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