The first reaction to a diagnosis of cancer is denial. But cancer is curable if caught early enough.

Many people believe that some diseases are common only in the West and that they will never make an entry in our country. Respiratory problem? It has to be bronchitis or asthma. Chronic case? It has to be tuberculosis.

If offered a lung cancer diagnosis, the response is a denial: “There is no family history of cancer, I don’t smoke...” Even after the diagnosis is made people will contact relatives in the U.S. for a second opinion and ask for case history and records to be sent there. The end result: treatment is delayed.

Cancer is curable if diagnosed early. One need not think that he/she can not get cancer. We swim through a sea of carcinogens every day. Breast cancer, prostate cancer and colon cancer have seen defeat if diagnosed early.

Late diagnosis

That brings us to an important point. Most lung cancer cases are diagnosed either in the third or fourth stage, when the disease is not treatable. Lung cancer has the highest death rate. Unfortunately it is also the cancer that can be prevented if smoking is completely banned. Both active and passive smokers would benefit. People working with industrial chemicals like asbestos, uranium and arsenic should take care to reduce their exposure. Air pollution, especially automobile gases, and drinking water with high arsenic content also can predispose to cancer

Nine out of 10 deaths are caused by lung cancer. Cigarette smoking not only causes cancer but also disarms the lung's natural defence mechanisms; hair-like microscopic structures called cilia. This allows carcinogens to enter the lungs easily.

Some regular smokers ask if they can be screened for lung cancer. Studies have not shown if screening for lung cancer is useful. But those with symptoms should get a CT scan if necessary with a dye injection. After this there will be other procedures like sputum examination, bronchoscopy or lung biopsy depending on the physician's advice.

There are surgical and medical options. Thanks to medical improvement, molecular diagnosis and markers can be detected and targeted and personalised therapies are available. Consult an oncologist.

Despite all the medical expertise and treatment options, it is the attitude of the patient and the family — not the diagnosis — that makes a huge difference. One of my patients who had been diagnosed with breast cancer five years ago came to me with fluid in the lung covering. The diagnosis was malignancy. As I was explaining her treatment plan, she asked me what would happen to her vacation. She had planned a vacation with her family long before this diagnosis was made. Neither her family members nor she was prepared to cancel the holiday. They would not let the diagnosis dampen their spirit.

Stay alert

A smoker and above 50 years

If cough continues despite treatment

X-ray shows changes that have not disappeared despite treatment

Coughing blood but x-ray is normal

Unexplained weight loss and loss of appetite

No improvement after a presumptive treatment for TB