How Genetic Mutations Can Trigger Lung Cancer

By  Dr. Sanketh Kotne, MD, DM Consultant Medical Oncologist,Vizag

Not every cough is just a cough, and not every patch on an X-ray is the result of pollution or age. A Human body is made up of millions of cells, each carrying a set of instructions embedded in our genes. These instructions guide how cells grow, divide, and function. But sometimes, a tiny error in this genetic instruction manual, what we call a mutation, can lead to major health problems, including cancer. Lung cancer, in particular, is a condition where such changes often go unnoticed until it’s too late.

Traditionally, smoking has been seen as the primary cause of lung cancer. While it remains a major risk factor, we now understand that it’s only part of the story. Today, an increasing number of patients are being diagnosed with lung cancer despite having no history of smoking. This has prompted the medical community to look deeper, into the microscopic world of our genes.

Genetic mutations can be either inherited or acquired. Inherited mutations are passed down from one generation to the next, but these are relatively rare in lung cancer cases. Acquired mutations, on the other hand, develop over a person’s lifetime, often as a result of environmental exposures. These exposures might include pollution, industrial chemicals, radiation, or even certain viral infections. In our region, where industrial growth has brought about environmental shifts, these factors may play a bigger role than we previously thought.

Among the various mutations linked to lung cancer, a few have received special attention in recent years. Changes in specific genes such as EGFR, ALK, and KRAS have been identified as drivers of cancer in the lungs. These mutations alter the way cells behave, encouraging them to grow uncontrollably and resist natural cell death. In simple terms, these faulty genes remove the brakes and push down the accelerator, leading to tumour development.

Understanding these mutations has transformed the way we treat lung cancer. Today, we no longer rely solely on chemotherapy or radiation. Instead, we use advanced treatments known as targeted therapies, which are designed to attack cancer cells based on the exact mutation they carry. For instance, if a patient’s tumour has an EGFR mutation, we can prescribe a medication that specifically blocks that genetic pathway. The result is often better outcomes with fewer side effects than traditional treatments.

In addition to targeted therapy, genetic insights are also guiding the use of immunotherapy—a treatment that boosts the body’s own immune system to fight cancer. These approaches represent a shift toward precision medicine, where treatment is tailored to the unique genetic makeup of each patient’s cancer.

The key to success, however, lies in early detection. That’s why genetic testing has become such an important part of the diagnostic process. By identifying the mutations present in a tumour at the outset, doctors can recommend treatments that are more likely to work from the very beginning. Genetic mutations are a silent yet powerful force behind many cases, and awareness is the first step toward fighting back.

Understanding the impact of invisible factors like genetic changes is crucial. While we may not be able to see these mutations, we can certainly act on them through early testing, personalized treatment, and staying alert to the signs our bodies give us.