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Disease also affecting men’s sexual health and women’s reproductive health
Lung cancer is emerging as a growing health concern in India, where it remains the fourth most prevalent cancer, even as doctors warn that the disease is no longer limited to smokers. Changing lifestyles, worsening air pollution, indoor smoke exposure and delayed diagnosis are all contributing to a rise in cases, they say, particularly among women and people who have never smoked. Recent research suggests the numbers will keep climbing over the coming years, making early detection and greater public awareness more important than ever.
“We are seeing more lung cancer cases among non-smoking women, linked to indoor air pollution, biomass fuel use, second-hand smoke and occupational exposure,” says Dr. Akshay Budhraja, Senior Consultant and HOD, Respiratory & Sleep Medicine, Aakash Healthcare. “Tobacco use among Indian women remains below 10%, so worsening air quality and indoor pollution are the likely drivers.”
“What has changed in the last few years is the kind of patient walking into our OPD,” says Dr Akshay Budhraja. “It’s no longer just the lifelong smoker in his sixties — we are seeing younger patients, more women, and a growing number who have never touched a cigarette. Air quality, occupational exposure and genetic predisposition are all playing a bigger role than they used to, and that means our screening approach has to widen well beyond the traditional smoker profile.”
Dr. Ruchi Singh, HOD & Senior Consultant – Radiation Oncology, from the Asian Institute of Medical Sciences, points to another worrying trend. “One of the most concerning things we are tracking is how late many patients present. Because symptoms like persistent cough or breathlessness are so easily mistaken for pollution-related irritation or a lingering infection, people delay getting scanned. Earlier detection through low-dose CT screening in high-risk groups remains our best tool for improving survival, and awareness needs to catch up with how the patient profile itself is changing.”
Lung cancer’s damage often extends well past the lungs themselves. “It can significantly impact a man’s sexual health and overall quality of life,” says Dr. Vineet Malhotra Head of Urology, VNA Hospital. Treatment side effects — fatigue, hormonal shifts, reduced libido, erectile dysfunction — compound with anxiety, depression and body-image concerns strain intimacy and relationships. Dr. Vineet urges men to raise these concerns with their care team, since counselling and lifestyle changes can help.
For women diagnosed during their reproductive years, the stakes are different but no less serious. “Chemotherapy, radiation, and certain targeted therapies may affect ovarian function, reduce fertility, and in some cases lead to premature menopause,” explains Dr. Vineet. “Menstrual irregularities, hormonal shifts and vaginal dryness often accompany treatment,” Dr. Vineet notes, and recommends discussing fertility preservation before treatment begins, ideally through a team that brings oncologists and fertility specialists together.
Dr. Ashwin Mallya, Uro-Oncologist and Robotic Surgeon, Sir Ganga Ram Hospital, said “Although primarily a thoracic malignancy, lung cancer frequently extends beyond the chest. Adrenal metastases are among its commonest distant manifestations, while renal metastases, though less frequent, are well recognised. These patterns underscore the importance of a multidisciplinary approach, often bringing urologists into the care of patients with advanced disease.”
Doctors are unanimous that quitting — or never starting — tobacco use remains the single biggest lever against the disease. “Smokers face nearly 20 times the risk of non-smokers, though the rising non-smoker caseload complicates that picture,” says Dr. Akshay Budhraja “Second-hand smoke is the third leading cause of lung cancer among non-smokers; radon gas, seeping in from soil, is the leading one, and home testing kits can catch it.”
“Occupational exposure to asbestos, arsenic, diesel exhaust and radiation adds further risk, especially when combined with smoking,” adds Dr. Ruchi Singh, “while regular exercise and a diet rich in fruits and vegetables may offer modest protection.”
As India’s lung cancer picture gets redrawn — by geography, gender and lifestyle rather than by tobacco alone — doctors say the response will need to change too, with pollution control and early detection taking their place alongside anti-tobacco campaigns.
