As Lung Cancer Cases Rise, Doctors Warn of Changing Risk Factors
Disease Affects Men’s Sexual Health & Women’s Reproductive Health
Team L&M
Lung cancer is emerging as a growing health concern in India, where it remains the fourth most prevalent cancer. Doctors warn that the disease is no longer limited to smokers. Changing lifestyles, worsening air pollution, indoor smoke exposure and delayed diagnosis all contribute to a rise in cases, particularly among women and people who have never smoked. Recent research suggests that the numbers continue to climb 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,” he adds. “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 all play a bigger role than they used to, and that means our screening approach has to widen well beyond the traditional smoker profile.”
A Changing Face of Lung Cancer
Dr. Ruchi Singh, HOD & Senior Consultant – Radiation Oncology, 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,” she says.
Beyond the Lungs: Hidden Health Consequences
Lung cancer’s impact often extends well beyond the lungs. “It can significantly affect a man’s sexual health and overall quality of life,” says Dr Vineet Malhotra, Head of Urology, VNA Hospital. Treatment side effects—including fatigue, hormonal shifts, reduced libido and erectile dysfunction—combine with anxiety, depression and body-image concerns, placing additional strain on intimacy and relationships. He urges men to discuss these concerns with their care team, as counselling and lifestyle changes can help.
For women diagnosed during their reproductive years, the consequences are different but equally serious. “Chemotherapy, radiation and certain targeted therapies may affect ovarian function, reduce fertility and, in some cases, lead to premature menopause,” explains Dr Malhotra.
“Menstrual irregularities, hormonal shifts and vaginal dryness often accompany treatment,” he notes, recommending that women discuss fertility preservation before treatment begins, ideally through a multidisciplinary team that includes oncologists and fertility specialists.
Dr Ashwin Mallya, Uro-Oncologist and Robotic Surgeon, Sir Ganga Ram Hospital, says, “Although primarily a thoracic malignancy, lung cancer frequently extends beyond the chest. Adrenal metastases are among its most common 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.”
Prevention, Early Detection and the Road Ahead
Doctors remain unanimous that quitting—or never starting—tobacco use is the single most effective way to reduce the risk of lung cancer. “Smokers face nearly 20 times the risk of non-smokers, though the rising number of cases among non-smokers complicates that picture,” says Dr Budhraja. “Second-hand smoke is the third leading cause of lung cancer among non-smokers, while radon gas, which seeps in from the soil, is the leading one, and home testing kits can detect it.”
“Occupational exposure to asbestos, arsenic, diesel exhaust and radiation also increases the risk, especially when combined with smoking,” adds Dr Singh. “Regular exercise and a diet rich in fruits and vegetables may also offer modest protection.”
As India’s lung cancer landscape continues to change—driven increasingly by geography, gender and lifestyle rather than tobacco alone—doctors say the country’s response also needs to evolve, with pollution control and early detection taking their place alongside anti-tobacco campaigns.
