Lung Cancer: Symptoms, Tests and Treatment Options in India

फेफड़े का कैंसर (lung cancer) — लक्षण, जाँच और इलाज। लंबी खाँसी को TB मानकर इलाज में देर न करें।

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Lung cancer is one of the most common cancers in Indian men and is rising in women too. In cities like Varanasi, Prayagraj, Gorakhpur and Patna, many patients first get months of cough syrup or TB medicine before anyone asks for a scan. That delay is the biggest problem. This guide explains the signs, the tests, and the main treatment options in simple words.

Who is at higher risk?

• Smoking cigarettes or bidi, including past smokers. Risk rises with the number of years smoked.
• Second-hand smoke at home or work.
• Indoor smoke from chulha (wood, coal, cow-dung cakes) in poorly ventilated kitchens.
• Air pollution and some workplace exposures such as asbestos, silica and diesel fumes.
• A past history of TB scarring or a family history of lung cancer.

People who have never smoked can also get lung cancer, especially a type called adenocarcinoma. So “I don’t smoke” does not rule it out.

Symptoms: lung cancer ke lakshan

• A cough that lasts more than 3 weeks, or an old cough that changes.
• Coughing up blood or blood-stained phlegm.
• Breathlessness, chest pain, or a hoarse voice that does not settle.
• Weight loss, poor appetite and tiredness without a clear reason.
• Repeated chest infections or “pneumonia” that keeps coming back in the same area.

Many of these signs also happen with TB, asthma or infections. That is exactly why the right test matters. Read more: A persistent cough: when a doctor should assess it.

Lung cancer vs TB: why the mix-up happens

In India TB is common, so a cough with weight loss is often treated as TB first. If sputum tests for TB are negative, or there is no improvement after a few weeks of TB treatment, ask your doctor clearly: “Should we do a CT scan of the chest and see a chest specialist or oncologist?” Both diseases can also exist together.

Which tests confirm lung cancer?

• Chest X-ray — often the first test, but it can miss small tumours.
• CT scan of the chest (with contrast) — shows the size and position of a lump or nodule.
• Biopsy — a sample is taken by bronchoscopy (a thin tube through the mouth or nose) or a CT-guided needle. Only a biopsy confirms cancer. See Does a biopsy spread cancer?
• Biomarker tests on the biopsy, such as EGFR, ALK, ROS1 and PD-L1. These decide whether targeted therapy or immunotherapy can be used. See biomarker testing questions.
• PET-CT and brain MRI — to check whether the cancer has spread (staging). See the PET-CT scan guide.

Types and stages

There are two main groups. Non-small cell lung cancer (NSCLC) is the most common and includes adenocarcinoma and squamous cell carcinoma. Small cell lung cancer (SCLC) grows faster and is strongly linked to smoking. Stage (1 to 4) tells how far it has spread. Stage and biomarker results together decide the plan. Read stage vs grade explained.

Treatment options

• Surgery — for early-stage NSCLC when the patient is fit enough. A part of the lung (lobe) is removed.
• Radiation therapy (sikai) — used after surgery, with chemotherapy, for patients who cannot have surgery, or to relieve pain and bleeding. See radiation therapy explained.
• Chemotherapy — often combined with radiation or immunotherapy. See chemotherapy and side effects.
• Targeted therapy — tablets for patients whose tumour has a mutation like EGFR or ALK. See targeted therapy.
• Immunotherapy — medicines that help the immune system attack cancer, used in selected patients. See immunotherapy.
• Palliative care — for breathlessness, pain and comfort at any stage, alongside treatment. See palliative care.

Ask the treating team for a written plan and cost estimate. Ayushman Bharat (PM-JAY) covers many lung cancer treatment packages at empanelled hospitals. See Ayushman card for cancer.

Questions to ask your doctor

• What type and stage is my lung cancer?
• Have biomarker tests (EGFR, ALK, PD-L1) been done? If not, why?
• What is the goal of treatment — to control it long-term, or to relieve symptoms?
• What side effects should I watch for, and whom do I call at night?
• Is this treatment covered under Ayushman card or my insurance?

Can lung cancer be prevented?

Stopping smoking at any age lowers risk. Free help is available on the National Tobacco Quitline 1800-11-2356. Improving kitchen ventilation or switching to LPG reduces indoor smoke. Long-time heavy smokers can ask a chest specialist whether a low-dose CT scan is right for them.

Frequently asked questions

Is lung cancer curable?

When found early and treated with surgery, many patients do well for many years. In advanced stages, treatment aims to control the disease and improve quality of life. Your oncologist can explain what is realistic for your stage.

Can a chest X-ray miss lung cancer?

Yes. Small tumours or those behind the heart can be missed. A CT scan is more sensitive if symptoms continue.

Lung cancer aur TB mein kya farak hai?

Both can cause cough, weight loss and blood in phlegm. TB is an infection confirmed by sputum tests; lung cancer is confirmed by biopsy. If TB tests are negative or treatment does not help, ask for a CT scan.

Do non-smokers get lung cancer?

Yes. Indoor smoke, pollution, second-hand smoke and gene changes can cause it in non-smokers.

What is EGFR testing?

It checks the tumour for a gene change. If present, tablets called targeted therapy may work well.

Related guides

• Persistent cough guide
• Getting a second opinion
• Treatment cost and written estimate

Sources

• National Cancer Institute (NCI): Non-Small Cell Lung Cancer Treatment (PDQ) — cancer.gov
• ICMR-NCDIR: Report of National Cancer Registry Programme 2020
• WHO: Lung cancer fact sheet
• National Tobacco Quitline Services, Ministry of Health & Family Welfare