A lung cancer diagnosis can feel like losing control in an instant. But according to a leading doctor, what follows is less about uncertainty and more about a structured clinical pathway. Those first few days are the hardest, according to Dr Manish Singhal, director, Yashoda Hospital, Ghaziabad, and an oncologist with over two decades of clinical experience. Also read | Can you get lung cancer if you don’t smoke?
He said in an interview with HT Lifestyle: “A lung cancer diagnosis is one of the hardest pieces of news a person can receive. In the days that follow, patients and families often feel they have lost hold of what comes next. What actually follows is a structured process: a series of tests to confirm the diagnosis, stage the disease and build a treatment plan suited to the individual.”
Late diagnosis remains a key challenge in India
Dr Singhal shared that lung cancer is the most common cancer among Indian men. The National Cancer Registry Programme projects about 111,000 new cases nationwide in 2025, he added. A major hurdle is late detection. The disease often develops silently, and in India, nearly half of patients are diagnosed only after the cancer has spread beyond the lungs, limiting treatment options, he highlighted.
The profile of patients in India also differs from that in the West. Dr Singhal shared that while smoking — with nearly 100 million adult smokers — remains the biggest risk, up to 50 percent of cases occur in people who have never smoked. He linked this to air pollution, second-hand smoke, radon, occupational exposures and genetics. Dr Singhal further highlighted that the trend is especially marked in women and younger people, with the average age of diagnosis in India in the mid-50s — about a decade earlier than in Western countries.
Dr Singhal urged awareness of warning signs regardless of smoking history: “A persistent cough, unexplained weight loss, chest pain or coughing up blood should not be ignored. For those at higher risk, low-dose CT screening can detect disease early, when treatment is most effective.” Also read | Can the kitchen harm your lungs? Oncologist on how to reduce AQI at home
Precision medicine is changing treatment
Once confirmed, doctors determine whether it is non-small cell or small cell lung cancer, its stage, and the patient’s overall health. The biggest shift in the last decade, Dr Singhal said, has been understanding tumour biology: “Every lung cancer is biologically distinct. Biomarker testing looks for specific genetic alterations. The results can direct treatment.”
Mutations in genes such as EGFR, ALK and ROS1 are common in non-smokers and younger patients, Dr Singhal shared. Identifying them allows for targeted drugs rather than chemotherapy alone. “This is precision medicine: care shaped by the biology of an individual tumour,” Dr Singhal said. Treatment today often combines surgery, radiotherapy, targeted therapy, immunotherapy and supportive care, he added.
Beyond treatment: support and new technology
Survival and quality of life also depend on nutrition, exercise, symptom monitoring and counselling, Dr Singhal said: “Care does not end with the medical treatment itself.” Looking ahead, tools such as liquid biopsies, advanced molecular diagnostics and AI are helping doctors track tumours more precisely, he highlighted.
Globally, according to Dr Singhal, lung cancer remains the leading cause of cancer death, with about 2.5 million new cases and 1.8 million deaths recorded in 2022. He concluded: “A diagnosis is still difficult. But a patient who understands the type and stage, asks about biomarker testing and stays in close contact with their team is better placed to weigh options. Those conversations are where most important decisions get made.”
Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
