Dr Harshil Alwani: Lung Cancer Risks for Non-Smokers. While smoking has long been considered the primary cause of lung cancer, doctors are now diagnosing the disease in non-smokers, particularly women and younger adults. Dr Harshil Alwani, a pulmonologist at Narayana Hospital, Jaipur, explains that if lung cancer in never-smokers were classified separately, it would rank among the top cancer killers globally.
According to Dr Harshil Alwani, lung cancers in non-smokers often have distinct genetic changes, such as EGFR mutations or ALK rearrangements, which differ from smoking-related cases. These mutations are not inherited but develop over time, and targeted therapies can be highly effective for these patients. Environmental factors, including long-term exposure to air pollution, especially PM2.5 particles, are strongly linked to these cancers, along with indoor pollutants, asbestos, and radon.
Symptoms of lung cancer in non-smokers can be subtle and often mimic other conditions. A persistent cough, unexplained fatigue, shoulder pain, recurrent pneumonia in the same lung area, or worsening shortness of breath may indicate the disease. Dr Harshil Alwani emphasizes that these symptoms are frequently misdiagnosed as allergies or infections.
Treatment has evolved significantly, with molecular testing now essential to identify patients eligible for targeted drugs or immunotherapy. The biggest challenge remains the misconception that never smoking means no risk. Delayed diagnosis is a major barrier to successful treatment. In conclusion, respiratory symptoms that persist or recur should always be thoroughly evaluated, regardless of smoking history.