Evolving trends in lung cancerEpidemiology, diagnosis, and management.

Lung cancer is one of the leading causes of cancer-related death globally. Among all the cancers, the number of patients afflicted with lung cancer is the highest, and the number is constantly rising.[¹] This international trend of lung cancer is paralleled in India.[²] Lung cancers represent a group of heterogeneous entities both in terms of histology and molecular profile.[³] Histologically, they are categorized into two types: non–small cell lung carcinoma (NSCLC, 85% of all lung cancers) and small cell lung carcinoma (SCLC, 15% of all lung cancers).[³] NSCLCs are typically subdivided into adenocarcinoma, squamous cell carcinoma (SqCC), and large-cell carcinoma.[³] Both NSCLC and SCLC have very low survival rates.[¹] Despite recent technological advances in the diagnosis, medical, and surgical treatments, the outcomes remain poor.[⁴]

The newer molecular diagnostic modalities have made it easier to detect cancer-related driver alterations, such as epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK).[⁵⁶] Furthermore, accurate staging of cancer is important to plan the treatment for the patients. Recently, an individualized treatment approach, including targeted therapies for driver mutations and immunotherapies, is being used for the patients.[⁶] However, a comprehensive data on lung cancer in India are lacking.[⁴]

Role of HPV in the landscape of oral cancer in India.

Oncological sciences have seen a remarkable evolution in the last few years. The last decade or so has seen rapid advancements in technology, leading to a better understanding of cancer biology and the development of newer therapeutics. One of the areas to benefit has been our comprehension of the role of human papillomavirus (HPV) in the development of head and neck cancers. While the association between HPV and cervical cancer is well established, its role in the development of oropharyngeal cancers is becoming increasingly recognized. In India, the consumption of tobacco is high, and as such, it still remains one of the leading causes of head and neck cancers in the country. The relevance of HPV infection in causing head and neck cancers needs further evaluation in the Indian context.

Five Most Common Cancers in J and K.

Breast Cancer

(18.59 percent)

Breast cancer remains the most common malignancy among Kashmiri women.

Late detection, stigma, and limited access to screening in rural areas exacerbate outcomes.

Early Signs include lumps, nipple discharge, skin dimpling, or persistent pain.

Prevention and Detection 

Monthly self-exams and clinical breast exams after age 30.

Mammograms are recommended annually after 40.

Lifestyle changes, reduce obesity, limit alcohol, and promote breastfeeding.

⬤ Stomach Cancer

(8.63 percent)

High rates of stomach cancer are tied to diets rich in salted, smoked foods, pickled, and dried foods, plus H. Pylori bacterial infections.

Early Signs include indigestion, abdominal pain, and unintended weight loss.

Prevention and Detection

Reduced intake of processed, salty, and smoked foods.

Screen for H. pylori and treat infections promptly.

Endoscopy for high-risk individuals (family history, chronic gastritis).

⬤ Ovarian Cancer

(8.09 percent)

Ovarian cancer often goes undetected until advanced stages due to vague symptoms like bloating or urinary urgency.

Early signs include persistent pelvic pain, appetite loss, and fatigue. 

Prevention and Detection

Regular pelvic exams and transvaginal ultrasounds for high-risk women.

Genetic testing for BRCA mutations (linked to breast and ovarian cancers).

Oral contraceptives may reduce risk.

⬤ Esophageal Cancer

(7.55 percent)

Kashmir’s fondness for noon chai (salted tea) and hot beverages may contribute to esophageal irritation.

Early signs include difficulty swallowing, chronic cough, and hoarseness.

Prevention and Detection

Avoid polluted air, including indoor pollutants, and excessively hot drinks.

Endoscopy for those with persistent acid reflux or Barrett’s oesophagus. 

⬤ Colon Cancer

(7.01 percent)

Rising colon cancer cases are linked to low-fiber diets, processed meats, and sedentary habits. 

Early signs include blood in stool, irregular bowel movements, and anaemia. 

Prevention and Detection

Colonoscopy screenings from age 45–50.

Increase fibre intake (fresh fruits, vegetables) and reduce red meat consumption.

Cancer specialists have often spoken about the late-stage diagnoses overwhelming public facilities and called for grassroots awareness and infrastructure.

“Women in Kashmir need to prioritise regular check-ups and advocate for their health,” they say.

Online Medical Consultation

Online medical consultations offer several benefits, including: 1. Convenience & Accessibility Consult doctors from anywhere, reducing travel time and costs. Ideal for people in remote areas with limited healthcare facilities. Available 24/7 in many cases, offering flexibility for busy schedules. 2. Cost-Effective Lower consultation fees compared to in-person visits. Reduces expenses on transportation and time off work. 3. Reduced Waiting Time Faster appointments with immediate or same-day consultations. Avoid long queues in hospitals or clinics. 4. Privacy & Comfort Consultations can be done from home, ensuring confidentiality. Beneficial for discussing sensitive health issues. 5. Access to a Wider Range of Specialists Connect with top doctors and specialists across different locations. Second opinions are easily accessible. 6. Digital Prescription & Medical Records Prescriptions are sent electronically for easy access. Medical history is maintained online for better follow-ups. 7. Ideal for Follow-Ups & Chronic Disease Management Regular monitoring for conditions like diabetes, hypertension, and mental health. Reduces unnecessary hospital visits. 8. Infection Control & Safety Minimizes exposure to contagious diseases, especially during pandemics. Safer for elderly and immunocompromised patients.

Rethinking metastatic brain cancer as a CNS disease.

Rethinking metastatic brain cancer as a CNS disease.

Advances in molecular biology, genetics, and epigenetics have refined our understanding of metastatic brain cancer and underscored the need for better classification and targeted approaches. The heterogeneity of brain metastases highlights the differences from their primary source of origin and contributes to therapeutic resistance. Before colonising the brain, tumour cells acquire specialised proficiencies that enable them to capitalise on the unique microenvironment of the brain. The tumour cells further orchestrate key adaptations to adjust to the brain microenvironment by manipulating the blood–brain barrier, evading immune surveillance, rewiring metabolic profiles, and reprogramming astrocytes. These adaptations facilitate tumour survival, growth, and treatment resistance. Recognising metastatic brain cancer as a distinctive CNS disease, rather than an extension of the primary cancer, would support the development of rational approaches that target its molecular and genetic features and improve research funding in this area. Here, we delve into the distinct genetic and phenotypic characteristics of metastatic brain cancer, and reflect on how a change in the perception of this disease could accelerate the development of more effective therapies and drive continued progress in the field of neuro-oncology.

Hematology and climate change....

more difficult to quantify, but with an increasingly ageing population, even a small increased risk would be worth mitigating because of its burden on human health.

Climate change is intensifying the spread and impact of neglected tropical diseases (NTDs) through multiple interconnected pathways. The recent UN Climate Change Conference (COP29), which took place in Baku, Azerbaijan on Nov 11–22, served as an opportunity to highlight these connections and call for integrated strategies to address both the root causes and immediate health impacts of NTDs in the context of climate change. However, the absence of a dedicated focus on NTDs remains a critical gap that must be addressed moving forward. A US$300 billion a year climate finance deal was struck at the conference, which will hopefully contribute to leveraging climate finance for health outcomes.

With only 25 years to go until we reach the 2050 Conference of the Parties goal of net-zero emissions, there is much work to be done to achieve this goal. Beyond the environmental impact on haematological diseases, there is also the environmental impact of haematology care. Work can be done to reduce the single-use plastics used in routine pathology testing. Life cycle assessments can be used to quantify the greenhouse gas emissions of various haematological procedures, such as blood transfusions. There will be many benefits to human health from policies that can mitigate the effects of climate change and reduce carbon emissions, and those of us in the field of haematology must do our part to contribute. Adapting health systems to address climate change is critical and necessary, and health-centred responses will be needed to secure a future in which world populations can thrive

Why Cancer Awareness important.

Cancer awareness plays a significant role in improving cancer prognosis by promoting early detection, timely treatment, and better disease management. Here are some key ways in which cancer awareness impacts prognosis:

1. Early Detection & Diagnosis

Awareness campaigns encourage regular screenings (e.g., mammograms, Pap smears, colonoscopies), leading to early-stage diagnosis.

Early-stage cancers are more treatable and have higher survival rates (e.g., breast cancer survival is >90% when detected early).

2. Prompt Medical Attention

Awareness helps individuals recognize symptoms (e.g., lumps, unusual bleeding, persistent cough) and seek medical care sooner.

Delayed diagnosis often results in advanced-stage cancer, reducing survival rates.

3. Improved Treatment Outcomes

Early diagnosis allows for less aggressive and more effective treatments.

Awareness leads to better adherence to treatment protocols, improving chances of remission and survival.

4. Prevention & Risk Reduction

Awareness about lifestyle factors (e.g., smoking, alcohol, diet, exercise) helps reduce cancer risk.

Vaccinations (e.g., HPV vaccine for cervical cancer) and preventive measures (e.g., sun protection for skin cancer) are more widely adopted.

5. Psychological & Social Benefits

Awareness reduces stigma, leading to better mental health support for patients.

It encourages participation in support groups and clinical trials, offering better treatment options.

Evidence-Based Impact

A study in The Lancet Oncology found that cancer survival rates improved significantly in countries with widespread awareness and screening programs.

WHO reports show that cervical cancer mortality drops by 50% in populations with strong HPV vaccination and screening programs.

Conclusion

Cancer awareness directly improves prognosis by facilitating early diagnosis, increasing treatment effectiveness, and encouraging preventive measures. Public health initiatives should continue promoting cancer education to enhance survival rates globally.