LUNG CANCER
Out of all types of cancers, cancer of the lungs causes highest number of deaths. Approximately 2.2 million people are affected with this disorder world-wide per year, resulting 1.8 million deaths every year. Lung cancer triggers more deaths annually than cancers of colon, breast and prostate combined.
The main risk factors for lung cancer include long-term exposure to tobacco smoke, air pollution and certain occupational hazards such as asbestos, arsenic and chromium. Family history of cancers and prior radiation therapy to chest wall are added risks. Eighty percent of lung cancers are associated with smoking tobacco. Smokers are at risk to get a lung cancer 15-20 times higher than nonsmokers. The good news is that deaths from lung cancers have decreased during the past few years because of reduced tobacco smoking, better screening tests and more effective treatment protocols.
Common symptoms may include persistent cough, chest pain, shortness of breath, blood in the sputum or haemoptysis, hoarseness of voice, palpable lymph nodes in the neck, repeated upper respiratory infections, recurrent bronchitis and unexplained weight loss. People tend to ignore the symptoms as smoker’s cough, flu or bronchitis until late. Diagnosis is verified by a chest X-ray followed by CT scan of the chest.
Heavy smokers are urged to have screening tests for early detection of lung cancers, with hope for better treatment. Current recommendation is to do low dose CT scan (LDCT) once a year for those individuals who are between 50 and 80 years old, who have 20 pack years of smoking history or are currently smoking or who quit smoking within the last 15 years. If any abnormalities are noted in the LDCT, extra tests are conducted such as regular CT scan, bronchoscopy, CT guided biopsy or surgery. A package of smoking means one pack cigarette per day for one year. Many individuals fall outside of these age limits for screening and there is a strong suggestion that insurance companies should allow screening from age 40 onward.
There are two types of lung cancers: non-small cell lung cancer (NSCLC), which is the most common, and small cell lung cancer (SCLC), which tends to grow and spread faster. Among the non-small cell cancers, they can be adenocarcinoma, squamous cell carcinoma or large cell carcinoma. Medicine and prognosis varies.
Treatment of lung cancer depends on the type of cancer, staging, patient fitness and molecular biology of the disease. Much progress has been made in the last decade alone. Various options include surgery, radiation therapy, chemotherapy, immunotherapy and targeted therapy. Each patient is treated individualised by a multidisciplinary team. Biopsy confirmation and staging procedures are done in this effort. This step may involve several other tests and procedures.
Surgery is the first choice for early non-small cell cancers with hope of cure. This may involve lobectomy or pneumonectomy. Surgery is more often being conducted by minimally invasive measures (VATS) and with robotic assistance.
Chemotherapy is used as adjuvant to surgery before or after surgery. Radiation therapy is an option for more advanced cancers as a palliation. A new development that is making impact is precision-targeted therapy based on tumour genetic testing for specific mutations. Several new drugs have been introduced and appear to show promise. Another fresh development is immunotherapy where the immune system is used to attack the cancer cells. Here also several new drugs have been introduced. Small cell lung cancers do not require surgery. They are treated with chemotherapy and immunotherapy. At times, radiotherapy is supplemented.
Efforts must be made to prevent lung cancer as far as possible. First priority is to stop smoking any type of tobacco. Second-hand smoking is also a risk factor. Living in a nonpolluted neighbourhood is important. Toxic fumes, smog, motor vehicle emissions, industrial wastes, radon exposure and climate changes are other risk factors. Breathing fresh air from natural surroundings is healthy. Occupational hazards from mining, asbestos handling and working with toxic materials or radiation emitters must be kept in mind. Society must take responsibilities in reducing atmospheric pollution.
Survival from lung cancer has improved during the last 30 years. This has to do with early detection and advancements in treatment protocols. Currently, if lung cancer is diagnosed in its early stage and treated appropriately, a five-year survival of 60-80 percent can be expected. But the fact remains that lung cancer is still the No. 1 cause of death among all cancers.
EYE CARE
May your Eyes be at their BesT
The month of May has a way of waking everything up. The light feels different. Colors look richer. The days stretch just enough for you to say, “let me just sit outside a little longer,” and suddenly it’s dark and your phone battery is at 2 percent.
And in all of this, we forget something simple — vision isn’t just about seeing well enough, it’s about enjoying what you see.
We clean out closets in spring. We service our cars. Some of us even promise to go to the gym (at least for the first week of May). But our eyes? We just expect them to show up and perform, no questions asked.
Maybe this month is a good time to change that.
May means outdoors. Golf courses, beaches, gardening, long drives, or just pretending to walk while actually checking emails on your phone. With all that sunshine comes UV exposure. Now, your eyes don’t complain loudly about it, they’re polite that way. But over time, UV light quietly contributes to aging changes inside the eye.
So yes, your sunglasses are not just a fashion accessory (even though they absolutely can be). They’re sunscreen for your eyes. And if you’re wondering — no, squinting is not a long-term solution. That’s just your eyes saying, “we need help here.”
Polarized lenses? Even better. Especially around water or while driving — less glare, more comfort, fewer “why is everything so shiny?” moments.
While we’re outside more, let’s be honest, we’re also still glued to screens. Phones don’t take summer vacations. If your eyes feel dry, heavy or just “tired for no reason,” it’s not your imagination.
Here’s a simple trick that actually works (and no, it’s not a gimmick): every 20 minutes, look 20 feet away for 20 seconds. It sounds almost too simple. That’s why most people don’t do it. Think of it like stretching during a long flight. Your eyes need that break just as much.
And then come allergies. May is when pollen shows up like an uninvited guest … and refuses to leave. Itchy eyes, watering, redness — you know the routine. And what do we all instinctively do? Rub our eyes like we’re trying to start a fire. That only makes things worse.
A better approach is surprisingly simple, use lubricating drops, keep windows closed when pollen is high, and wear sunglasses outdoors. Yes, again. They’re doing double duty here. And if it just won’t settle down, it may not be “just allergies.” Sometimes dryness or surface irritation hides behind that same discomfort.
One of the most common things people say is, “I can manage.”
You can manage blurry vision. You can manage glare at night. You can manage constantly adjusting your glasses.
But the question is, why should you have to?
If lights are streaking, halos are bothering you, or you’re working harder to focus than you used to, your eyes are not being dramatic. They’re being honest.
And here’s the good news, eye care today is not what it used to be. Many things that once meant “just live with it” now have thoughtful, customized ways to improve them. Not one-size-fits-all. Not rushed. Just designed around the individual.
There’s a quiet shift happening. People are no longer satisfied with “good enough vision.” They want clarity. Comfort. Ease. Not because they’re picky but because once you experience better vision, you realize what you were missing.
Now, this doesn’t mean everyone needs something drastic. Sometimes it’s as simple as updating your glasses, treating dryness, or fine-tuning how your eyes work together. And sometimes, yes, it means exploring more advanced options like next-generation Lasik and custom cataract surgery. The key is not to assume. The key is to find out.
In the meantime, a few small habits go a long way. Drink water, your eyes like hydration more than your coffee does. Eat color, greens, oranges, reds, if it looks like a rainbow, your eyes approve. Blink more often, sounds funny, but most of us forget, especially on screens. Wear protection when needed. And every now and then, check in on your eyes — not because something is wrong, but to keep it that way.
At the end of the day, vision is not just medical. It’s emotional.
It’s how you watch your child from across the field, how you read a message from someone you love, how you notice the ocean, the green on a golf course, or the expression on someone’s face.
And sometimes, we don’t realize what we’re missing, until we see it clearly again.
As May unfolds, with all its light, color, and energy, it’s a good moment to pause and ask: am I just seeing, or am I truly experiencing what I see?
Because clear vision isn’t just about eyesight.
Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at [email protected] or visit www.gulanivision.com