When it comes to lung cancer, it is mostly associated with smoking or tobacco use. In fact, about 90% of lung cancer cases are attributed to smoking, according to the American Lung Association (ALA). But there is also a rare type of lung cancer that can affect non-smokers. This condition is called ALK-positive lung cancer, which occurs in approximately 5% of all lung cancer patients.
In an interaction with the OnlyMyHealth team, Dr Urvashi Prasad, Director, Office of Vice Chairman, Niti Ayog, and an ALK cancer survivor opened up about her battle with the disease, the treatments she received, and the kind of mental and emotional challenges she had to overcome throughout her cancer journey.
Understanding ALK-Positive Lung Cancer
ALK, or anaplastic lymphoma kinase, is a gene that is present in all of us. Its primary function is to create a protein that facilitates cell development and growth. However, in some people, for some unknown reason, it switches on and leads to this uncontrolled replication of cells, which we commonly understand as cancer, explained Dr Prasad.
"In simpler terms, it is known as non-smoking cancer. When you have cancer that originates from the lungs, there's a tendency to think that it is linked to smoking, but in this case, lung cancer happens pretty much exclusively in non-smokers," she added.
According to the doctor, women, particularly younger women, have a higher predisposition to this particular type of cancer. The demographic is much younger, and women of Southeast Asian descent are more susceptible, she said.
Data suggests that approximately 30% of lung cancer patients diagnosed under age 40 and about half of ALK-positive lung cancer patients are diagnosed before the age of 50.
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I Was Young, Did Not Smoke, And Had No Symptoms
Looking back at her own journey as an ALK survivor, Dr Prasad shared, "I was physically, completely fit. I had no symptoms, and obviously somebody so young and a non-smoker, you're never going to think of lung cancer; that's the last thing that you think of, and that's the last thing that doctors think of. None of the doctors came up with even the possibility that I could have something like this."
“It was only when I fell very sick last year; all my symptoms were actually liver-related because by then the cancer had already spread to the liver and various parts of the body. So in my case, it's what we call stage four, or metastatic cancer, which means that cancer has spread from its origin, which is the lung, to different organs in the body,” she added.
According to data shared by ALK POSITIVE, about 90% of those diagnosed with ALK-positive cancer find out about their condition when the cancer has already spread to other parts of the body. "Without any cancer treatment, half of patients with metastatic ALK cancer would die within less than 12 months," the charity added.
More Research Needed To Determine The Cause Of ALK Cancer
When asked about the cause of ALK-positive lung cancer, Dr Prasad said, “We really don't know the reasons why something like this gets triggered in someone, and so it could be anything from air pollution to any kind of mental trauma that you might be dealing with.”
According to her, there is a need for more research to be able to answer questions about its origin.
However, certain risk factors may increase the likelihood of the genetic alterations that lead to ALK-positive cancer, including:
- Exposure to certain environmental factors or toxins
- Younger individuals, particularly those who have never smoked or have a limited smoking history
- Non-smoking females
- Underlying genetic predispositions or factors that make certain individuals more susceptible
Cancer Treatments Are Widely-Varying
According to Dr Prasad, there are many different types of cancer treatments, ranging from surgery, radiation, and chemotherapy to targeted therapy.
The doctor herself is on targeted therapy, which involves taking oral tablets every day that specifically target the particular cancer that she has.
“Every individual, even with the same type of cancer, could be on different types of treatment,” she said.
Furthermore, Dr Prasad emphasises the need for more research to find a cure for ALK lung cancer.
She said, “It's rare today, but actually, even if you speak to doctors, and I've spoken to many, they say the numbers are going up. Also, another challenge is that the cancer often becomes resistant to a particular type of medication, which demands switching to other medications. We only have so many options available, which is why we need many more options in order to be able to prolong someone's lifespan.”
Overcoming Mental Challenges
Besides the physical toll the disease takes on the patient, it can also be difficult to cope with it mentally. But because there is so much focus on the physical impact of cancer, people tend to overlook the impact it has on one’s mental, psychological, and social well-being.
“For me, in the few months after my diagnosis, I was in a state of complete shock. I was unable to even understand what had hit me. I was in severe depression and, of course, anxiety and suicidal ideation—I had all of that because suddenly you're hit with this at such a young age—something completely out of the blue, completely unexpected. You know you're staring down at this prospect of your life that could be over at any time,” shared Dr Prasad.
Therefore, she highlights the importance of seeking help. “Let's not be ashamed to reach out for help and support, and if you're on the other side, dealing with somebody who has a condition like this, then you must just reach out to them, and even if all you can do is just listen to them, that's a great service,” she concluded.