Lung Cancer Awareness Month 2025: Asthma Or Something More Serious? Doctor Decodes The Warning Signs

It often begins with something ordinary. A nagging cough. Shortness of breath that gets blamed on winter chill or Smog. A wheeze that refuses to go away. For many Indians, these signs sound familiar and the first thought is almost always asthma or more likely to be Tuberculosis. Yet, doctors like us today are seeing a worrying trend where early lung cancer hides behind these minor symptoms. According to the Global Asthma Report 2022 by the Global Asthma Network, nearly 35 million people in India suffer from asthma, while 4,50,000 lives are lost globally every year to the disease.

Asthma has long been one of the leading causes of illness and death in rural India and is expected to rise sharply in the coming decades. Once thought of as a winter-triggered condition, it now troubles patients throughout the year. Today, this is most likely to be driven by worsening air quality and urban pollution.

We see many patients who come with wheezing and breathlessness, but when their symptoms don't improve with regular treatment, it often leads us to discover something more serious. Here, the challenge lies in knowing when not to assume that it's just asthma.

When Lung Cancer Hides Behind Familiar Symptoms

Lung cancer in its early stages often imitates asthma or tuberculosis. Patients experience chronic cough, wheezing and fatigue, which appear no different from common respiratory complaints. Because asthma is far more widespread, doctors tend to begin with standard asthma medication. When patients fail to respond or when their symptoms get worse, further testing becomes much more essential.

Asthma, being an inflammatory disease of the airways, usually shows improvement once inhalers or steroids are prescribed. In contrast, lung cancer persists and progresses silently. This difference in response often helps doctors identify when something is not adding up.

Why Misdiagnosis Happens

In India, the prevalence of asthma and tuberculosis adds to the confusion. Pollution further complicates the picture, as chronic cough and breathlessness have become everyday complaints. Many patients living in polluted cities assume their symptoms are normal or stress-related. By the time they come for a scan, the cancer has often advanced.

Misdiagnosis also leads to unnecessary treatments. Some patients labelled as severe asthma cases are prescribed biologic drugs, which are costly and ineffective against undiagnosed cancer. This not only delays the right intervention but also increases emotional and financial strain.

Red Flags That Demand Attention

Doctors advise patients and families to stay alert to warning signs that distinguish lung cancer from asthma. Persistent cough that worsens with time, chest pain localized to one side, blood in sputum, unexplained weight loss and hoarseness or difficulty swallowing should never be ignored.

Investigations such as chest X-rays or CT scans can reveal suspicious growths. Bronchoscopy allows doctors to view the airways directly, while a biopsy confirms the cancer diagnosis. The key lies in timely escalation and not treating every cough as asthma.

Awareness Can Save Lives

Asthma and lung cancer share the same stage of symptoms but tell two very different stories. What feels like another episode of wheezing might be the body's alarm for a deeper threat. For doctors, the message is clear: trust patterns but verify exceptions. For patients, it's to seek clarity early.

In a country where pollution and respiratory illnesses have become part of daily life, vigilance is no longer optional. Sometimes, what seems like asthma could be the warning sign of something far more dangerous and catching it early can change everything.

(By Dr Karn Mehra, Consultant Pulmonology, Fortis Manesar)

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