Written by: Jyoti Pande Lavakare5 min readAug 2, 2026 07:00 AM IST First published on: Aug 2, 2026 at 07:00 AM ISTThERE ARE things they don’t tell you about lung cancer until your feisty mother is diagnosed with it, and they say it is terminal. They don’t tell you that lung cancer has no symptoms in the early stages, and that the lungs have few pain nerve endings, and tumors can grow large before causing any discomfort. They don’t tell you that even at an advanced stage, symptoms are mild — a persistent cough, hoarseness, wheezing, a little chest pain, and perhaps some breathlessness, which is what your mother complained about. Because she was a Hindustani classical vocalist, and the breathlessness was interfering with her riyaz, which was also her sadhana, her deeper, spiritual discipline.They don’t tell you that even if your mother never smoked a single cigarette in her life, bore four healthy children, ate clean, and was rarely sick, a single PET scan can quickly unravel that illusion of good health, show it for what it is — smoke and mirrors — and alter the trajectory of her life on her birthday. They don’t tell you that it was the polluted air she breathed for most of her adult life that triggered her disease. And when they do, they say it almost casually, like you should have known. Aren’t you the daughter who studies air pollution, simplifies and amplifies that research, and writes to bring awareness about the health harms air pollution triggers? All that information seems to have coalesced in your mother’s lungs. What sort of a cosmic joke is this?AdvertisementAugust 1 is World Lung Cancer Day. Here are some things they don’t tell you that you should know. It is preventable, but rising sharply. It was previously mostly linked to smoking, targeting older, male smokers; it now attacks more non-smoking women, and younger people. The WHO classifies outdoor air pollution and PM2.5 as Group 1 carcinogens, the same category as tobacco smoke. Delhi’s annual average PM2.5 in 2025 was nearly 20 times the WHO safe limit. Children, older people and pregnant women are the most vulnerable. Every newborn in India is a smoker from their first breath. Smoking kills. Breathing is the new smoking.But more than data, what they don’t tell you is what your family will go through. That, at first, everything will feel normal — until it doesn’t. They don’t tell you about the collective denial amongst your mother’s dearly beloved; the tears and fights that will lead to tests and retests, CT scans, MRIs, X-rays, molecular testing, genetic and biomarker testing. They don’t tell you about the many doors of doctors, pathologists, and technicians you will wait outside, the many labs you will visit to repeat biopsies and cytologies in the hope that one of them may cast doubt on the death sentence served to your mother. They don’t tell you about the rise and the fall of hope. They especially don’t tell you about the despair.Yes, things will still feel normal — until they draw pleural fluid from your mother’s lungs during the first biopsy. The thought of a needle in her lungs is scary, but the relief she feels immediately after makes it bearable. Even when it happens again, and again. You wish you hadn’t learnt that pleural effusion is the buildup of fluid in the narrow space between the outer lung lining and the chest wall, so the lung can’t expand fully. It feels like slow drowning, someone tells you, and you wish they hadn’t. After nearly two litres of pleural fluid are removed over three extractions, tested and retested, malignant cells are found, then a malignant mass, and dismay turns to despair — they don’t tell you how quickly. They don’t prepare you for the stunned disbelief in your mother’s eyes when she finds out, even when no one tells her. A death sentence on a birthday. Just days after Diwali, when you were happy and lit oil lamps and celebrated the Supreme Court banning firecrackers.AdvertisementThere was your life before your mother was diagnosed with terminal lung cancer — BC — and then, there was your life after she died — AD. These two were separated by just three months.you may likeIn the BC part of your life, you were part of a group that advocated for clean air, went to schools and hospitals to spread awareness that air pollution kills. But even though you knew so much about its health harms, you still didn’t know the difference between Non-Small Cell Lung Cancer (85% of cases), Small Cell Lung Cancer — its more aggressive twin — and metastatic adenocarcinoma. You had never heard of bronchoscopy, mediastinoscopy, thoracentesis, EGFR or ALK mutations. You didn’t know what a BiPAP was.Things they don’t tell you are that lung cancer, unlike other forms of painful cancers, doesn’t hurt. It just feels like you are suffocating, every breath constricted. It takes away first your agency, then your dignity before it takes away your breath and your life. Things they won’t tell you are that while other cancers have palliatives in the form of morphine, lung cancer has none. Because what can you give someone who is struggling to breathe?Lavakare is the author of ‘Breathing Here is Injurious to Your Health’