Association of pulmonary tuberculosis with lung carcinoma: An epidemiological study

Introduction: Tuberculosis (TB) is a serious public health problem in developing countries, with India bearing highest burden. Lung cancer (LC), especially adenocarcinoma, is also increasing all over the world, with India having highest mortality in males due to lung cancer. Both diseases do co-exists producing diagnostic dilemma and treatment controversies. We intended to explore the incidence of both diseases at a tertiary cancer centre. Materials and Methods: This longitudinal study was conducted between 2014 to 2017. Diagnosis and treatment of TB were according to DOTS protocol. For lung cancer biopsy was mandatory for diagnosis. Results: Our study was conducted on 42 patients at the Department of Radiotherapy, R.G. Kar Medical College. In 19 of the 42 patients, the diagnosis of TB and LC occurred simultaneously, whereas, in 23, the occurrence was sequential. Fifteen (35.7%) patients reported having had TB twice. TB treatment was given as Category 1 of DOTS in 21 patients (50%) and Category 2 in 15 (35.7%). In 6 (14.3%) patients, the data on treatment regimen were either not provided or unavailable. Regarding carcinoma lung management, 50% of patients were purely treated as palliative intent. Twenty percent of patients received chemotherapy with platinum doublet. Thirty percent of patients were given best supportive care. Conclusion: The symptoms of TB and lung carcinoma overlap with each other. If we get any patient with lung cancer not much improving after anticancer treatment, diagnosis of TB should be kept in mind. Similarly, in any diagnosed case of pulmonary TB, development of lung cancer should be considered if not improved with anti-tubercular treatment.