Patient's Query
Hello doctor,
My father is 72 years old and has been smoking roughly 20 cigarettes a day since his late twenties. He also drinks about three to four glasses of whiskey every evening for as long as I can remember.
Recently, he had a routine checkup, and his chest X-ray showed a suspicious shadow in the upper right lobe, which the radiologist flagged for further investigation. They have scheduled a CT scan and bronchoscopy for next week.
His spirometry results indicated an FEV1 of 58 percent, which the pulmonologist said suggests moderate COPD. Additionally, his liver enzymes are elevated, with ALT at 87 and AST at 102. He has lost weight and has been coughing up mucus with slight blood streaks twice in the last month.
How does alcohol and smoking for 45 years increase cancer risk in a 72-year-old? I am trying to assess whether lung cancer is now a real possibility for him, and which combination of these habits has caused the most damage to his body.
He himself is very calm about the situation, which somehow makes it scarier for us children. What should we be preparing ourselves for?
Please guide me.
Hello,
Welcome to icliniq.com.
I have read your query and understand your concern.
I can understand how worrying this must feel for you and your family, especially when these findings come up unexpectedly. Given your father’s long history of smoking and regular alcohol intake, it is natural to think about the possibility of cancer, but at this stage, nothing is confirmed yet.
Smoking for several decades is the main factor that increases the risk of lung cancer. It causes repeated damage to the airway lining over many years, and those changes can eventually turn into cancer in some individuals.
Alcohol, on the other hand, affects the liver more directly, but when taken regularly along with smoking, it weakens the body’s overall repair mechanisms and increases the combined risk of cancers.
The symptoms you mentioned, like weight loss, cough with occasional blood streaking, and the shadow seen on X-ray, are the reasons further tests have been advised.
These can be seen in lung cancer, but they can also occur in infections, old scarring, or other smoking-related lung diseases. I have seen patients with similar histories where the final diagnosis turned out to be non-cancerous, so it is important to wait for the CT (computed tomography) scan and bronchoscopy before concluding.
His spirometry showing moderate COPD (chronic obstructive pulmonary disease) explains some of his breathing limitations and is consistent with his smoking history. The elevated liver enzymes are most likely related to alcohol use, though they may need separate evaluation if they remain high.
At this point, you do not need to prepare for the worst, but you should be mentally ready for a proper diagnosis once the tests are done. The next steps planned are appropriate and will give clarity.
If it does turn out to be cancer, treatment decisions depend on stage and overall fitness, and many patients at this age still receive meaningful treatment. If it is not cancer, then most other causes are manageable.
What you are feeling right now is completely understandable. Often, the patient remains calm while the family feels more anxious, and that is a very normal response.
Hope I have addressed all of your queries and concerns. Do follow up whenever needed.
Thank you.
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