Sharmila Tagore diagnosed with zero-stage lung cancer: What it means

Sharmila Tagore's cancer was diagnosed in 2023 and removed surgically without chemotherapy, says daughter Soha Ali Khan

Veteran actress Sharmila Tagore was diagnosed with zero-stage lung cancer in 2023, a fact she kept private until recently. Her daughter, Soha Ali Khan, shared in a recent interview that the cancer was detected at an extremely early stage, allowing for successful surgical removal without the need for chemotherapy. This early detection meant the cancerous cells were confined to the top layers of the lung tissue and had not spread deeper or to other areas, significantly increasing the chances of a full recovery.

 

In a conversation with internet personality Nayandeep Rakshit, Khan revealed that the lung cancer diagnosis had been an exceptionally rare case of early detection.

 

“With my mother, she was one of the very few people to be diagnosed with lung cancer at stage zero, and no chemotherapy, nothing. It was cut out of her and she is, touchwood, fine,” she said. 

 

What is zero-stage or stage 0 lung cancer?

Zero-stage cancer, also known as carcinoma in situ, is the earliest form of lung cancer. “It means that abnormal cells are present in the innermost lining of the lung or bronchus but have not spread to surrounding tissues or organs. It is often asymptomatic, making early detection uncommon. At this stage, the disease is highly treatable and often curable with timely medical intervention. This stage is sometimes referred to as ‘pre-cancer’, though the cells have the potential to become invasive if left untreated,” explains Dr Mayank Singh, Associate Professor of Medical Oncology at Aiims, Delhi, in a telephonic conversation with Business Standard. For example, zero-stage lung cancer refers to a condition where cancer cells are found only in the top layer of cells lining the lung airways. In Tagore’s case, the timely diagnosis allowed for a straightforward surgical intervention, and she has since resumed her normal life without further treatment. 

Common types of zero-stage cancer

• DCIS (Ductal Carcinoma in Situ) – breast cancer stage 0
• CIN 3 (Cervical Intraepithelial Neoplasia) – cervical cancer stage 0
• Bowen’s Disease – skin cancer in situ
• Bladder carcinoma in situ
• Colorectal adenomas – precursors to colorectal cancer

Causes of zero-stage cancer

According to Cleveland Clinic and the National Breast Cancer Foundation, like other stages of cancer, stage 0 is primarily caused by genetic mutations in cells that lead to uncontrolled growth. These mutations can be triggered by various factors:

 

Genetic predisposition

• Inherited gene mutations (like BRCA1/BRCA2 in breast cancer)
• Family history of cancer can increase the likelihood of early changes

Environmental and lifestyle factors

• Tobacco smoke: Linked to early cellular changes in lung, throat, and bladder cancers
• Alcohol: Can damage cells and lead to DNA changes
• Radiation exposure: UV rays (in skin cancer), X-rays, etc.
• Chemical exposure: Asbestos, benzene, certain dyes, etc.

Infections

• HPV (Human Papillomavirus): Strongly linked to cervical cancer (including stage 0, or CIN 3)
• Hepatitis B and C: Associated with liver cancer
• H. pylori: Can lead to early stomach cancer changes

Hormonal factors

 

Oestrogen and progesterone imbalances can promote abnormal cell growth in the breast or uterus.

 

Diet and obesity

 

High-fat diets, processed foods, and obesity are linked to inflammation and increased cancer risk. 

How is zero-stage cancer detected?

According to Dr Singh, zero-stage cancer is typically detected incidentally during medical evaluations for unrelated health concerns, routine scans, or pre-surgical evaluations, since it often causes no symptoms. It may also be detected when people with BRCA (BReast CAncer) gene mutation or cancer history in the family get their examination done. Its detection depends heavily on advanced imaging techniques and non-invasive tests. Ways in which zero-stage cancer can be detected include:

Incidental findings on imaging

 

Many cases of stage 0 lung cancer are found accidentally when a person undergoes a CT scan or chest X-ray for another condition (like pneumonia or injury). According to Cleveland Clinic, an American non-profit academic medical centre based in Cleveland, Ohio, early lung cancers are often found on scans done for other reasons.

 

Biopsy

 

If an abnormal area is found, biopsy may be used to collect tissue samples and analyse.

 

Low-dose computed tomography

 

The most common method to detect early-stage lung cancer (including stage 0) is LDCT, particularly in high-risk groups such as long-term smokers or those exposed to harmful environmental substances. LDCT scans the lungs in thin layers to detect tiny nodules or abnormalities before symptoms appear. People aged 50–80 with a 20+ pack-year smoking history, current smokers, or those who quit within the past 15 years, according to the American Cancer Society.

How are zero-stage cancers treated?

Treatment for stage 0 cancers typically focuses on complete removal of abnormal cells and ensuring the cancer does not progress. Options vary by cancer type but may include:

 

• Surgical resection: Removal of the lesion or affected tissue. In lung cancer, this may involve wedge resection or segmentectomy.
• Local ablative therapy: Includes photodynamic therapy, laser therapy, or cryotherapy.
• Surveillance: In selected low-risk cases, doctors may recommend active monitoring instead of immediate treatment.

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