MAGAZINE Voices Devdutt Pattanaik Ravi Shankar Utkarsh Amitabh Anu Aggarwal Luke Coutino Mata Amritanandamayi Buffet People Wellness Books Food Art & Culture Entertainment NEW DELHI november 9 2025 SUNDAY PAGES 12 Malevolent Marauder The cancer surge among millennials and Gen Z is a major health crisis nobody wants to talk about By Toufiq Rashid I t starts quietly—something tiny hidden, and harmless at first. A small , change deep inside the body begins to grow wild, breaking the rules of nature. It spreads without warning, taking over the spaces where life once moved freely By the time it shows itself, it’s already rooted deep, . stealing energy sleep, and peace of mind. Doctors chase it with scans and , medicines, but it’s clever—it hides, returns, fights back. When it finally takes hold, everything changes. The body feels like a stranger’s, and fear becomes a constant companion. Days are marked by hospital visits and test results, not by sunshine or laughter. Families hold on to hope, even when strength fades. It is a quiet terror, powerful and unfair—a reminder of how fragile life can be, and how much courage it takes just to keep going. At 31, Rohan should have been planning his next trek in Himachal, not learning how to pronounce adenocarcinoma. Fit, cheerful, and the office’s go-to for wellness advice, he brushed off months of stomach cramps as “bad biryani and too much stress.” When his doctor finally said “colon cancer,” he laughed in disbelief. “I don’t even smoke!” he said. The oncologist replied softly “You , don’t have to. The air you breathe, the water you drink, and your pace of life are enough.” That grim observation sums up a growing tragedy: cancer is creeping into the lives of India’s young, once thought immune to it. Oncologists across the country report a startling surge in cases among those aged 20 to 40. “When I began practising, a cancer patient in their 20s was an exception,” says Dr Pakhee Aggarwal, a gynaecological oncologist in Delhi. “Now, I meet one every week.” While poor diet, lack of exercise, and erratic lifestyles are often blamed, a darker culprit hides in plain sight—pollution. India’s cities consistently rank among the most polluted in the world, and doctors are seeing the fallout in their wards. “We are literally breathing carcinogens,” says Dr Rakesh Kumar Agarwal, a surgical oncologist in Mumbai. “The air is thick with PM2.5 particles that lodge deep into lungs, damaging DNA and inflaming cells. Over time, this chronic assault can trigger cancerous changes—even in those who’ve never smoked.” A 2023 study by the Indian Council of Medical Research (ICMR) linked long-term air pollution exposure to rising cases of lung, breast, and bladder cancers. Meanwhile, industrial pollutants—from pesticides in food to heavy metals in groundwater—compound the risk. “We are absorbing toxins in ways we don’t even realise,” says Dr Surender Dabas. “Plastic packaging leaches microplastics and endocrine disruptors into our food. These chemicals mimic hormones and interfere with cell function, especially in younger bodies.” The irony is cruel: the young, who should be healthiest, are also the most exposed. The urban elite who jog in smog-filled air, eat imported salads wrapped in plastic, and spend hours in front of glowing screens are breathing, eating, and living in slow-motion contamination. And then there’s stress—the silent accelerator. Modern India’s young professionals live on adrenaline, caffeine, and deadlines. The pressure to achieve—to In 2024, India is estimated to have about 15,62,099 new cancer cases and Women now account for 51.1% of new cases in 8,74,404 cancer deaths some registry analyses The crude incidence rates in 2024: 107.4 and 113.3 per about per 1,00,000 for males, nexus,” where environmental toxins and psychological strain act in tandem. Pollution inflames, stress weakens, and together they leave young immune systems too fatigued to fight. “It’s the modern double whammy says Dr Menon. “The air ,” outside and the pressure inside—both are killing us softly .” The Long Battle At 34, Chandrima had everything going for her. Newly married, she was running her father’s business with energy and ambition. Her days were packed with meetings, ideas, and plans for the future. She was health-conscious and aware— someone who had read enough about breast cancer to know the importance of self-examination. But awareness, she would soon realise, does not shield you from fate. “Even when I was getting my MRI done, I kept thinking nothing could be wrong,” she recalls quietly “I told myself this can’t happen to . me. I’m too young, too careful.” But when the results came, it hit her like a storm. “At first, I couldn’t process it. Cancer, to me, was something that happened to other people. Older people,” she says. Chandrima decided to face it—not with despair, but defiance. The surgery was difficult, but it was the chemotherapy that truly tested her spirit. “Chemo breaks you,” she says softly “You lose your hair, . your eyelashes, your brows. You look in the mirror and don’t recognise yourself. You stop wanting to meet people because you can see the pity in their eyes.” There were moments of darkness—days when the fatigue was overwhelming, when nausea made eating impossible, when every cell in her body ached. But the hardest part, she says, wasn’t physical. It was emotional. “You keep asking—why me?” As treatment progressed, something shifted inside her. “When I started volunteering at cancer hospitals, I saw stories far more painful than mine,” she says. “I met patients as young as 16 or 18 battling breast cancer. That changed everything for me.” Now cancer-free, Chandrima devotes a large part of her time to giving back. Alongside running her NGO for child education, she volunteers at AIIMS Delhi, speaking to patients and their families, offering comfort and courage. Doctors, too, have been sounding the alarm. Prof. Atul Batra, Associate Professor of Oncology at AIIMS and Chandrima’s treating doctor, confirms that her story is part of a much larger—and troubling—pattern. “We’re seeing more breast cancer cases in younger populations,” he explains. “Even people in their late teens and early 20s are being diagnosed. Among them, Between 1990 and 2023, incidence increased by 26% (from 84.8 per 1,00,000 to 107.2 per 1,00,000) and 1,00,000 for females mortality by 21% About 1 in 9 Indians may develop cancer in their lifetime Current new cases (1.4 million+ in recent years) could rise to 2 million or more by 2040 The most common types of cancer in 2024 For men Oral cavity 1,13,249 cases For Women Breast 2,38,085 cases Lung 74,763 cases Cervix 78,499 cases Prostate 49,998 cases Ovary 48,984 cases earn more, post more, outperform more—has turned daily life into a physiological experiment in burnout. “Chronic stress floods the body with cortisol and adrenaline,” explains psychiatrist Dr Anjali Menon. “These hormones were designed for short bursts of survival. But when they stay elevated, they suppress the immune system and disrupt DNA repair mechanisms. That’s the perfect storm for cancer cells to grow unchecked.” Priya, 28, a tech worker from Bengaluru, knows this intimately “My life was one long Zoom call,” . she says. “I’d sleep at 3 am, survive on coffee and instant noodles, and tell myself I was fine. Then I found a lump.” Diagnosed with lymphoma, she recalls her doctor telling her, “Stress didn’t cause your cancer alone—but it created the conditions for it to thrive.” Experts now speak of the “pollution-stress Some regions (especially North-East India) show higher incidence rates something called triple negative breast cancer is becoming increasingly common.” Traditionally cancer has been considered a , disease of age—a battle one fights in the later chapters of life. But in India, that notion no longer holds true. “In the West, breast cancer was typically seen in women in their 60s and 70s,” says Dr VK Bansal, Professor of Surgery at AIIMS. “In India, it’s been a decade earlier, around 50. But now Turn to page 2