Lung Cancer Treatment in India

Cancer happens when the cells in a part of the body grow abnormally faster and in an uncontrolled manner due to mutation in the DNA of the cells. Similarly cancer in the lungs happens when the cancer cells invade the lungs and destroy the healthy cells of the lungs thereby hindering the normal functions of the lung. Cancer in the lungs may take several years to develop.

At times, these cancer cells may spread to affect other parts of the body through metastasis. Lung cancer often goes unnoticed in the early stages as it hardly produces any symptoms. Advanced cancer may show symptoms like blood in the cough, persistent cough, chest pain, hoarseness in the voice, recurrent chest infection etc. There are two main types of lung cancer:

1. Small cell lung cancer (SCLC):

   Small cell lung cancer starts in the air tubes that advances to the bronchi and affects the lung tissue. It produces large tumors that can spread faster to other parts. This is usually seen in chronic and life time smokers. It has two subtypes:

   • Small cell carcinoma (oat cell carcinoma) is most common.
   • Combined cell carcinoma
2. Non-small cell lung cancer (NSCLC):

   Makes up 85% of all lung cancers which are slow-growing and larger and have the following types;

   • Squamous cell carcinoma
   • Adenocarcinoma
   • Large cell carcinoma

The staging of lung cancer is essential in order to know the extent of the spread of the disease and make the treatment plan accordingly. The lung cancer is thus staged as:

1. Localized: cancer is confined to the lungs
2. Regional: cancer has spread to lymph nodes in the chest
3. Distant: cancer has spread to other parts of the body.

Causes of Lung Cancer:

Following are the risk factors that are responsible for developing lung cancer.

• Age: It has been observed that lung cancer mostly affects older adults.
• Smoking: Tobacco smoking is the leading cause of lung cancer. Tobacco contains several chemicals like carbon monoxide that are carcinogenic in nature which immediately trigger changes in your lung tissue. The longer you smoke tobacco, more are the chances of getting lung cancer.
• Genetic inheritance: If any of your immediate family members have had lung cancer, then the risk is higher that you may acquire the disease.
• Exposure to carcinogens like asbestos, radon, arsenic, coal products, diesel exhaust, mustard gas, etc. is likely to trigger the development of lung cancer over a period.
• Past medical history of lung diseases like TB, COPD, chronic bronchitis, and emphysema.
• Exposure to ionizing radiation

Symptoms of Lung Cancer:

Lung cancer symptoms do not always appear until the disease has progressed. Some people, on the other hand, experience symptoms early on. These are some of them:

• Coughing that doesn’t seem to be getting better
• Hoarseness
• Blood in the phlegm or sputum
• Weakness
• Wheezing
• Infections that recur or don’t go away
• Coughing or laughing resulting in chest pain

Coughing, shortness of breath, chest pain, exhaustion, and/or unintended weight loss are all indicators of advanced lung cancer. Bone discomfort, headache, muscular weakness, and/or eyelid drooping are signs and symptoms indicating the cancer has spread to other parts of the body.

When is Lung Cancer Treatment Needed?

If you are suffering from any of the aforementioned symptoms mentioned above, you should see a doctor immediately who will advise you on various tests for the correct diagnosis. If you are diagnosed with lung cancer, the treatment should be started without any delay.

Lung Cancer Treatment Options in India

Treating lung cancer is very challenging. To regulate the survival rates, it is essential to know the stage of the disease. The treatment for lung cancer can either be curative in which the interventions are done to control the growth of the cancer, or it can be palliative, which aims to improve the quality of life by managing pain and associated symptoms.

1. Surgery:

   Surgery to treat lung cancer is considered the gold standard which is performed to excise the cancerous tumor and the surrounding lung tissue to cure the patients when the disease is particularly localized. Initially, only traditional open surgeries were performed for resection of the tumor. The recent advances in surgical procedures have made minimally invasive surgery the primary option for surgical resection of lung cancer. The following procedures are now being performed by the surgeons using VATS which is video-assisted thoracic surgery and robotic surgery as well.

   • Wedge resection or segmental resection: done to remove only the small part of the diseased lung.
   • Lobectomy: most commonly performed to remove the lobe of your lung if the cancer is extensive.
   • Pneumonectomy: to remove the entire lung if the cancer has invaded all the lobes.

2. These procedures are done using minimally invasive VATS technology that involves the insertion of a thin tube that is attached to the thoracoscope (camera) and the specialized small surgical instruments to carry out the required surgery. The thoracoscope provides images on the monitor using which the surgeon removes the tissue with more ease and precision.

3. Chemotherapy:

   It comprises specialized drugs that destroy the growing cancer cells. The drug may be injected intravenously or can be taken orally in the form of pills.

4. Radiation therapy:

   This uses high-powered energy beams like X-rays or protons to kill the cancerous cells. It can either be used as a sole treatment or can be combined with chemotherapy with or without the surgery. Following radiation therapy, most of the patients are relieved from the pain, obstruction in the airways, shortness of breath etc. It can be done using,

   • External radiation or
   • Brachytherapy (internal radiation)
5. Radiosurgery:

   The innovation in radiation therapy is radiosurgery, which is used in very limited patients where tumors are small but undergoing surgery may prove harmful. In such cases, surgery is done using radiosurgery, in which high doses of radiation are focused precisely on targeted cells in the lungs to kill the cancer cells without harming the nearby tissues.

How is Lung Cancer Surgery done?

Surgery is indicated in most cases of lung cancer. Depending on the size, location and extent of spread of the tumor, either wedge/ segmental resection, lobectomy or Pneumonectomy procedure is performed to excise the tumor and tissues surrounding it. These procedures are now being performed using the minimally invasive VATS approach.