Lung cancer treatment India

 Lung Cancer Treatment in India Some facts about Lung Cancer

  • Cancer that affect the lungs is the lungs cancer. It is most common type of cancer and is rated as number one cause of deaths in both men and women throughout the world.
  • Cigarette smokers have much higher chance of developing lung cancer. However passive exposure to tobacco smoke can lead to lung cancer
  • Mostly there are two types of lung cancer, small cell lung cancers (SCLC) and non-small cell lung cancers (NSCLC).
  • The extent to which the cancer has spread in the body determines the stage of the cancer.
  • Treatment Includes: a combination of surgery, chemotherapy, and radiation therapy along with newly invented experimental methods.
  • As the disease is mostly diagnosed at an advanced stage so the general prognosis of lung cancer is poor. 40%- 50% of victim can survive for five years if they are at the early stage of cancer, but only 1%-5% can survive for five years if they are in advanced or inoperable stage of lung cancer.
  • The most important measure to prevent lung cancer is smoking cessation.

What is Lung Cancer?

The basic units of the body, the cells, grows normally, divides, and dies. But when the cell undergo a mutation that causes them to grow rapidly and uncontrollably cancer occurs. Normally, the body maintains a system to check and balances on cell growth, so that only when new cells are needed, division of cells occurs to produce new cells. disturbance in this system results in an uncontrolled division of cells that eventually forms a mass called tumor.

Tumors can be benign or malignant. Usually benign tumors can be removed and don't spread to other parts of the body. We mean malignant tumor when we speak of cancer. Malignant tumors grows vigorously and invade or affect other tissues of the body. From the original tumor cancer cells can break away and enter through the bloodstream, forming tumor in other parts of the body. This process is known as metastasis.

Lung Cancer can spread to any part of the body, but most common sites for lung cancer metastasis are particularly the adrenal glands, liver, brain, and bones.

Lung cancer can occur at any part of the lungs, but 90% to 95% of cancers of the lung mostly arise from the epithelial cells. These are the cells lining the larger and smaller airways known as bronchi and bronchioles. Because of this cancer is also sometimes termed as bronchogenic cancers or bronchogenic carcinomas. Another term of cancer is carcinoma.

What are symptoms of lung cancer?

Lung cancer might not cause chest pain or even any of the symptoms as stated in some cases. In 25% of lungs cancer victims, it may be first discovered on a routine chest X-ray or CT scan as a solitary small mass known as coin lesion ( as the round tumor looks like a coin). These patient mostly report no symptoms at the time the cancer is discovered.

However common symptoms of lung cancer are

  • A cough that doesn't go away and increases over time
  • Chest pain
  • Blood in cough
  • Shortness of breath, wheezing, or hoarseness
  • Problems with pneumonia or bronchitis is continuous
  • Swelling in the neck and face
  • Sometimes blurred vision if the cancer cells spreads to the brain
  • Weakness, loss of appetite or weight loss
  • Fatigue
  • Psychological symptoms which includes depression and mood changes
What are the causes of lung cancer?

Smoking

Smoking tobacco in the form of cigarettes, cigars, and pipes is strongly correlated with the lung cancer. Tobacco use, is responsible for 90% of the lung cancer. Smoking cigarettes is more dangerous than cigars and pipes. A cigarette smoker has a risk of developing lung cancer 25 times more than a non-smoker, while a pipe or cigar smoker have a risk of lung cancer 5 times more than a non-smoker. The number of cigarettes smoked and the time over which smoking has occurred, directly increases the risk of lung cancer.

Tobacco and tobacco smoke contain 4,000 chemicals compounds. These compounds mainly includes nitrogen oxide and carbon monoxide and are responsible for cancer-causing or carcinogenic. An immediate change in the lung tissues is triggered by inhaling the chemicals in a cigarette. Initially our body is able to repair the damage, but as exposure continues it ability to do so decreases. However the risk of developing lung cancer decreases every year followed by smoking cessation, because the normal cells in the lung grow and replace damaged cells.

Second-hand smoke or Passive smoking

Non-smoker are exposed to cigarette smoke regularly everywhere in our daily life like at home or work, or in restaurants and bars, this increases the risk of lung cancer by 20% to 30%.

Genetics

According to the recent research if a member of our immediate family like mother, father, sibling, aunt, uncle, or grandparent has or had lung cancer, then this slightly increases our risk of developing the disease, even being a non-smoker. However, more researches are going on this genetic cause of lung cancer and is not still not clear.

Age

As older the person becomes, more the person is exposed to harmful chemicals, therefore this increases the risk of cancer. Usually lung cancer occurs in people aged 50 or older.

Diet

Some research have stated that beta carotene supplements can increase the risk of lung cancer in smokers. If a person does not take a proper mix of healthy foods like fruits and vegetables, then that person have a higher risk for lung cancer, especially if the person is a smoker.

Past Lung Disease

Past lung diseases like tuberculosis, recurring bronchitis, emphysema, and chronic obstructive pulmonary disease (COPD), can lead to inflammation and scarring in the lungs. A person may have a higher risk of developing lung cancer if he has a history of chronic diseases that affect the lungs.

Radiation Therapy

Radiation therapy treatment used to treat other cancers, like Non-Hodgkin’s lymphoma and breast cancer, can make the risk of lung cancer higher in a person, especially if he is a smoker.

Environmental Factors
  • Radon
    Radon is a natural radioactive gas which is an odourless, colourless, and tasteless gas and is a natural decay product of uranium. This gas occurs naturally with the breakdown of uranium in rocks and soil. Radon gas is known for causing lung cancer. It has been estimated, 12% of lung-cancer deaths is due to radon gas. Unsafe levels of radon gas can be present in work environments and homes, where it is not detected. People who smoke have a higher risk of getting affected by radon than those who don’t smoke. In the United States the second-leading cause of lung cancer is radon gas.

  • Asbestos
    Asbestos is an industrial material. Following exposure to asbestos, asbestos fibers are silicate fibers which can persist in the lung tissues for a lifetime. Small fibers become airborne and can be inhaled, when the material is disturbed. If a person is regularly exposed to asbestos, the risk of developing lung cancer is higher for that person, while the risk is even much more if the person is a cigarette smoker.

  • Other Chemicals and Minerals
    Other chemical exposure like arsenic, beryllium, cadmium, vinyl chloride, nickel compounds, chromium compounds, coal products, mustard gas, chloromethyl ethers, and diesel exhaust, increases the risk for lung cancer.

  • Air Pollution
    Recent research states that air pollution is another cause of lung cancer. In cities where air quality is low, can slightly increase the risk of developing lung cancer. About 5% of lung cancer deaths around the world are due to air pollution.


What are the types of lung cancer?

Two types of lung cancer are Small Cell Lung Cancer (SCLC) and non-small cell lung cancer (NSCLC). The names is given according to how the cells appear to pathologists under a microscope. Each type and stage of lung cancer requires unique treatments.

Small Cell Lung Cancer (SCLC)
15-20% of all lung cancers are small cell lung cancer. These cell are oval shaped and smaller than most other cancer cells so it is termed as small cell lung cancer (SCLC). It starts in the bronchi that is the air tubes that lead to the lungs or in lung tissue. It grows very fast and can produce large tumors that can travel through the bloodstream and quickly spread throughout the body. Heavy or lifetime smokers are mainly affected by small cell lung cancer.

Small cell lung cancer(SCLC) includes three subtypes. They are oat cell carcinoma, mixed small cell/large cell carcinoma, and combined small cell carcinoma. Among these three types of small cell lung cancer oat cell cancer is more common.

Non-Small Cell Lung Cancer (NSCLC)
About 80% of the lung cancer cases are due to the Non-small cell lung cancer (NSCLC). In Non-Small Cell Lung Cancer the cancer cells are larger and unlike small cell lung cancer it grows slowly. Non-Small Cell Lung Cancer (NSCLC) has three sub-types NSCLC consists of three sub-types:

Squamous cell carcinoma (or epidermoid carcinoma) : This is responsible for 25%- 30% of all lung cancer. It starts in the cells that line the air passages. If it is not treated in time it can spread to the lymph nodes, bones, adrenal glands, liver, and brain. This cancer is mostly found in men than women as it is a result of smoking.

Adenocarcinoma : This is responsible for 40% of lung cancer. It generally starts in the mucus-producing (outer) part of the lungs. It grows very slow. It is the common type of lung cancer in women and nonsmokers.

Large-cell (undifferentiated) carcinoma : This is responsible for 10% to 15% of the lung cancer. All non-small cell lung cancer that can’t be categorised as squamous or adenocarcinoma is included in this type. It grows rapidly and it sometimes appears near the surface, in the outer edges of the lungs.

How is lung cancer diagnosed?

Doctors diagnose lung cancer using a physical exam, evaluation if the medical history, chest X-ray (Chest X-rays can show suspicious areas in the lungs but are not able to determine if these areas are cancerous, CT scan (A CT scan of the chest can be done when X-rays do not yield sufficient information about the extent or location of a tumor), Magnetic resonance imaging or MRI ( MRI scans are needed when precise detail about a tumor's location is required), Bone scans (Doctors can do a bone scan to determine whether a lung cancer has spread to the bones), Sputum cytology (In this test confirmation of malignant cells is done by a pathologist),Bronchoscopy ( Examination of the airways by bronchoscopy can show areas of tumor that can be sampled (biopsied) for diagnosis by a pathologist), Needle biopsy (Fine needle aspiration through the skin can be helpful in retrieving cells for diagnosis from tumor nodules in the lungs).

Once a patient gets a positive diagnosis, his doctor will categorize the lung cancer in stages. The progression or extent of the cancer is described by progression and this help the doctor to determine which treatment is best. It should be noted that the stage does not indicate the outcome of the lung cancer. The prognosis of the patient depends on the overall health, strength, coinciding conditions, and response to treatment.

What are the treatment for Lung cancer?

There are three main types of treatment for lung cancer and they are chemotherapy, radiation therapy, and targeted therapy. Targeted therapy uses substances which attack cancer cells without producing any harm to the normal cells. Based on the type and the stage of the lung cancer in the patient, doctor will determine which type is best.

  • Curative Surgery : In the early stage of lung cancer, a lung cancer surgeon known as thoracic surgeon will perform surgery to remove the tumor, surrounding lymph nodes, and tissue. This is known as wedge resection. Such procedure highly increases the chance of survival for some types of cancer.

  • Palliative Surgery : Pain in certain areas of the body can be there for the presence of the tumor. It may also cause breathing difficult. The tumor is removed to make the person comfortable by palliative surgery.

  • Chemotherapy : This is a systemic therapy, and it uses strong drugs to slow or kill cancer cells throughout the whole body. In this case drugs can be taken orally, in the form of pills or liquid form, but are mostly administered intravenously. The dosage and length of treatment widely varies. It can be prescribed as often as daily, and as long as years, based on the type of lung cancer and the patient's response to the treatment. Chemotherapy treatment has a major drawback that is it damages healthy cells along with cancerous ones. It has several side effects like hair loss, nausea, and vomiting.

  • Radiation Therapy :High-energy rays to kill or reduce cancer cells are used in radiotherapy. For decreasing the possibility of damaging healthy cells radiation can be focused to specific areas. The doses are mostly given over a period of weeks or months. For some patient this is the main treatment, while for others radiotherapy will be given to kill cancer cells that remain after surgery.

  • Targeted Drug Therapy : This is a new treatment. It uses drugs that zero in on defects within the cell that make it cancerous.

  • Bevacizumab (Avastin) : Bevacizumab disables growth of the tumor by stopping it from creating a new blood supply. Research has stated that people with advanced lung cancer can be helped by bevacizumab when it was used in combination with chemotherapy.

  • Erlotinib (Tarceva) : Erlotinib blocks the chemicals that signal grow and divide in the cancer cells. On people with certain cancers erlotinib is used, who haven’t been helped by chemotherapy.

  • Supportive Care : Supportive care, or comfort care, is recommended when the prognosis is not good and chances for recovery are slight.

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