Lung Cancer Treatment and Surgery in India

Overview

Lung cancer develops when a cell in the lung becomes abnormal and begins to duplicate uncontrollably. These abnormal cells eventually form a mass, or tumor, and can spread to other parts of the body if not treated. Lungs are the breathing organs located in the chest surrounded by a thin, protective membrane called the pleura. Each lung is divided into lobes; the right lung has three lobes, and the left lung has two lobes. Within the lungs are flexible airways called bronchi, which branch out into many smaller airways called bronchioles. The bronchioles lead to small, grape-like clusters of air sacs called alveoli. Oxygen and carbon dioxide pass to and from the alveoli into capillaries and carry blood throughout the body.

Symptoms of Lung Cancer:

Signs and Symptoms sometimes seen in lung cancer are as follows:

• A cough that doesn't go away and gets worse over time
• Chest pain that doesn't go away
• Coughing up blood
• Feeling short of breath
• Wheezing
• Losing your voice (hoarseness)
• Getting sick with pneumonia and bronchitis a lot
• Swollen neck and face
• Not hungry, losing weight without trying
• Feeling tired

Types of Lung Cancer:

There are two major types of lung cancer. Each type of lung cancer grows and spreads in different ways. Each type may be treated differently.

• Non-Small Cell Lung Cancer - This is the most common type of lung cancer, accounting for about 85% of all lung cancers. It usually spreads more slowly than other lung cancers. There are three major types of non-small cell lung cancer:
  • Squamous Cell Carcinoma - Squamous cell Carcinoma (also called epidermoid carcinoma) begins in the special cells, called epithelial cells, which line the air passages. Thus it may occur within the larger breathing tubes.The most common cause of squamous cell carcinoma is smoking.
  • Adenocarcinoma - Adenocarcinoma usually begins in the mucus-producing cells of the lungs. While it has been linked to smoking, adenocarcinoma is the most common type of lung cancer in non-smokers.
  • Large Cell Carcinoma - Large Cell Carcinoma is responsible for about 10% to 20% of lung cancers. Large cell carcinomas include all lung cancers that cannot be classified as squamous cell carcinomas or adenocarcinomas.
• Small Cell Lung Cancer : Small cell lung cancer accounts for about 15% of all lung cancers. As the name implies, small cell lung cancer involves cancer cells that are smaller in size than most other cancer cells. Although the cells are small, they are able to quickly reproduce and form large tumors, as well as to spread to other parts of the body. There are three major types of small cell lung cancer:
  • Small cell carcinoma
  • Mixed small cell/large cell
  • Combined small cell carcinoma

Causes of Lung Cancer:

Smoking tobacco is the main cause of lung cancer. People who live or work with people who smoke are also at increased risk because they are exposed to second-hand smoke. Other factors that increase the risk of lung cancer includes:

• Family history
• Exposure to Radon Gas
• Asbestos
• Metals like chromium, cadmium, arsenic
• Chronic lung diseases such as tuberculosis

Diagnosis of Lung Cancer:

Because early lung cancer often has no symptoms, it is difficult to diagnose the disease in its early stages. Some diagnostic tests that may be used include:

• Sputum Test - Phlegm, or spit, is studied to see if cancer cells from the lungs are present.
• Chest X-ray - X-rays use low doses of radiation to create images of the body.
• Computed Tomography (CT or CAT) Scan - This is a special X-ray that uses a computer to create a series of images, or slices, of the inside of the body.
• Magnetic Resonance Imaging (MRI) Scan - This is a test that produces images of the inside of the body using a large magnet, radio waves and a computer.
• Positron Emission Tomography (PET) Scan - This is a technique to obtain three-dimensional, color images using short-lived radioactive substances. The PET scan can detect cancerous tumors because of their ability to absorb the radioactive material.
• Bronchoscopy - During this test, the doctor looks into the bronchi through a special instrument, called a bronchoscope, that slides down the throat and into the bronchial tubes. The lighted end of the tube allows the doctor to see any abnormal areas. If abnormal tissue is found, the doctor can take cells from the walls of the bronchial tubes or cut small pieces of tissue to look at under the microscope to see if there are any cancer cells. This is called a biopsy.
• Needle Aspiration Biopsy - The doctor also may use a needle to remove tissue from a place in the lung that may be hard to reach with the bronchoscope. The needle will be put through the skin, in between the ribs, under the guidance of a CT scan. This is called a needle aspiration biopsy.
• Mediastinoscopy - This is a procedure in which the doctor inserts a lighted tube through a small incision (cut) above the breast bone to view the structures of the center of the chest.
• Surgical Lung Biopsy - The doctor also may look inside your chest cavity. The doctor can examine the chest cavity through a special instrument called a thoracoscope and take tissue samples (biopsies) from the lungs. Standard surgical sampling of the lung may also be required.

Stages of Lung Cancer:

The stage of a cancer describes its size and whether it has spread beyond its original site. Knowing the extent of the cancer helps the doctors to decide on the most appropriate treatment. Generally cancer is divided into four stages:

• Stage 1 is small and localized
• Stages 2 and 3 have spread into surrounding structures
• Stage 4 has spread to other parts of the body.

Staging of Small Cell Lung Cancer:

Small cell lung cancers are divided into just two stages:

• Limited disease - the cancer cells can be seen only in one lung, in nearby lymph nodes, or in fluid around the lung known as a pleural effusion.
• Extensive disease - it is clear that the cancer has spread outside the lung, within the chest area or to other parts of the body.

However, small cell lung cancer often spreads outside the lung quite early on. So even if the doctor can’t see any spread of the cancer on your scans, it’s likely that some cancer cells will have broken away and travelled through the bloodstream or lymphatic system. To be safe, small cell lung cancers are usually treated as though they have spread, whether any secondary cancer can be seen or not.

Staging of Non-Small Cell Lung Cancer:

The overall staging for NSCLC uses I through IV, with I being the earliest stage and IV being the latest. Evaluation of the tumor, lymph nodes, and metastases are included in the overall stage.

• Stage I - The earliest stage of lung cancer. The tumor is found only in one lung and has not spread to any lymph nodes.
• Stage II - The tumor has spread to lymph nodes that are contained within the surrounding lung.
• Stage IIIa - The tumor has spread to the lymph nodes outside of the lung, to those the tracheal area, including the chest wall and diaphragm on the same side as the cancer started.
• Stage IIIb - The tumor has spread to the lymph nodes on the opposite lung or in the neck.
• Stage IV - The tumor has spread to other parts of the lungs or distantly throughout the body

Types of Lung Cancer Surgery:

Surgery depends on the size and location of the tumour. Surgery is most commonly used for non-small cell cancers that are still small and have not spread. Surgery is not usually done for small cell lung cancer unless tumours are found at a very early stage, before the cancer has started to spread. Surgery for non–small cell lung cancer can be done in several ways.

• Wedge Resection (segmentectomy) - The surgeon removes a small wedge-shaped piece of lung that contains the lung cancer and a margin of healthy tissue around the cancer. This is likely to be done when your lung function would be decreased too much by removing a lobe of lung (lobectomy). The risk of lung cancer coming back (recurring) is higher with this method.
• Lobotomy - Lobectomy is the removal of one lobe of the lung. Your surgeon will recommend this type of operation if they think the cancer is just in one part of one lung. It is the most common type of operation for lung cancer. Bilobectomy is the removal of two lobes of the lung.
• Pneumonectomy - A pneumonectomy (or pneumectomy) is a surgical procedure to remove a lung. The most common reason for a pneumonectomy is to remove tumourous tissue arising from lung cancer. The operation will reduce the respiratory capacity of the patient; before conducting a pneumonectomy, the surgeon will evaluate the ability of the patient to function after the lung tissue is removed. After the operation, patients are often given an incentive spirometer to help exercise their remaining lung and to improve breathing function.
• Removing Lymph Nodes - During your operation your surgeon will remove some of the lymph nodes from around the lung. This is because the lymph nodes may contain cancer cells that have broken away from the main cancer. The surgeon sends the lymph nodes to the laboratory where they are examined under a microscope. If the nodes contain cancer cells this may affect the treatment that you need after the surgery.

Treatment for Lung Cancer:

• Radiation Therapy for Lung Cancer - In external beam radiation therapy, a large machine is used to carefully aim a beam of radiation at the tumour. The radiation damages the cells in the path of the beam – normal cells as well as cancer cells. In brachytherapy, or internal radiation therapy, radioactive material is placed directly into or near the tumour.
• Chemotherapy for Lung Cancer - Chemotherapy may be given as pills or by injection. Chemotherapy drugs interfere with the ability of cancer cells to grow and spread, but they also damage healthy cells. Healthy cells can recover over time.
• Targeted Therapies for Lung Cancer - Targeted therapies use drugs or other substances to block the growth and spread of cancer cells. These drugs are able to attack specific types of cancer cells. Targeted therapy is sometimes used to treat non–small cell lung cancer that has come back or that does not respond to chemotherapy.
• Photodynamic Therapy for Lung Cancer - Photodynamic therapy uses a special drug that starts to work when exposed to light. The drug is injected into your bloodstream and absorbed by the cancer cells. When exposed to a high-energy laser light, the drug becomes active and destroys the cancer cells. Photodynamic therapy can be used to treat some cases of early-stage lung cancer. It can also be used to help relieve symptoms of a blocked airway.

Benefits of Lung Cancer Treatment and Surgery:

Many people are frightened at the idea of having cancer treatments because of the side-effects that can occur. Although the treatments can cause side effects, these can usually be well-controlled with medicines. The potential benefits of treatment of Lung Cancer vary depending upon the individual situation and stage of Lung cancer. With the newer molecular targeted agents, similar or even greater symptomatic benefits are observed. With both first-line and second-line agents, there are palliative benefits. Such chemotherapy improves quality of life. The treatment increases your body's natural ability to fight cancer. It does this by giving a boost to your immune system.

Risks of Lung Cancer Surgery:

Risks from lung cancer surgery include damage to structures in or near the lungs, general risks related to surgery, and risks from general anesthesia. Your surgeon and anesthesiologist will discuss these risks with you prior to surgery. The most common risks include:

• Bleeding
• Infection
• Damage to nearby structures
• Risks from general anesthesia
• Blood clots

Lung Cancer Treatment and Surgery in India:

Indian hospitals and physicians have saved lives by dramatically increasing five-year survival rates for all stages of lung cancer, which has become one of the leading causes of cancer deaths for both men and women across the world. Advanced research and study is taking place in most of the India hospitals that offers advanced lung-cancer patients free screenings of their tumors for genetic mutations, some of which might be targets for treatment with existing or experimental therapies. The Lung cancer team provides a range of radiation therapy options to treat all types of lung cancer. The welcoming, state-of-the-art cancer hospitals in India house the latest treatments and technologies where you can receive all of your treatment under one roof by an experienced medical team. The expert medical team in India consists of highly-skilled, compassionate doctors and other clinicians who work together to deliver a personalized treatment plan tailored to your needs. The hospitals in India provide aggressive cancer treatment, so you and your family can focus on healing.

Cities in India that offers Lung Cancer Surgery under the supervision of best surgeons, doctors and hospitals are as follows :

Cost of Lung Cancer Treatment and Surgery in India:

Having lung cancer might mean that you have to give up work or spend more money than usual on things like transport to appointments or extra prescriptions. This might make you worry about how you and your family are going to manage. For people without health insurance, prescription drugs can be too expensive in western countries. Often the cost of treatment of lung cancer deters people from getting the help they need. Indian has become a very popular destination for such patients. If you are looking for low cost Lung cancer surgery, India is the best option for all of them.

Some of the common countries from which patients travel to India for surgery are:

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