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Department: Artemis Cancer Institute
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Lung Cancer
Your body is made up of many types of cells. In normal course, cells grow, divide, and produce more cells to keep the body healthy. However, at times, this process may not function properly and cells may become abnormal, forming more cells, in an uncontrolled manner.
These extra cells form a mass of tissue, called a growth or a 'tumour'. Tumours can be benign, which means non cancerous, or malignant, which means cancerous. Lung cancer occurs when a malignant tumour forms in the tissue of the lung.
TYPES OF LUNG CANCER
There are 2 major types of lung cancers.
Non - small Cell Lung Cancer : It is the most common form of lung cancer.
Small Cell Lung Cancer : It is sometimes called 'oat cell cancer'. This form of cancer grows more quickly and is more likely to spread to other organs in your body.
WHAT CAUSES LUNG CANCER ?
Smoking is the leading cause of lung cancer. Apart from smoking, other risk factors are exposure to environmental pollution, exposure to chemicals like asbestos and gases like Radon. 80% of lung cancer can be attributed to smoking. The longer you have been smoking, greater the risk. But quitting smoking anytime considerably reduces the risk of getting lung cancer. Even after the diagnosis of lung cancer, quitting smoking will certainly improve general health and the chances of success of the current treatment. Passive smokers are also at an increased risk of getting lung cancer.
WHAT ARE THE SYMPTOMS OF LUNG CANCER ?
Some of the common symptoms that might hint at the underlying disease are :
If the cancer has spread beyond lungs, the symptoms could be varied.
HOW IS LUNG CANCER DIAGNOSED?
If you have any of the above symptoms, you should immediately see a doctor. He will ask for a detailed medical history. After this, he will do a physical examination before conducting any of the following test:
Chest X-ray : Once a malignant tumour begins to cause symptoms, it is usually visible on an X-ray. However an X-ray is not effective in detecting small tumours. Therefore some other tests would be required even if the X-ray picture appears normal.
Chest X-ray : Once a malignant tumour begins to cause symptoms, it is usually visible on an X-ray. However an X-ray is not effective in detecting small tumours. Therefore some other tests would be required even if the X-ray picture appears normal.
Sputum cytology : This is an initial test to arrive at a diagnosis. A sample of phlegm (mucus you cough up from your lungs) is evaluated for cancer cells. The absence of cancer cells. However, does not rule out lung cancer, if cancer cells are detected, further tests will be done to confirm the diagnosis.
Fine needle biopsy : This test confirms the presence of lung cancer. Under this procedure, a biopsy is done to confirm the diagnosis. A bronchoscopy (described below) is done to get a sample of tissue from the cancer site and also the adjoining lymph nodes. This tissue sample is examined by the pathologist for cancer cells.
Bronchoscopy : This is done to detect cancers in all pathways. Within the lungs. A lighted, flexible tube called a bronchoscope is passed through your mouth / nose into your wind pipe and finally into your lungs. This enables your doctor to visualize all pathways and detect any cancerous areas. During this, test samples are also taken for examination by the pathologist at a later date. Your doctor gives you some sedatives and local anaesthesia to ensure that your remain relaxed and comfortable during the procedure.
Blood tests : A complete blood count (CBC) and blood chemistry is done. A CBC determines whether your blood has the correct number of various cell types. Blood Chemistry tests may help in detecting the spread of cancer to your liver and the bones.
Other tests which might be used under special circumstances are :
Certain imaging tests that might confirm the diagnosis as well as determine the extent of spread are :
Computed Tomography (CT) : It is a very sensitive test that can detect cancer at an early stage. This test ascertains the exact size, shape, and position of the tumour, along with enlarged lymph nodes.
Magnetic Resonance Imaging (MRI) : Your doctor will recommend this test, if he suspects that the cancer has spread to your brain or spinal cord.
PET scan : This test may detect a lung cancer at an early stage. It also helps in determining the extent of the spread of lung cancer.
Radionuclide Bone Scan : This test helps in detecting the spread of cancer to the bones.
HOW IS LUNG CANCER TREATED?
Your doctor first finds out the 'stage' of the cancer. Then he selects the right treatment option for you. To find out the stage of the cancer, he will do a 'Staging'. Staging is a process of finding out how far the cancer has spread. It also has implications on your recovery rate and success of the treatment. There are different staging systems for small cell and non-small cell lung cancer.
The treatment options are :
These treatments will be prescribed either on their own or in a combination, depending on the stage of the cancer.
Surgery
Depending on the type and stage of the cancer, surgery may be suggested by your doctor to remove the tumour and some of the lung tissue around it. He might remove either a lobe or sometimes even the entire lung, depending on the spread and severity of the cancer. However, after this surgery, you will be able to return to your normal activities, provided you do not have a pre-existing disease in the lung like emphysema or chronic bronchitis.
Laser surgery may also be administered if you have other medical problems or if the cancer is widespread.
Chemotherapy
In Chemotherapy, certain drugs will be used to destroy the cancer cells. These drugs will be administered either through a vein, or orally. Usually a combination of drugs is given.
Radiation Therapy
Radiation Therapy will kill or shrink the cancer cells by using high-energy rays (such as X-rays). The source of radiation is usually external.
External beam radiation therapy will be usually given in daily doses, 5 days a week, for a period of 4 to 6 weeks.
Combination Therapy
You might be prescribed a combination therapy. In this therapy, you will be administered a combination of surgery with either chemotherapy of radiation therapy, or both. Chemotherapy and radiation therapy are administered either before the surgery to shrink the tumour so that it can be surgically removed or after the surgery to target residual tumour.
WHAT ARE THE SIDE EFFECTS OF TREATMENT?
All of these therapies have some inevitable side effects because along with cancer cells, treatment also damages healthy cells and tissues. The side effects of cancer treatment mighty vary. Some of the common side effects of therapies are : fatigue, loss of appetite, nausea, short - term memory loss (loss of recently - learned information), chills, shortness of breath, neuropathy (numbness and tingling in the arms or legs), skin reactions and hair loss. They depend mainly on the type and extent of the treatment. However, with medication, most of these side effects are manageable.
PAIN MANAGEMENT
The management of pain is an integral part of cancer therapy. Medications are the cornerstone of cancer pain treatment and their use is aimed at providing the greatest pain relief possible with the fewest number of side effects and the greatest ease of administration. Your doctor will prescribe appropriate medication that ensures maximum pain relief. Sometime your doctor might recommend some interventional procedures like surgery and / or injections.
FOLLOW UP CARE
Follow up care is an essential element of the overall treatment plan. Regular checkups will be advised to detect any changes in the health as early as possible. Strict adherence to therapy is a must to ensure proper recovery. You might also need the help of some rehabilitation services to regain strength and proper functioning of different organs.
CANCER CARE AT ARTEMIS
At Artemis Health Institute, state-of-the-art facilities are available for cancer diagnosis, treatment, follow up care and rehabilitation. These include advance imaging technologies such as a PET Scan, DWIBS and 3TMRI for diagnosing cancer. The hospital is also equipped with state-of-the-art radiation therapy such as Image Guided Radiation Therapy (IGRT) and Brachytherapy.
In temporary brachytherapy, the radioactive material is placed inside or near a tumour for a specific amount of time and then withdrawn. In temporary brachytherapy, a delivery device, such as a catheter, needle or applicator is placed into the tumour using fluoroscopy, ultrasound or CT to help position them. The physician may insert the radioactive material at the same time remotely through the delivery device, and later remove the material and delivery device. Temporary brachytherapy can be administered at a high-dose rate (HDR). AHI has HDR Brachytherapy from Nucletron, Model Microselectron HDR.X.
Diseases:-
The oncologists at AHI are equipped to treat various kinds of cancers, including but not limited to:
- Larynx
- Colorectal Cancer
- Hodgkin's Disease
- Leukaemia
- Prostate Cancer
- Oesophagus Cancer
- Oral Cancer
- Thyroid Cancer
Special Care Units / Diagnostic Equipment / Facilities
- Diffusion Weighted Whole Body Imaging with Background Body Signal (DWIBS)
- 3 Tesla MRI (Magnetic Resonance Imaging)
- Mammography System
- PET Scan
- Advanced CT Scan (64-slice CT)
- PET-CT Fusion Technology
- Dual Head Gamma Camera
- Brachytherapy
- Image Guided Radiation Therapy (IGRT) - the first in North India
Team of Specialists:
- Dr Ranga Rao Consultant- Medical OncologyView Profile
- Dr. Deep Goel, Gastrointestinal Surgeon Consultant- Surgical OncologyView Profile
- Dr Subodh Pandey Consultant- Radiation OncologistView Profile