Lung Cancer is leading cancer killer of men & women in America, taking more lives each year than colon, prostate & breast cancers combined. While over 400,000 people in US are living with lung cancer, this disease ails elderly the most with about 81% are over 60 years of age. With survival rate of 17% that is drastically lower than all other cancers, only about 15% of lung cancers are diagnosed in early stages. More than half of the patients diagnosed by lung cancer pass away within a year. Invariably, smoking is responsible for about 90% of lung cancer cases. Exposures to asbestos is another risk factor, while a combination of smoking & asbestos seriously increases risk of lung cancer.
What is Lung Cancer?
Lung Cancer is cancer which starts in the lungs. In order to understand lung cancer, it would be immensely helpful to know normal structure & function of lungs. Lungs are two spongy organs located within the chest. The left lung is slightly smaller as heart takes up some space on this side of the body. Air enters through nose or mouth & fills up our lungs when we breathe in through the trachea. Trachea is divided into tubes called bronchi which enter lungs & divide in smaller bronchi. These in-turn divide further into smaller branches called bronchioles at the end of which tiny air sacs known as alveoli are located. Several blood vessels run through alveoli which absorb oxygen & pass carbon dioxide from inhaled & exhaled air respectively. Taking in oxygen & expelling carbon dioxide is exactly the main function of our lungs. Lung cancers usually start in cells lining bronchi & other parts of the lung like alveoli or bronchioles. Pre-cancerous changes in lung cell structure are thought to occur at the onset of lung cancer. Alteration of lung cell DNA promotes cells to grow faster in an abnormal way. As they do not form any mass or tumor at this stage, they go undetected by x-ray & cause no symptoms. Progress to true cancer happens when these abnormal cells grow to form a tumor large enough to be detected by imaging tests. Metastasize occurs when some of these cells break free & move to other parts of the body. Most often lung cancer is life-threatening since it tends to spread before detection by imaging tests like chest x-ray.
Risk Factors for Lung Cancer
Risk factors or causes include anything that effects chances of getting lung cancer. However, having a risk factor or several risk factors do not mean to translate into cancer. While some people who eventually develop lung cancer may not be having any known risk factors at all. Therefore, it is quite difficult to know which risk factor may have actually contributed to the development of cancer.
Some Common Risk Factors
- Tobacco Smoke – By far this is the leading risk factor for lung cancer. Almost 80% of lung cancer deaths are found to result from smoking. Even if people do not smoke, simply breathing in second-hand smoke can increase risk of developing lung cancer by almost 30%. Second-hand smoke is said to cause over 7,000 deaths each year.
- Radon – This is a naturally occurring radioactive gas resulting from breakdown of uranium in rocks & soil. It is tasteless & can neither be seen or smelt. This is the second leading cause of lung cancer in US. Radon is more dangerous indoors than outdoors, & is a high risk for people who have lived several years in radon-contaminated houses.
- Asbestos – Asbestos fiber workplace exposure is a great risk for developing mesothelioma, a cancer which starts from the lining surrounding lungs. People who work with asbestos in mills, mines, textile plants & places where insulation is used are many times more likely to die of lung cancer.
Other Lung Cancer Causing Factors
- Radioactive Ores like Uranium
- Inhaled Chemicals & Minerals
- Diesal Exhaust
- Air Pollution
- Radiation Therapy to Lungs
- Arsenic in Drinking Water
- Personal or Family History of Lung Cancer
- Certain Dietary Supplements
Detection & Diagnosis of Lung Cancer
Early detection of lung cancer is not possible as there are no associated symptoms. It is usually detected in an advanced non-curable stage. Even if some symptoms also appear they are often mistaken for other problems associated with long-term effects of smoking which eventually delay diagnosis. In some cases, early detection was only possible due to accidental result of tests for other problems. Doctors have only recently found a lung cancer screening test which can help lower risk from dying of lung cancer.
Signs & Symptoms of Lung Cancer
Most of the signs & symptoms of lung cancer do not occur until they are spread beyond cure. However, some of the most common lung cancer symptoms are –
- Cough which gets worse but does not go away
- Chest pain which is worse with deep breathing, laughing or coughing
- Loss of appetite & weight-loss
- Coughing out blood or rust colored sputum
- Feeling weak or tired
- Shortness of breath
- Infections like pneumonia or bronchitis that do not go away or keep coming back
- Fresh onset of wheezing
Group of Very Specific Lung Cancer Symptoms
Some lung cancers cause a group of extremely specific symptoms which are described as syndromes.
- Horner Syndrome – This is cancer of the top part of lungs which may damage a nerve passing from upper chest to neck. They can also cause severe shoulder pain & affect certain nerves to the eye & parts of face causing group of symptoms known as Horner Syndrome.
- Superior Vena Cava Syndrome – Superior Vena Cava or SVC is a large vein carrying blood from head & arms to the heart. Passing close to upper part of right lung & lymph nodes inside chest, tumors may push SVC & cause blood to back up in veins resulting in swelling of face, neck, arms & upper chest.
- Paraneoplastic Syndromes – Few lung cancers make hormone-like substances which enter blood stream & cause problems in distant tissues & organs even without cancer actually spreading to other parts of the body. These problems which are known as Paraneoplastic Syndromes are often the first symptoms of lung cancer.
Types of Lung Cancer
There are two major types of lung cancer affecting people. These are the Small Cell Lung Cancer or SCLC & Non-Small Cell Lung Cancer or NSCLC. Another very uncommon type of lung cancer is a combination of SCLC & NSCL. Treatments for SCLC & NSCLC are quite different from each other.
1. Small Cell Lung Cancer
Almost 10 – 15% of all lung cancers are Small Cell Lung Cancers. SCLC is named for its size of cancer cells when observed under microscope. Other names for SCLC include Oat Cell Carcinoma, Oat Cell Cancer or Small Cell Undifferentiated Carcinoma. This cancer very often is found to start in bronchi near the center of the chest & tends to spread widely fairly early in course of the disease. It is extremely rare for someone who has never smoked to have SCLC.
2. Non-Small Cell Lung Cancer
Around 85 – 90% of lung cancers are found to be NSCLC or Non-Small Cell Lung Cancers. NSCLC has 3 main sub-types which differ in size, shape & chemical make-up when observed under a microscope. It is the similarity in approach to treatment & prognosis which brings them together as sub-types.
- Squamous Cell (Epidermoid) Carcinoma – Almost 25 – 30% of all lung cancers are found to be squamous cell carcinomas. They normally start in early versions of squamous cells which are flat & line inside airways of the lung. Often linked to a history of smoking, they tend to be found in middle of the lungs, near bronchus.
- Adenocarcinoma – Almost 40% of lung cancers are found to be adenocarcinomas. They start in early version of cells which normally secrete substances like mucus. adenocarcinomas generally occur in current or former smokers, but are also common among non-smokers. It is more common among women than men, & occurs more in younger people than other types of lung cancers. Found in outer parts of the lung, adenocarcinomas tend to grow slower than other lung cancers & are most likely to be found before they spread outside lungs. People with adenocarcinoma in situ tend to have better prognosis than patients with other types of lung cancers.
- Large Cell (Undifferentiated) Carcinoma – This cancer accounts for almost 10 – 15% of all lung cancers. Tending to grow & spread quickly, they can appear in any parts of the lung & which makes it pretty hard to treat. Another sub-type of large cell carcinoma is Large Cell Neuroendocrine Carcinoma which is a fast growing lung cancer quite similar to SCLC.
- Other Sub-Types of NSCLC – Few other sub-types of NSCLC include Adenosquamous Carcinoma & Sarcomatoid Carcinoma which are far less common.
Other Types of Lung Cancers
- Typical Carcinoid Tumors
- Atypical Carcinoid Tumors
- Adenoid Cystic Carcinomas
- Adenoid Cystic Lymphomas
- Adenoid Cystic Sarcomas
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Treatments for Lung Cancer
Treatment of lung cancer invariably depends upon the stage of cancer & the size of tumor. Patients with small tumors close to the edge of lung are good candidates for minimally invasive lung cancer surgery while others would require large incisions & thoracotomy so as to reach lungs.
Types of Lung Cancer Treatments
- Wedge Resection or Segmentectomy – This lung cancer surgery is meant to remove only a portion of lobe of the lung. It is generally performed for patients who cannot tolerate lobectomy or pneumonectomy. Wedge Resection is most effective in early stages of lung cancer. Benefit of this procedure is that while removing as much of cancer as possible, as much of healthy lung can be saved. However, risk of remaining lung tissue containing or developing cancerous cells in future cannot be ignored.
- Lobectomy – Most commonly performed lung cancer surgery, Lobectomy removes one lobe or a section of the lung. When both lobes are removed it is known as bilobectomy. This surgical procedure is beneficial when cancer is confined to one portion or lobe of lung. Benefit of lobectomy is that while removing as much of cancer as possible & leaving as much of healthy lung. However, as with segmentectomy, risk of remaining lung tissue containing or developing cancerous cells in future cannot be ignored in lobectomy as well.
- Pneumonectomy – Pneumonectomy surgical procedure involves removing entire one lung. This is a beneficial treatment when cancer is centralized in the lung overlapping multiple lobes. Patients can breathe & function well with a single lung.
For patients who cannot withstand lung cancer surgery.
- Radiation Therapy
- Radiofrequency Ablation
- Photodynamic Therapy
- Targeted Therapies
Benefits of Lung Cancer Surgery
The biggest benefit of lung cancer surgery is having the satisfaction of removing entire cancer from the lung. However, this does not mean that surgery is necessary. In cases where surgery can cause severe disability, the patient & doctor must sit together & decide whether living with cancer is better than living with disability. It is important to consult your doctor & find out what surgery can offer in terms of curing & extending life including potential risks & potential benefits before going into particular surgery
Why Choose India for Lung Cancer Treatment?
India holds a special place for medical tourism in a global context. Healthcare infrastructure in the country is of the most advanced international standards, with many top surgeons having trained for decades in UK & the United States. With increasing costs of healthcare in developed countries, surgical interventions are beyond reach of the common population. Affordable & low-cost medical solutions in India offer respite to international patients without any bias.
Best Lung Cancer Treatment with Travcure
Travcure medical tourism is one of the fastest growing companies catering to international patients in Southeast Asia. Travcure healthcare consultants are associated with several top chains of hospitals like Wockhardt, Fortis, Apollo, Columbia Asia, & Max Healthcare apart from a host of local favorites like AIIMS, AHI, Tata Memorial, & Bombay Hospital. They can provide you with the best offers & take care of every detail from the moment you arrive to a successful departure. Travcure also offers you free initial online consultation to a variety of medical problems for international patients.