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Lung Cancer

Quite uncommon until the advent of cigarette smoking, Lung Cancer was not even recognized as a distinct disease until 1761. Miners developed disproportionate amounts of lung disease which was eventually recognized as lung cancer in 1870; first connection between radon gas & lung cancer was confirmed & established in the 1960s. Medical literature case reports numbered 374 cases worldwide in 1912. With a recognized link between smoking and lung cancer, an aggressive anti-smoking campaign originated in Germany in 1929. Surgeon General of the United States first recommended smokers should stop smoking in the year 1964. Although first successful Pneumonectomy was performed for lung cancer in 1933, Radical Radiotherapy was initially used in 1950s to be followed by improvised continuous hyperfractionated accelerated radiotherapy was developed in 1997. While initial attempts at surgical resection failed in 1960s, successful chemotherapy regimens began developing in the 1970s. Identified as the leading cause of death from cancer among men and women in the United States, it claims more lives every year than breast, ovarian, prostate and colon cancers combined together. Smoking is the greatest risk factor for lung cancer.

Lung Cancer

What is Lung Cancer?

Cancer which begins in the lung is called primary Lung Cancer. Lungs are two spongy organs inside chest which take in oxygen while inhaling and release carbon dioxide during exhalation. Uncontrolled growth of abnormal cells in one or both lungs, typically in cells lining the air passages divide rapidly & form tumors. As these tumors become large & numerous, they also undermine lung capacity to provide oxygen to the blood stream. These tumors however, can be benign or malignant. Tumors which remain in a single place and do not spread are called ‘Benign Tumors’. Malignant Tumors are dangerous and spread to other parts of the body through lymphatic system or the blood stream. When metastasis occurs, cancer is much harder to treat.

Signs & Symptoms of Lung Cancer

Typically, there are no signs and symptoms of lung cancer in early stages. They occur only when disease is in advanced stages.

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Common signs and symptoms of lung cancer include –

  • Change in ‘smoker’s cough’ or chronic cough
  • New type of cough which does not go away
  • Coughing out blood, even in small quantities
  • Chest pain
  • Shortness of breath
  • Wheezing
  • Losing weight without reason
  • Hoarseness
  • Headache
  • Bone Pain

In case you are still smoking with above signs and symptoms and are finding it difficult to quit, seek an appointment with your doctor. Your doctor can recommend a strategy which will help you quit smoking. Counseling, nicotine replacement products and medications can also be quite helpful.

Types and Causes of Lung Cancer

Majority of lung cancers are caused by smoking, including secondhand smoke. But then, lung cancers also occur among people who have never smoked or exposed to secondhand smoke. However, doctors understand that smoke causes lung cancer by damaging cells lining the lungs. Cigarette smoke is full of carcinogens which are able to infect and change lung tissue. Although body is able to repair damage to an extent, repeated exposure increasingly damages normal cells. Overtime, this damage may cause cells to act abnormally and develop cancer.

Lung cancer is of two major types based on appearance of cancer cells under microscope. Doctors decisions for treatment are based on the type of lung cancer affecting a patient.

These two types of lung cancers include –

  • Small Cell Lung CancerThis type of cancer almost exclusively occurs in heavy smokers & is far less common than non-small cell lung cancer.
  • Non-Small Cell Lung CancerThis is an umbrella term used for many types of lung cancers which behave in a similar fashion. Non-small cell lung cancers generally include large cell carcinoma, adenocarcinoma and squamous cell carcinoma.

Lung Cancer Risk Factors

There are a number of factors which increase risk of lung cancer. While some of these like smoking can be controlled, others like family history are beyond scope.

Lung cancer risk factors include –

  • SmokingNumber of cigarettes & number of years of smoking invariably add to risk of developing lung cancer. Quitting at any point of time significantly lowers risk of developing lung cancer.
  • Secondhand Smoke ExposureEven if you were a non-smoker, risk of developing lung cancer increases if you are exposed to secondhand smoke.
  • Radon Gas ExposureProduced by natural breakdown of uranium in rock, soil & water which eventually becomes part of air we breathe, unsafe levels of radon gas accumulates within homes & building to cause lung cancer.
  • Exposure to Asbestos and Other CarcinogensWorkplace exposure to cancer causing substances like asbestos, arsenic, nickel & chromium can increase risk of developing lung cancer, especially among smokers.
  • Family History of Lung CancerThere is an increased risk of developing lung cancer if you have a parent, sibling or child with this disease.

Diagnosing Lung Cancer

Screening for lung cancer saves lives as the disease can be found in early stages. In case you are 55 years of age or above, talk to a doctor about benefits & risks of lung cancer screening.

Tests to look for cancerous cells and rule out other conditions in diagnosis of lung cancer include –

  • Sputum Cytologyin case you have cough and produce sputum, observing sputum under microscope can at times reveal presence of lung cancer cells.
  • Imaging TestsX-ray image of lungs can reveal abnormal mass or nodules; though a CT scan may reveal small lesions in lungs which might not be detected by X-rays.
  • Tissue Sample BiopsySample of abnormal cells can be removed through biopsy procedures like bronchoscopy, mediastinoscopy, or needle biopsy using X-ray or CT images through chest wall and lung tissue so as to collect suspicious lung cells. Biopsy samples can be taken from lymph nodes and/or or other areas where cancer has spread.

Stages of Lung Cancer

Once lung cancer is diagnosed, extent or staging of cancer will help decide the most appropriate treatment procedure of disease. Tests for staging may include imaging so as to look for evidence of cancer spread beyond lungs. These may include bone scans, positron emission tomography (PET), magnetic resonance imaging (MRI) or CT scans.

Lung Cancer Stages

  • Stage ICancer is limited to lung and has not spread to lymph nodes at this stage. Tumor is typically smaller than 5 cm or 2 inches at this stage.
  • Stage IITumor may have grown over 5 cm or 2 inches at this stage or may be smaller yet involving nearby structures like lymph nodes, diaphragm, chest wall or pleura, the lining around lungs.
  • Stage IIITumor may have grown large at this stage or invaded other organs nearby lungs. This stage may also indicate smaller tumor with spread to lymph nodes farther away from lungs.
  • Stage IVWhen cancer has spread beyond affected lung to the other lung and/or to distant body areas.

Small cell lung cancer is quite often described as extensive or limited; Limited indicating that cancer is limited to one lung while extensive indicating that it has spread beyond one lung.

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Lung Cancer Treatments

Lung cancer treatment plan is based on a number of associated factors including type & stage of cancer, overall health and individual preferences. Options may include one or more treatment procedures like surgery, radiation therapy, chemotherapy or targeted drug therapy.

  • SurgeryThis treatment is meant to remove lung cancer along with a margin of healthy tissue. Procedure employed to fulfill this purpose include –
    • Wedge ResectionThis removes small section of lungs which contains tumor along with margin of healthy tissue.
    • Segmental ResectionIt is designed to remove larger portion of lung but not the entire lobe.
    • LobectomyThis is meant to remove the entire lobe of one lung.
    • PneumonectomyIt is employed to remove an entire lung.

Surgery can also involve removing lymph nodes from chest so as to check them for signs of cancer. Risks of lung cancer surgery include infection, bleeding and shortness of breath post surgery. When a portion of lung is removed, remaining tissue normally expands over time in order to make it easier to breathe. Respiratory therapists are recommended so as to guide patients through breathing exercises for aiding recovery.

  • ChemotherapyDrugs or combination of drugs are used to kill cancer cells in chemotherapy. Normally administered orally or intravenously, these are given in series of treatments over weeks or months with breaks in-between for recovery. Often prescribed after surgery so as to kill remaining cancer cells, it is also used prior to surgery in cases where tumors are required to shrink for easy removal. Chemotherapy is also at times administered to relieve pain & other symptoms in advanced stages of cancer.
  • Radiation TherapyHigh-powered energy beams from X-rays & protons are used in radiation therapy to kill lung cancer cells. Directed towards cancer cells from outside called external beam radiation or put inside through catheters, seeds or needles inside body near cancer cells is known as brachytherapy; radiation therapy can be applied after surgery so as to kill remaining cancer cells. It is also used as first treatment in cases where lung cancer cannot be removed through surgery. Radiation therapy is also useful for relieving pain and other symptoms in advanced cases of lung cancer. Stereotactic body radiotherapy typically is an ideal option for treating very small lung cancers in place of surgery. Many beams of radiation are directed from different angles at lung cancer in this procedure which is completed in one or few sessions.
  • Targeted Drug TherapyThis is a new type of treatment for lung cancer which works by targeting specific abnormalities within cells. Often utilized in combination with chemotherapy, targeted therapy drugs include – 
  • Ramucirumab (Cyramza)
  • Nivolumab (Opdivo)
  • Erlotinib (Tarceva)
  • Crizotinib (Xalkori)
  • Ceritinib (Zykadia)
  • Bevacizumab (Avastin)
  • Afatinib (Gilotrif)

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Some of these targeted therapies only work for patients whose cancer cells display certain genetic mutations. For this purpose, cancer cells will be tested in laboratory to evaluate which drugs may be helpful.

  • Clinical TrialsThese are generally experimental lung cancer treatments. Clinical trial treatments can be an option for patients with limited options or for people whose lung cancer treatments are not working. Although they do not guarantee a cure, some clinical trials may be latest innovations. Participation in clinical trials will also help your doctor better understanding and treat similar lung cancer cases in future.
  • Palliative CarePatients with lung cancer experience signs and symptoms as well as side-effects of treatment. Palliative care also known as supportive care is specialty of medicine which involves working with doctors so as to minimize signs & symptoms in order to ensure comfort during and after aggressive cancer treatment. People receiving palliative care generally report improved mood & quality of life. This kind of supportive care in fact compliments regular cancer treatment.

Lung Cancer Treatment Packages with IndianMedTrip

Lung cancer treatment is comparatively low cost in India. IndianMedTrip is associated with the best cancer hospitals in India so as to give affordable lung cancer treatment packages to international patients from all around the world. Emerging as the fastest growing medical tourism company in the country, IndianMedTrip will take care of all your requirements including selection of proper treatment & top hospital to a warm reception, comfortable travel, convenient accommodation, scheduling appointments, minimum wait period, treatment, aftercare, effective recuperation and warm farewell. IndianMedTrip will also organize online consultation with doctors post surgery as part of the follow-up plan.

 

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