Lung cancer is the most frequent kind of cancer among Indian men. Every year, 75,000 new instances of lung cancer are diagnosed in the United States. Men account for 50,000 of the cases, while women account for 25,000 (WHO Globocan 2022). Lung cancer is responsible for 5.6% of all new cancer diagnoses and 8.1% of all cancer deaths. Importantly, lung cancer is becoming more common in women and nonsmokers.
Lung cancer risk factors include smoking, passive smoking, air pollution, and a weakened immune system. It can occur in patients with chronic inflammatory illnesses and a family history of lung cancer. Smoking is responsible for 80-90% of lung cancers.
Lung cancer symptoms include coughing, breathing difficulties, voice changes, and blood in sputum. Advanced cancer can cause chest discomfort, lack of appetite, weight loss, and neck and body swelling.
Tuberculosis, a major public health issue in India, can resemble lung cancer symptoms, making early identification difficult4. Due to these and other causes, only 15% are present early when surgery can be curative.
On first suspicion of lung cancer, a chest CT scan is excellent. If a worrisome lesion is found, a needle or bronchoscopy-guided biopsy is performed. The biopsy is needed to confirm lung cancer and determine its subtype. A PET CT scan is generally done to determine cancer stage after diagnosis.
The therapy of lung cancer varies on the subtype, stage, age, fitness, and patient preference.
Small cell lung cancer has two phases. Limited-stage cancers of the lung and lymph nodes are treated with radiation and chemotherapy. Small cell lung tumors that have spread are treated with chemotherapy. In recent years, immunotherapy has been shown to improve symptom management when coupled to chemotherapy. but also longer life.
Non-small cell lung cancers have four phases. Standard therapy for stage one and two is surgical resection. Some procedures can be done with limited access, such video-assisted thoracoscopic surgeries. Robotic lung cancer resections are becoming more common. These minimally intrusive methods remove cancer safely and swiftly. After surgery, many of these patients will be candidates for chemotherapy to minimize recurrence and enhance survival. All patients who have successful procedures are now recommended to have EGFR mutation and PDL 1 tests. New research shows that targeted treatment or immunotherapy may improve outcomes for people with positive testing.
A tiny proportion of stage l/ll lung cancer patients who cannot have surgery can benefit from radiation, particularly Stereotactic Radiosurgery.
Stage III is treated with chemotherapy-immunotherapy, surgery, radiation, and immunotherapy. There is strong evidence that adding one year of immunotherapy to radiation and chemotherapy for stage III lung tumors that are not operable improves outcomes.
State |V lung cancer therapy has changed significantly. In the last decade, chemotherapy has been the predominant treatment for this stage, however there have been substantial advancements.
Most of these patients undergo NGS tumor molecular profiling. These tests have changed therapy from “one size fits all” to more individualized. This test no longer requires biopsy tissue, rather a blood sample can be utilized. This test identifies 20-40% of people with genetic abnormalities that can be addressed with targeted medication. These patients seldom need chemotherapy, and tailored treatment is safer and more successful. Immunotherapy has also improved results. Current immunotherapy treatments are injectable and reactivate the body’s immune cells to attack tumor cells. In certain circumstances, immunotherapy alone or in combination with chemotherapy improves quality of life and lifespan.
As treatment advances, it’s important to treat in experienced centers and make decisions in multidisciplinary tumor boards with surgical, medical, and radiation oncologists, chest specialists, pathologists, and physiotherapists.
Even advanced lung cancer patients live long, productive lives. Ongoing research into tumor vaccines, targeted treatment, and immunotherapy medications will boost average survival across all phases.
