Lung cancers can arise in any part of the lung, but 90%-95% of cancers of the lung are thought to arise from the epithelial cells, the cells lining the larger and smaller airways (bronchi and bronchioles); for this reason, lung cancers are sometimes called bronchogenic cancers or bronchogenic carcinomas.
Lung cancers generally are classified into two types:
Non-small cell lung cancer is the most common type of lung cancer, accounting for about 85 to 90 percent of all diagnoses and Small cell lung cancer, also known as oat-cell cancer, accounts for less than 20 percent of lung cancer cases. In most cases, this cancer type is caused by tobacco smoking. It tends to spread quickly to other parts of the body.
Smoking is the leading cause of lung cancer. More than 80 percent of lung cancer deaths can be attributed to smoking. lung cancer is the most common type of cancer among men and women in India. Our Thoracic Cancer Management Team (CMT) is focused on battling this grave danger; our blue print to combat lung cancer comprises of a 360 degree, multi-disciplinary approach that combines the best of technology, the most skilled personnel and cutting-edge treatment modalities.
After conducting a physical exam and reviewing your health and family history, your oncologist will order various tests to diagnose and analyze your condition. An accurate diagnosis helps your medical team determine the best course of treatment. The most common tests for lung cancer include:
At APCC, we offer the most advanced therapies for lung cancer performed by lung cancer specialists who have extraordinary expertise. Your care team collaborates to determine the best plan to fight your cancer based on the stage, location, genetic profile and your overall health.
Surgery is an important aspect of multi-modal treatment for Lung Cancer. It is effective when the cancer is confined to the lungs. Surgery is also used to take out residual cancerous tissue after chemo therapy or radiation treatment.
The most common surgical procedures are :
The treatment can be given to cure patients whose lung cancers are confined to the chest but cannot be removed surgically. Using the most-advanced technologies, we can now deliver powerful doses of radiation directly to your tumour with exquisite precision. Highly trained medical physicists work in subspecialized teams with radiation oncologists to create an individualized radiation treatment plan for every patient. Radiation therapists are present during each radiation procedure to ensure that the correct dose of radiation is being delivered precisely where it is needed.
Intensity-modulated radiation therapy (IMRT)
IMRT uses sophisticated computer programs to calculate and deliver variable doses of radiation directly to the tumour from different angles. This technology targets the tumour while sparing the healthy tissue that surrounds it, enhancing your radiation oncologist’s ability to administer a lethal dose of radiation to a lung tumour and increasing your chance for cure.
Some people with lung cancer may be treated with a specialized form of IMRT called Image-Guided Radiation Therapy (IGRT). IGRT involves the use of sophisticated imaging tests to verify the position of the patient and the location of the tumour prior to and during the delivery of the treatment. Imaging tests play a crucial role in helping doctors to accurately plan and effectively deliver radiation therapy
Stereotactic Body Radiation Therapy
Stereotactic body radiation therapy (SBRT) is a treatment for non-small cell lung tumours that are small in size and confined to the lung. It can also be used to treat lung metastases, when cancerous cells from another area of the body have spread to the lungs.
Proton therapy is extremely beneficial for lung cancer treatment; our specialists are able to deliver highly effective and very precise doses of protons to the exact location of the lung cancer. There is very minimal exposure to normal lung tissue and bone marrow, resulting in a much lesser possibility of lung injury. Reducing bone marrow exposure may reduce treatment-related fatigue and, when necessary, allow for the delivery of more intensive chemotherapy during or after proton therapy.
In treating Lung Cancer, Chemotherapy is often used after surgery to kill any cancer cells that may remain. It can be used alone or combined with radiation therapy. Chemotherapy may also be used before surgery to shrink cancers and make them easier to remove; it can also be used to relieve pain and other symptoms.
In recent years, there has been a major paradigm shift in the management of Non-Small Cell Lung Cancer (NSCLC). NSCLC should now be further sub-classified by histology and driver mutation such as EGFR, ALK, KRAS, MET, ROS1, etc. Translational research advances now allow such mutations to be inhibited by either receptor monoclonal antibodies (mAb) or small molecule tyrosine kinase inhibitors (TKI). Whilst empirical chemotherapy with a platinum-doublet remains the gold standard for advanced NSCLC without a known driver mutation, targeted therapy is pushing the boundary to significantly improve patient outcomes and quality of life.
Immunotherapy for Lung Cancer
Drugs that empower the immune system to recognize and fight cancer have proven to be a very effective way to treat patients with lung cancer. In 2015, the FDA approved two new immunotherapy drugs, Nivolumab and Pembrolizumab for the treatment of Non-Small Cell Lung Cancer that has stopped responding to standard chemotherapy. Both of these medications block a protein called PD-1 found on immune cells. PD-1 acts like a brake on the immune system, tamping down immune responses. Nivolumab and Pembrolizumab release this brake, allowing the immune system to mount a stronger attack against cancer.
People with lung cancer often experience both the symptoms of the cancer, as well as side effects of treatment. Supportive care is essential during the treatment process. Our multi-faceted team is focussed on ensuring patient comfort and a better quality of life.
APCC has been a leader in improving radiation therapy for oesophageal cancer. We have developed tools to deliver powerful doses of radiation to tumours with precision. Our radiation team works together to keep you safe during every step of your treatment.
We don’t usually use radiation therapy alone to treat oesophageal cancer, but it can be important in combination with chemotherapy and surgery. Often, you will begin treatment for oesophageal cancer with four to six weeks of radiation therapy along with chemotherapy.
In some cases, chemo-radiation is the primary therapy, and surgery is used only if the tumour does not have a complete response to the chemo-radiation. In other cases, chemo-radiation just shrinks the tumour before surgery.
Radiation therapy can also be used for palliative treatment. For example, it can shrink a tumour so you can swallow better, or to relieve pain.