Thoracic Cancer - Overview

Thoracic cancer is a type of cancer that affects the chest region, including the lungs, thymic, or tracheal. Lung cancer is referred to as the most common thoracic cancer worldwide. It is the second most common cancer in both men and women in the US. While 10 to 15% of lung cancers are small cell lung cancers, non-small cell lung cancers account for a majority of 80 to 85%. Lung cancer is mostly diagnosed in people aged above 65 years and is a rare condition for people below 45 years of age. Understanding the nuances of lung cancer types, and watching out for the evident and subtle signs and symptoms is crucial.

Types of Thoracic Cancer

Thoracic cancer or lung cancer is commonly categorised into Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC).

Non-small cell lung cancers can be further categorised into:

Adenocarcinoma: This type of cancerous development is usually found in the outer parts of the lungs, and in cells that secrete mucus. Unlike other variants of lung cancers that are more common in men and those with smoking habits, this cancer is commonly found in women and in the younger population.

Squamous Cell Carcinoma: These cancers usually initiate in the squamous cells that line the inside of the airways in the lungs and commonly found near the bronchus. These cancers are often linked to consistent and rigorous smoking habits.

Large Cell Carcinoma: These cancers can grow on any part of the lungs and are faster in spreading. Treating this variant of thoracic cancer is quite challenging.

Adenosquamous Carcinoma and Sarcomatoid Carcinoma are the other rarely occurring forms of NSCLCs.

Small Cell Lung Cancers, though account for only 10-15% of the lung cancer burden, spread faster than NSCLCs. Patients diagnosed with SCLCs may respond better to chemotherapy, radiation therapy and proton therapy and the chances of recurrence are mostly high

Signs & Symptoms of Thoracic (Lung) Cancer

Different people have different symptoms of thoracic cancer. While some people might have symptoms specific to the lungs, some might have specific to other organs. The symptoms may include:

  • Continuous coughing that doesn’t stops
  • Pain in the chest
  • Wheezing or shortness of breath
  • Weight loss without any reason
  • Feeling tired all the time

These symptoms can be because of other illnesses as well. Hence it is recommended to consult a doctor if anyone faces these symptoms

Thoracic Cancer Causes and Risk Factors

Some of the most common causes of thoracic cancer (lung cancer) include:

  • Smoking tobacco (active and passive)
  • Exposure to asbestos and other radioactive chemicals
  • Exposure to other cancer-causing agents
  • Inherited and acquired genetic changes
  • Certain dietary supplements
  • Air pollution
  • Personal and family history of lung and other variants of thoracic cancers

Thoracic Cancer Diagnosis and Treatment

Diagnosis of thoracic cancer is a multi-step process. It will require the patient to visit the healthcare provider to discuss the symptoms and perform a physical examination. As the symptoms of thoracic cancer might resemble other common illnesses, the doctor can further prescribe blood tests, chest X-rays, and imaging tests. The doctor can also ask for a PET/CT to see how much the cancer has spread.

The treatment of thoracic cancer will depend on the type of cancer and the extent to which it has spread. Some common treatment methods are:

  • Chemotherapy
  • Radiation therapy
  • HPV infection, or human papillomavirus, associated with neck and head cancer, is rising.
  • Radiofrequency ablation
  • Targeted drug therapy
  • Immunotherapy
  • Surgery
  • Proton therapy

Proton Therapy for Thoracic Cancer

Proton therapy is an emerging technology that helps improve the treatment of thoracic cancer patients. Over the past few decades, proton therapy technology has made rapid strides. Proton therapy for thoracic cancer is a technology that projects focused beams on the affected region. It is particularly well-suited for thoracic cancer because sensitive organs surround the affected area.

Because of the rapid technological strides, the outlook for thoracic cancer patients has improved significantly. Today there are better ways to treat the patient while not impacting the overall health and life quality. Proton therapy is a modern advanced treatment that takes high-energy particles and deposits radiation on the tumour.

While the conventional methods release energy before and after the impact, proton therapy for thoracic tumours only releases energy during radiation.

Benefits of Thoracic Cancer Patients Treated with Proton Therapy

Proton therapy is improving rapidly with every passing day as more researchers focus on its benefits. The main advantage of proton therapy over conventional treatments is that it emits focused radiation to the affected area and the surrounding healthy cells remain unaffected. Proton therapy for thoracic cancer helps reduce complications and improves the patient’s quality of life

Moreover, it has fewer side effects compared to traditional radiotherapy methods. Some of the vital benefits of the therapy are highlighted below:

  • Reduced chances of secondary tumour in the future
  • Provides better control and precision to the healthcare professional
  • Minimal damage to the surrounding normal tissues and organs
  • Better survival rate and reduced toxicity

Side Effects of Proton Therapy for Thoracic Cancer

After treating thoracic malignancies through proton therapy, a patient has fewer side effects. Some of the most common effects include fatigue and skin-related issues. Moreover, a patient might encounter other common problems like redness, swelling, dryness, and blistering.

Studies have shown that proton therapy for thoracic tumours has a low rate of side effects. It is also important to note that the patient’s overall condition and other medical problems should always be accounted for when thinking about side effects.

What can the patients expect from proton therapy for Thoracic Cancer?

Before the treatment, the patient undergoes a simulation or a planning session. It primarily focuses on finding the correct position for the patient to undergo the treatment. The patient’s position is critical as the radiation should reach the designated area without hindrance. Moreover, the patient should also feel comfortable during the process. It usually takes around ten days for the planning and quality checks before the treatment can begin.

Proton therapy for thoracic cancer is usually planned for five days a week. Most patients with thoracic malignancies undergo radiation therapy for five to six weeks. Moreover, proton therapy can be combined with other treatment methods for better results. The treatment is painless and swift. While the process only takes a few minutes, the overall session might last around 30 minutes

How Can the Patients Prepare for Thoracic Cancer Proton Therapy?

As highlighted, before the actual treatment, the patient goes through a simulation and other imaging tests to ensure that the proton reaches the right spot. While planning the proton therapy for thoracic cancer, below are a few things that can help prepare.

  • Get details about the treatment process from the oncologists and the healthcare team. Understand the process in detail, question about the sessions and the expectations.
  • Discuss any potential side effects and how they can help in managing them.
  • Make sure to follow the treatment plan provided including the medications and the appointments.
  • Continue maintaining a healthy diet and regular exercise to keep the body strong while providing the necessary nutrients.
  • Seek help with childcare, transportation, or other activities while undergoing the treatment.
  • Do not hesitate to ask any questions about the treatment, the plan, or the process.

Which Thoracic Cancer Benefit the Most from Proton Therapy?

Proton therapy can be a great option for thoracic cancer patients who have locally advanced disease. It is ideal for people for whom cancer has not spread to different organs of the body. Moreover, it is also ideal for patients where surgery is not possible or who are having recurrent thoracic cancer.

You should note that the treatment method for thoracic cancer depends on multiple factors, and the decision depends on the evaluation by the cancer specialists. Factors like the cancer stage, location, health of the patient, and the patient’s preference are taken into consideration along with potential benefits and risks of different treatment methods

It is best advised to consult your cancer care team to understand more about the treatment and the potential benefits and risks.

What is the Cost of Proton Therapy for Thoracic Cancer?

The cost of the therapy depends on different factors surrounding the case. For example, it depends on the type of cancer, the exact location, and the patient’s health condition. Once the patient provides all the details to the oncologist, an accurate estimation can be derived.

Doctors

DR. SRINIVAS CHILUKURI

SENIOR CONSULTANT - RADIATION ONCOLOGY (THORACIC)

DR. KHADER HUSSAIN

CONSULTANT - THORACIC SURGICAL ONCOLOGY

DR. ABHIJIT DAS

CONSULTANT - THORACIC SURGICAL ONCOLOGY

DR. RAJIV SANTOSHAM

SENIOR CONSULTANT - THORACIC SURGERY

DR. SUJITH KUMAR MULLAPALLY

CONSULTANT - MEDICAL ONCOLOGY (THORACIC)

DR. ARUNAN MURALI

HEAD OF RADIALOGY

DR. RAMYA A

CONSULTANT MEDICAL ONCOLOGY

DR. SHAM SUNDAR C

CONSULTANT – RADIATION ONCOLOGY

Dr. ALEC REGINALD ERROL CORREA

CONSULTANT – MEDICAL GENETICS

FAQs about Proton Therapy for Thoracic Cancer

Thoracic cancer is a type of cancer that affects the chest region and the organs present in the chest region including the lungs, windpipe, and others.

Some common risk factors for thoracic cancer are history of smoking, family history of thoracic cancer, age, different medical conditions, or exposure to harmful chemicals

Proton therapy is a targeted radiation therapy method that uses an intense beam of protons to deliver high radiation dosage to specific areas of the patient's body. It can be an effective treatment method for patients of different cancers including thoracic cancer.

Proton therapy for thoracic cancer can be used in different ways depending on the diagnosis and the patient’s condition. The doctors can decide to use it as a standalone treatment or can also combine it with other traditional treatment methods. Moreover, the treatment continues for around 4-5 weeks with 5 sessions per week

There is no concrete evidence that proves that the proton therapy is more effective than other traditional methods for thoracic cancer. While some studies suggest that the proton therapy is more effective, others suggest no significant difference between the different treatments. With time and more research the relative effectiveness of the proton therapy against traditional treatment methods will be more clear.

A patient undergoing proton therapy gets fewer side effects than conventional therapy. This is because of the specialised proton beam that directly impacts the tumour. The side effects associated with proton therapy usually last for a few weeks. The oncologists’ team explains the side effects and the time taken for a full recovery post-treatment.

The radiation that comes out of this therapy has a concise life. It gets into the patient’s body and impacts the cancer tissues with little side effects on other surrounding organs. After the session, there is no risk of exposure to radiation for your loved ones.

There is no pain during the session, and the procedure only takes a few minutes. However, people with other conditions or physical limitations can feel discomfort during the session because of lying idle in a single position.

The radiation only impacts the cancer cells for a short time during the therapy session. No secondary radiation with the patient can affect them or others staying with them. There is no risk of exposure to radiation for others. Any type of physical proximity, including sex, is safe.

Proton therapy for thoracic cancer is advisable for children as it is highly beneficial. Children have growing bodies, and thus it is necessary not to harm the other healthy tissues with radiation. Thus, proton therapy is ideal for them as it has no exposure to the surrounding areas.