Cancer mortality rates are climbing in India and are under-reported due to poor recording of cases. In a population-based study done between 2003-2010 in West Bengal, showed around 23% cases of lung cancer among all cancer patients. According to GLOBACON 2020 data, the cumulative risk of lung cancer is 1 in 101 population, with 1 in 68 for male and 1 in 201 for the female population (Age 0 – 74 years).
What are the risk factors?
Smoking along with air pollution being the mainstay of reason for lung cancer, other causes like – occupational exposure to chemical carcinogens (arsenic, silica, nickel etc.) also plays some role.
What are the symptoms?
Initial stages of lung cancer do not cause any specific symptoms. In most cases, it appears when the disease becomes advanced and they usually are – Persistent cough, Shortness of breath, Sputum with or without blood, Chest pain, Weight loss, Hoarseness of voice etc.
How to get lung cancer detected early?
Patient with these symptoms and risk factors should be more cautious regarding lung cancer and should be screened for lung cancer with Chest XRAY and CT scan.
How it can be diagnosed?
Diagnosis should be confirmed with PET-CT Scan and CT guided or bronchoscopy guided TRUCUT biopsy.
What are the types of lung cancer?
Lung cancer are of three types – Non-Small Cell, Small Cell and Carcinoid. Among them, Small cell variety is worse and more aggressive.
Is surgery possible in lung cancer?
Yes, it can be removed and it’s one of the best treatment – if not the best. This is very much in contrary to the common belief (even believed by few clinicians) and myth, that lung being the most important organ for breathing and respiration, in turn being alive – cannot be operated upon or diseased lung cannot be taken out with the patient being alive and active after the operation. This wrong understanding has been refuted by many international studies and committee recommendations.
Up to which stage it can be surgically removed?
Stages of lung cancer are from Stage I to Stage IV. For Non-Small Cell type upto stage IIIA (LOCALLY ADVANCED), for Small Cell type upto Stage IIA (LOCALLY LIMITED) and for Carcinoid type upto Stage IIIA (LOCOREGIONAL DISEASE) – surgery can be performed with curative intent.
Will a patient remain active after lung cancer surgery?
In fact, lung can be taken out in part or even full of one side according to the disease involvement, if the patient is found to be fit with some simple preoperative evaluation (pulmonary function test, DLCO etc.). Thereby the patient will be having almost near preoperative activity level with better-quality disease-free life postoperatively.
How to decide the line of treatment of lung cancer?
The question of surgical or nonsurgical management of lung cancer (with chemo or radiotherapy or both) or whether it is curable or not – cannot be answered simply in a single line – rather it depends on the stage of cancer and patient condition.
But a carefully individualized treatment planned by a group of specialists (Multidisciplinary Board) involving – Thoracic Surgeons, pulmonologists, Medical and Radiation Oncologists and radiologists – who regularly handles lung cancer patients in a hospital setting – will provide a good quality disease-free survival for lung cancer patients.
The importance of multidisciplinary team lies in the fact that – it is based on International recommendation and free from individual clinician’s bias or aptitude.
Is Minimal access surgery possible in lung cancer?
The surgery for lung cancer has come a long way from the standard 25-30 cm long cut on chest to a Minimal Access Surgery with 5 cm cut on chest wall and with equivalent result from cancer clearance perspective, albeit with a lot less of pain, discomfort and hospital stay and quicker recovery to normalcy.
What do we practice?
This Minimal Access / Video-Assisted Thoracoscopic (VATS) / Thoracoscopic Lung Resection Surgery along with Multi-Disciplinary Team approach, is now the internationally acclaimed standard of care for lung cancer patients and is being practiced regularly in our Hospital.
Dr. Amitabha Chakrabarti & Dr. Manujesh Bandyopadhyay | Consultant General Thoracic, Thoracoscopic Oncosurgeon & Vascular surgeon | Narayana Superspeciality Hospital, Howrah