Diagnosis

When a person shows symptoms of lung cancer or is considered at a higher risk for lung cancer, the doctor will recommend them to go through several tests to identify the presence of cancerous cells. Lung cancer can often be misdiagnosed and treated as tuberculosis if not adequately investigated. Some of the tests to diagnose cancer are-

Imaging Test- During this process, an abnormal mass can be revealed through an X-ray image. If the X-ray scan is inconclusive, a CT/PET-CT scan is recommended. A CT scan clearly shows small lesions.

Biopsy of Lungs -A tissue sample is taken from the lungs through a biopsy to analyse the presence of cancer cells. Different methods can do a biopsy, and they are -

Bronchoscopy- The patient is sedated to pass a lighted tube down the throat to the lungs to get a closer view and to examine the condition of the lungs.

Mediastinoscopy- This procedure is done in the operation theatre with general anaesthesia, where the doctor makes a small cut at the base of the neck to pass a lighted instrument to take a sample of lymph nodes with the help of surgical tools.

Image-guided needle biopsy for lungs- A needle is passed through the chest wall and then through the infected lung tissue to obtain a sample of lymph nodes. This procedure is performed by examining imaging tests like CT scan or ultrasound.

A pathologist analyses all samples collected during the biopsy to investigate further. Once cancer cells are present, the patient must undergo a further test to know the cancer stage. In this process, a radioactive chemical is injected to highlight unusual areas of bone in the MRI-brain, CT, and PET scan images. Depending on the stage of the cancer and pathology report, the patient may be asked to undergo molecular tests on biopsy samples, which will help decide the treatment plan.

Treatment for Lung Cancer

Once the patient has been diagnosed with lung cancer, a group of doctors coordinate to discuss treatment methods and inform each other about important decisions taken during the treatment. The team includes -

A thoracic surgeon or surgical oncologist who is a specialist in lung and chest surgeries

A pulmonologist

A medical oncologist

A radiation oncologist

There are two major types of lung cancer -

Non-Small Cell Lung Cancer (NSCLC)

Small Cell Lung Cancer (SCLC)

Non-Small Cell Lung Cancer (NSCLC) 

NSCLC is the most common type of lung cancer, comprising 80% of lung cancer. Some of the standard treatment methods are -

Surgery for Lung Cancer- Performing surgery on lung cancer patients entirely depends on the stage of cancer and the health condition to withstand surgery. Surgery is reserved for patients who are diagnosed at an early stage. During the surgery, a portion of the infected lung or the entire lung is removed based on the severity of the infection.

Radiation therapy for Lung Cancer- Radiation treatment is performed with the help of powerful beams emitted from X-rays and protons to kill cancer cells. During the process, the affected area is targeted by radiation from a moving machine while the patient lies down on a table. Radiation can be used after surgery, during the early stages of NSCLC, or in painful sites to provide symptomatic relief. A combined treatment of radiation and chemotherapy is recommended for Stage III patients who are not candidates for surgery.

Chemotherapy for Lung Cancer- The treatment includes the use of drugs to eradicate cancer cells. These drugs are induced either orally or through veins in arms. The drugs are combined to provide a series of treatments for a few weeks or months. Chemotherapy is usually performed after surgery to eradicate any cancer cells left behind. Chemotherapy is also combined with the radiation process for the treatment of Stage III cancer and is usually the only treatment option for Stage IV disease.

Targeted Drug Therapy for Lung Cancer- Patients suffering from Stage IV lung cancer due to a specific type of mutation in cancer cells (EGFR, ALK, ROS, MET, etc) are recommended to undergo targeted drug therapy. The irregularity in the cell is blocked by drugs that kill cancer cells. With advancement in cancer research and medical science, these drugs have drastically improved the survival rate of advanced stage cancer.

Immunotherapy for Lung Cancer- Immunotherapy is a new approach in lung cancer treatment. These drugs are given intravenously. It makes way for the patient's immune system to fight against cancer cells by clearing the proteins covering the immune system. As of now, Immunotherapy drug is recommended only for patients suffering from advanced lung cancer.

Palliative Care for Lung Cancer- It is specialised care to improve the quality of life for patients living with advanced-stage cancer. Supportive care helps relieve pain, treat vomiting, improve fatigue, etc. It is given with or without chemotherapy. It is also given to patients who are not fit for any cancer-directed therapy or to patients where medical therapy fails.

Small Cell Lung Cancer (SCLC) 

SCLC is less common but more aggressive and tends to spread more quickly than NSCLC. It often requires a different approach to treatment, which may include: 

Chemotherapy: Chemotherapy is often the primary treatment for SCLC due to its tendency to spread early. It can help control the cancer and improve symptoms.

Radiation Therapy: Radiation therapy may be used alongside chemotherapy to target tumours in the chest or other areas where the cancer has spread.

Combination Therapy: A combination of chemotherapy and radiation therapy is frequently used to treat SCLC, especially in limited-stage cases.