‘Side effects of each treatment are different and all are reversible or curable’: Dr. Ramakant Dehspande
“Lung cancer and its adversities can be lethal, if remains undiagnosed or left untreated. A multidisciplinary approach can successfully eliminate the cancer from lungs and patient may resume normal life after recovery, says Dr. Ramakant Dehspande, Chief of Thoracic Surgical Oncology, Asian Institute of Oncology.”
There are different sizes and stages of lung cancer, which are treated differently. Broadly, specialists categorize various types of lung cancer into two basic forms Non-small cell lung cancer and small cell lung cancer.
- Non-small cell lung cancer
Non-small cell lung cancer (NSCLC) accounts for more than 80% of lung cancers with main subtypes including adenocarcinoma, large cell carcinoma and squamous cell carcinoma. Often prognoses and treatment and of all these subtypes are similar. Other subtypes of NSCLC are sarcomatoid carcinoma and adenosquamous carcinoma, which are less common.
- Small cell lung cancer
Small cell lung cancer (SCLC) is not very common and found in less than 15% of cases, but this type of cancer spread very fast with more recurrence rate. The preferred treatments for this type of lung cancer are radiation therapy or chemotherapy.
Stages of Lung cancer
The staging of lung cancer helps in deciding the severity of the disease, course of treatment, and chances of survival. Detection of cancer at an early stage increases the chances of successful treatment and full recovery of the patient. A small legion located in one area is known as the first stage; a little larger tumor is called stage 2; spread within the lungs is called stage 3, and if it spread to other parts then termed as stage 4.
Surgery for lung cancer
To remove an infected part of lung cancer tissues, surgery is a preferred option of treatment. A lung cancer specialist decides by examining the patient’s condition and other parameters.
“Surgery continued to be the gold standard for the treatment of stage 1 and stage 2 lung cancers because it removes the entire tumor or infected part from the body minimizing the causes of recurrence. An experienced team of lung cancer specialists can bring down the mortality or recurrence to a negligible level,” says Dr. Ramakant Dehspande.
Types of Surgery
In general two types of surgical intervention are performed one is known as conventional or open surgery and other type is minimally invasive or telescopic or robotic. “Robotic is no different from other form of open surgery it is just like same thing is done by machine guided by humans. Rest operative parameters remain the same,” avers Dr. Ramakant
Different surgical intervention for removing lung cancer consists of:
- Wedge resection refers to removing a small part of lung, which has the tumor, along with some healthy tissues to ensure that no traces of cancer are left behind.
- Segmental resection involves removal of a larger section of the lung.
- Lobectomy is a process of removing the complete lobe of one lung.
- Pneumonectomy refers to removal of entire lung.
“If surgery is done to remove entire lung then there are some activity-related restrictions post-surgery. In early-stage chances of survival are more than 80%, which is more important than the associated side effects or restrictions of a specific modality,” informs Dr. Deshpande.
It will take one to three months to recover fully, meanwhile, patient may experience small breathing issues while walking or performing routine tasks. “Once the surgery is done and patient leave the hospital, some physiotherapy sessions and medications followed by one or few cycles of chemotherapy are given for complete eradication of the cancer ensuring the life is back to normal,” he continues.
Lung cancer treatments
On the basis of disease spread, type and patient profile, various modalities are adopted to treat the lung cancer. Small cell lung cancer is typically cured by using chemotherapy and radiation therapy. Non-small cell lung cancer is generally cured with surgery, radiation therapy, chemotherapy, targeted therapy, or by combining some of these options.
- Surgery is opted when cancer tissues are removed from lungs.
- Radiation therapy involves the usage of high-energy beams to destroy kill the infected cells.
- Chemotherapy is administration of specific drugs to reduce the cancer cells or kill them completely.
- Targeted therapy is a procedure of using drugs that target the cancer cell to inhibit their growth or spread.
- Immunotherapy is a technique to use body’s immune system to fight against cancer. Normally this technique is used in advanced stage of lung cancer.
There several forms of traditional medicine or therapies that may help in recovery, pain management and good after life for a lung cancer patients. These may include Acupuncture, Aromatherapy, Massage Therapy, Hypnosis and Yoga. These treatments are not cure alternatives to the established line of treatments, and always considered as supportive therapies to keep a lung cancer patient at ease.
Of late, the concept of precision medicine is gaining importance in oncology which includes immunotherapy and targeted therapy. Both of these therapies have shown improvement in cure and survival rate of stages III and IV patients. However, for early stage cancer surgery and chemotherapy is the preferred choice, because for a small or localized legion entire body’s immune system can’t be altered or subjected to a change. However, trials are on for use of these medicines for early stage lung cancer.
How treatment option chosen?
After preliminary examination and diagnosis, the patient must consult with the doctor and discuss the survival possibilities, treatment options available, recovery time, and life after the treatment. The patient is also ethically entitled to seek second opinion in consent with the present doctor. A multidisciplinary team (MDT) comprising of medical specialists from various streams discusses different options to choose a treatment regime for lung cancer patient. The panel may include pulmonologists, surgeons, thoracic surgeons, medical oncologists, chemotherapist, radiation oncologists, physiotherapists, nutritionist etc.
Once the diagnosis confirms lung cancer, an immediate consultation with doctors and treatment is must. Earlier the stage of cancer, better the treatment and recovery.
“It is advisable that patient should not ignore or confuse the deadly disease symptoms with any other disorder like TB or asthma or normal cough. Any symptom of lung disease lasting for more than a month can be lung cancer,” cautions Dr. Deshpande.
Nowadays, Indian hospitals and doctors are well equipped to treat lung cancer at any stage. Survival rates are also high after proper diagnosis and treatment for the lung cancer. Most of the hospitals are also offering post treatment care and supportive therapies to the patients for faster and better recovery.
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Dr. Ramakant Deshpande
MS; FICS; FAIS; DHA
Experience: 31+ years
Chief of Thoracic Surgical Oncology, Asian Institute of Oncology
Padmashree award by the President of India in 2014