Understanding Lung Cancer
Lungs are exposed to a lot of toxic substances we inhale, such as pollution or tobacco, which is why lung cancer is so common. There are two most common kinds of lung cancers: they do not grow identically and require different treatments.
- Small Cell Lung Cancer
- Non-Small Cell Lung Cancer (most frequent)
Small Cell Lung Cancer
Small cell lung cancer is more serious because it often cannot be detected early. By the time it's diagnosed, it has usually spread to other organs.
Major types of small cell lung cancer include:
- Small Cell Carcinoma
- Mixed Small Cell/Large Cell
- Combined Small Cell Carcinoma
Non-Small Cell Lung Cancer
This is the most common type of lung cancer. It typically spreads more slowly than small cell lung cancer.
Major types of non-small cell lung cancer include:
- Squamous Cell Carcinoma
- Adenocarcinoma
- Large Cell Carcinoma
Pleural Mesothelioma
When cancer develops in the lining of the lungs (pleura), it's called pleural mesothelioma. The pleura is a sac containing the lungs and a membrane called the mesothelium, which secretes fluid that helps the lungs expand and contract during breathing.
Lung Cancer Overview
Risk Factors
- Smoking (primary cause)
- Exposure to secondhand smoke
- Family history of lung cancer
- Air pollution and asbestos exposure
- Radon gas exposure
Signs & Symptoms
- Persistent cough or changes in cough
- Shortness of breath
- Chest pain or discomfort
- Unexplained weight loss
- Recurring lung infections
Prevention
- Avoid smoking and tobacco use
- Limit exposure to pollutants and toxins
- Test your home for radon
- Eat a healthy diet rich in fruits and vegetables
- Regular health screenings and checkups
Treatments and Procedures
Surgery, radiation therapy and chemotherapy, and immunotherapy (used alone or in various combinations) are the standard methods used to treat lung cancer. The choice of treatment depends on many factors, including the type of tumor, the extent of the disease when it is diagnosed, the age and general health of the patient, and other variables.
Small Cell Lung Cancer
For small cell cancers, only chemotherapy can be efficient. Sometimes, thoracic radiotherapy is also associated. As the risk of brain metastasis is very high (blood goes directly from lungs to brain), a prophylactic skull radiation exposure is done.
Surgical procedures that may be employed include wedge or segmental resection (removal of a portion of the affected lungs), lobectomy (removal of the entire lobe of the lung), or pneumonectomy (removal of the entire right or left lung).
Non-Small Cell Lung Cancer
For non-small cell cancers, if the tumor can be removed surgically, the surgeon will remove one lobe or the entire affected lung (depending on the size and location of the tumor) and the closest lymph nodes, which can contain cancerous cells. If the patient is too weak to have an operation, radiotherapy associated with chemotherapy can be done instead. When the tumor has spread too much and is not removable, or if there are metastases, the patient is treated by radiotherapy along with chemotherapy.
Pleural Mesothelioma
For cancer of the pleural mesothelioma, treatment options are limited. Only a handful of mesothelioma patients afflicted with this form of the disease are candidates for surgery to remove tumors, especially since the tumors are often large and widespread by the time of diagnosis. If only outer pleura is affected, chemotherapy can be efficient. The possibility of surgery has to be discussed for every patient specifically. Most of the time, both pleura and lung are removed, and radiotherapy is associated. Surgery may be an option later, if the oncologist thinks the removal of a lung would benefit the patient. More often, pleural mesothelioma patients are treated with radiation or chemotherapy.
Immunotherapy
Immunotherapy drugs for lung cancer help your body recognize the cancer as foreign and harmful so your body can fight it.
Immunotherapy for Lung Cancer
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Immune checkpoint inhibitors
The most progress in immunotherapy for lung cancer has been made in immune checkpoint inhibitors. Immune checkpoints are molecules on the immune cells that can start or stop an immune response. The immune system uses these molecules to help determine what is normal and what should be attacked. Cancer cells sometimes trick the immune system by displaying these checkpoints to stop the body from attacking them. Immunotherapy drugs can prevent the immune system from getting tricked and help stimulate a response against cancer cells.
These drugs can have similar side effects to chemotherapy, including fatigue, nausea, itching, skin rash, and more, but they are generally less toxic than chemotherapy. However, because the drugs work by stimulating the immune system, it is possible to develop immune-related side effects from an over-stimulated immune system that can affect how your organs function.
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Cancer vaccines
When most people think of vaccines they think of treatments that prevent disease. However, there is another type of vaccine called a therapeutic vaccine. This type of vaccine treats an existing cancer by making the immune system better at killing cancer cells. These vaccines target proteins that are present in cancer cells that are either not present in normal cells or are only sparingly present in normal cells. Sometimes, the vaccines are customized to target proteins that are unique to an individual’s cancer. In other cases, the vaccines target cancer-specific proteins shared by many people.
Before a vaccine is given, it is often necessary to first take a medicine to dampen the types of immune cells that may allow a cancer to grow and boost the types of immune cells that can respond to cancer. There is currently no approved vaccine for lung cancer treatment.
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Adoptive T cell therapy
In this therapy, T cells (a type of white blood cell in the immune system) are removed from your body and then altered in a laboratory so they are better at attacking your specific cancer cells. Finally, the enhanced T cells are put back into your body to help it fight cancer.
Removing the T cells from your body can be done by a procedure called plasmapheresis which helps filter your blood to specifically identify certain types of blood cells. It can also be done by removing part of the tumor and separating T cells from the tissue.
Technology Used
Apart from surgery and chemotherapy, new age technology used to treat lung cancer include Radiology and Radiation Oncology, which are advanced imaging technologies used to detect lung cancer.
Technologies for Detection of Cancer:
- Computerized Tomography (CT)
- Nuclear Medicine
- MRI
- Ultrasound
- PET Fusion MRI and CT
New cutting-edge equipment include the CyberKnife® VSI robotic radiosurgery, which offer pain-free, non-invasive treatment with far greater accuracy and speed. Other leading-edge treatment technologies available include:
- Robotic Surgical System
- Adaptive Intelligence guided Radiotherapy
- Trilogy Image Guided Radiation Therapy System (IGRT)
- Intensity Modulated Radiation Therapy System (IMRT)
The oncology clinic is comprised of physicians dedicated to treating lung cancer and metastases with the latest technology. Because the physicians are specialists in oncology, hematology, medical oncology, surgical oncology, radiation oncology, and lung cancer treatment, you can rest assured you’re receiving the best care available. Specialists in other areas of care collaborate when necessary to provide a comprehensive approach to lung cancer treatment.
- Smoking (primary cause in 85–90% of cases)
- Secondhand smoke
- Exposure to radon gas, asbestos, or air pollution
- Family history
- Previous lung diseases
- Persistent cough
- Coughing up blood
- Shortness of breath
- Chest pain
- Hoarseness
- Unexplained weight loss
- Fatigue
- Repeated lung infections like pneumonia or bronchitis
- Chest X-ray or CT scan
- Sputum cytology
- Bronchoscopy (looking inside the lungs)
- Biopsy (tissue sampling)
- PET/CT scans (to detect spread)
- Non-Small Cell Lung Cancer (NSCLC) – Most common
- Small Cell Lung Cancer (SCLC) – Fast-growing, more aggressive
- Surgery
- Radiation therapy
- Chemotherapy
- Targeted therapy
- Immunotherapy
- Palliative care (in advanced cases)
- Quit smoking (or don’t start)
- Avoid secondhand smoke
- Test your home for radon gas
- Wear protective gear if exposed to hazardous materials at work
- Maintain a healthy diet and lifestyle
- Get screened if you're at high risk
- Are 50–80 years old
- Have a 20+ pack-year smoking history
- Currently smoke or quit within the last 15 years
