Lung cancer is one of the most common cancers and it affects millions of people in India every year. It is one of the leading causes of cancer-related deaths. The number of cases have also been on the rise, including in non-smoker population. 1 in 16 people will be diagnosed with Lung cancer in their lifetime. The rising incidence and delayed diagnosis of lung cancer in India are grave concerns. For those who are suffering from this condition, finding the best lung cancer surgeon in Delhi is crucial in order to get the best treatment. In this article we will try to present all the important information about lung cancer and its treatment, including surgery and other options. We will also try to highlight the important factors to keep in mind while choosing your treating physician.
Introduction to Lung Cancer
Abnormal and uncontrolled growth of cells in the lung tissue can lead to formation of lung cancer. The cancer that originates in the cells of the lung is called a “Primary Lung Cancer” and if the cancer cells reach the lung from some other organ, it is called a “Secondary Lung Cancer“
Broadly, Primary lung cancers are classified into 2 main types, based on the cell of origin:
- NSCLC – Non Small Cell Lung Cancer
- SCLC – Small Cell Lung Cancer
NSCLC is the most common type of lung cancer, accounting for approximately 80 – 85% of all cases. The three main varieties of NSCLC are:
- Squamous Cell Carcinoma
- Large Cell Carcinoma
It is also one of the leading causes of cancer-related deaths in India. Lung cancer kills almost 3 times as many women as Breast cancer, and almost 3 times as many men as Prostate cancer
Smoking is the most common risk factor for lung cancer.
Other risk factors for lung cancer include second-hand smoke, exposure to certain chemicals, air pollution, radon gas and asbestos exposure, genetic predisposition, underlying lung disorders like COPD, arsenic in drinking water and increasing age.
Symptoms of Lung Cancer
The symptoms of lung cancer vary depending on the type and stage of the disease. Early signs of lung cancer may include:
- Persistent cough
- Chest pain
- Shortness of breath
- Coughing up blood or Hemoptysis
- Unexplained weight loss
- Hoarseness of voice
Read more about: Symptoms of Lung Cancer
Causes of Lung Cancer
Smoking is the number one cause for development of lung cancer. Cigarette smoke contains thousands of dangerous chemicals, out of which about 70 are cancer causing agents. Cigarette smoke is responsible for about 80% to 90% of all lung cancer cases in India. There is also a lot of Bidi and Hukka smoking in India as well.
Second-hand smoke: Adults who are exposed to second hand smoke have a 20-30% risk of developing lung tumours.
Other risk factors for lung cancer include exposure to certain chemicals, air pollution, asbestos exposure, increasing age, family history, previous lung diseases like COPD, exposure to Radon gas, arsenic in drinking water etc.
Diagnosis of Lung Cancer
The diagnosis of lung cancer requires a detailed history and a complete physical examination in the clinic. If your doctor suspects lung cancer you will be asked to undergo a battery of investigations. These may include:
- CT Chest: To find the location, size and extent of tumour in the lung
- Biopsy: To ascertain whether the suspected lung lesion is cancerous or non cancerous, tissue from the lungs needs to be examined under a microscope. A biopsy is needed to get this tissue. This biopsy may be an Ultrasound or CT scan guided biopsy if the lung tumour is peripherally located in your lungs. But if the tumour is central in position your doctor may get the biopsy by Bronchoscopy TBNA or EBUS.
- Mediastinal Staging: The lymph nodes of the chest also need to be sampled by EBUS or Mediastinoscopy for accurate staging of the disease.
- Other tests: Further imaging studies in the form of a whole body PET CT scan, MRI Brain, bone scan etc may be ordered to ascertain the extent of the disease in the body.
Treatment Options for Lung Cancer
The type and stage of lung cancer decides the treatment. The options available are:
Surgery for Lung Cancer
Surgery is the first-line choice for early stage lung cancer which means when the tumour has not yet spread beyond the lungs. When done timely surgery has the potential to cure the patient completely. But unfortunately very few lung cancers that present to doctors are operable due to delayed diagnosis. Since it is a complicated surgery you should opt for the best lung cancer surgeon in Delhi or your city.
Radiation therapy uses high-energy X-rays or other particles to kill cancer cells and shrink tumours.
- External-beam radiation
- Brachytherapy- localized form of radiation therapy
It is a form of treatment that is used to kill cancer cells. Anti-cancer medications are administered in the vein, and the session lasts up to a few hours. The treatment is performed in cycles of 1-3 weeks.
It can be given pre-surgery, post-surgery or even as definitive treatment alone or with radiation therapy.
It is a type of treatment that uses drugs to target specific cancer cells. So your doctor may recommend molecular targeted therapy that includes the administration of drugs that work in subsets of patients whose tumours have specific genetic changes that have the potential of promoting tumour growth.
Proton therapy is a type of radiation therapy that uses protons instead of X-rays to treat cancer. It can be used to treat lung cancer, but it’s relatively new, and not all centers have the capability to provide it.
Immunotherapy is a type of treatment that helps the body’s immune system to fight cancer. It can be used alone or in combination with other treatments.
Checkpoint inhibitors: These drugs block certain proteins on the cancer cells that help them evade the immune system.
CAR T-cell therapy: This is a type of immunotherapy that involves removing T cells from the patient’s blood, altering them in a lab to recognize and attack cancer cells, and then infusing them back into the patient.
Supportive care is an essential part of lung cancer treatment. It includes measures to control symptoms, improve quality of life, and prevent complications. It can include:
- Pain management
- Nutrition support
- Physical therapy
- Psychological support
Finding the Best Lung Cancer Surgeon in Delhi
This can be a daunting task because there are many surgeons in the city. So it can be difficult choice to make. To find the right or best lung cancer surgeon in Delhi or your nearby city is to do some research and ask for referrals from your doctor or other healthcare professionals.
Once you have zeroed onto a surgeon based on the surgeon’s experience, qualifications, and success rate with lung cancer cases, it is important to see if you are comfortable with the surgeon and his team. Ask as many questions about the surgery, post surgical care, recovery etc. You should also not hesitate to ask about the facilities of the hospital where the surgeon works.
Types of Lung Cancer Surgery
Lung cancer surgery is a major operation and can be a very invasive procedure. There are several different types of surgery that can be used to treat lung cancer, including lobectomy, segmentectomy, and pneumonectomy.
- Lobectomy is the most common type of lung cancer surgery. It involves removing the entire lobe of the lung that contains the cancerous tissue.
- Segmentectomy is similar to a lobectomy except that it involves removing only a smaller part of the lobe called a segment that contains the cancer.
- Pneumonectomy is a more radical type of surgery that involves removing the entire lung.
Lung resection is often combined with a mediastinal lymph node sampling or dissection. Traditionally the approach used for lung cancer surgery is an open surgical approach called a “Thoracotomy”. Here a large incision is made on the side of the chest and involves cutting the muscles and spreading the ribs. This allows the surgeon to put his hands inside the chest to operate.
Best Lung Cancer Surgeon in Delhi
Dr. Kamran Ali – Lung Cancer Surgeon in Delhi
Risks and Benefits of Lung Cancer Surgery in India
Like any other major surgery, lung cancer surgery carries certain risks. These include bleeding, infection, pain, abnormal heart rate or rhythm, clotting in blood vessels and a reaction to the anaesthesia. There is also a risk of injury to the remaining part of lung parenchyma causing air-leak. Other surrounding tissues in the chest are also at risk of injury.
Tips for Choosing the Best Lung Cancer Surgeon in Delhi
When choosing the best lung cancer surgeon in Delhi, there are several things to consider.
- Surgeon’s skill and experience in handling similar cases.
- Surgeon’s knowledge of latest treatment protocols and familiarity with new technologies for lung cancer treatment.
- A surgeon who is approachable. One who is willing to answer all your questions and give you the time and attention you need.
- Referrals from pulmonologists or other physicians also can play an important role in decision making.
- A previous patients experience and confidence in the surgeon of your choice may also go a long way in boosting your confidence to go ahead with the surgery.
Dr. Kamran Ali is a Lung Cancer Surgeon who has trained at Centres of Excellence across the World. He has extensive and deep experience treating people with lung cancer by a safe and scientific approach.