Lung cancer is the most common cancer in the world and the leading cause of cancer deaths. In India, the incidence is also high. About 2.5 million people are affected worldwide and more than 70,000 in India every year. The cause of lung cancer is environmental, most often due to smoking, so in many cases it can be prevented. They are very rarely hereditary and never contagious, i.e. they are not spread by physical contact. Unfortunately, the incidence in non-smokers is also increasing. Let us see what Dr. Jacob George, Consultant Medical Oncologist at Manipal Hospital, Goa, has to say about this.
Lung cancers are aggressive tumors. Patients often present with advanced-stage disease, and the risk of recurrence after treatment for early-stage cancer is also high. Like other types of cancer, lung cancers are treated with surgery, radiation therapy, and systemic therapy. [which includes chemotherapy]. Improvement of tools that aid diagnosis such as positron emission tomography (PET-CT), molecular tests and surgeries. [eg. minimally invasive techniques like Robotic surgery, VATS] and radiotherapy [stereotactic radiation] Outcomes have improved and treatment complications have decreased. Patients diagnosed with early-stage lung cancer have a chance of cure after standard surgical resection. Unfortunately, the risk of recurrence remains high with surgery alone.
Therefore, adjuvant treatment in the form of chemotherapy is required. Patients with inoperable tumors and those with operable tumors that are not suitable for surgery are mainly treated with radiotherapy. Advanced lung cancer is incurable and treatment remains palliative. The mainstay of treatment is systemic therapy. Survival of patients without treatment is only a few months and is slightly better with conventional treatment, including chemotherapy. However, in the last decade or two, with the progress of molecular biology, new treatment modalities have emerged, mainly targeted drugs and immunotherapy.
Modern cancer treatments require mandatory molecular testing that has helped individualize cancer treatment based on tumor biology. This has resulted in better outcomes – not only better disease control but also a significant improvement in survival. These new treatment modalities also have a role to play in early-stage disease as adjuvant treatment alongside surgery, radiotherapy, and chemotherapy. The addition of these drugs in early-stage lung cancer has decreased recurrence and thus cured more patients affected by this aggressive cancer.
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