Lung Cancer

What is Lung Cancer?

Cancer starts when cells in the body begin to grow out of control. Lung cancer is a type of cancer that starts in the lungs. Lung cancer begins in the lungs and may spread to lymph nodes or other organs in the body, such as the brain. When a person has lung cancer, they have abnormal cells that cluster together to form a tumor. Unlike normal cells, cancer cells grow without order or control, destroying the healthy lung tissue around them. These types of tumors are called malignant tumors. When the cancer cells spread, they prevent organs of the body from functioning properly.

What causes lung cancer?
Anyone can get lung cancer. Lung cancer happens when cells in the lung mutate or change. Various factors can cause this mutation (a permanent change in the DNA sequence of a gene) to happen. Most often, this change in lung cells happens when people breathe in dangerous, toxic substances.

CAN-C - Most technologically advanced centre for lung cancer treatment in Bangalore.

Here, you will find information about signs and symptoms, causes and risk factors, types, diagnosis, staging and prevention about lung cancer.

Most lung cancers do not cause any symptoms until they have spread, but some people with early lung cancer do have symptoms. The most common symptoms of lung cancer are:

1

A cough that does not go away or gets worse

2

Coughing up blood or rust-colored sputum (spit or phlegm)

3

Chest pain that is often worse with deep breathing, coughing, or laughing

4

Hoarseness, Loss of appetite, Shortness of breath

5

Unexplained weight loss, Feeling tired or weak

6

Recurrent lung problems, such as bronchitis or pneumonia

7

Changes in the voice or being hoarse


If lung cancer spreads to other parts of the body, it may cause:


1

Bone pain (like pain in the back or hips)

2

Nervous system changes (such as headache, weakness or numbness of an arm or leg, dizziness, balance problems, or seizures), from cancer spread to the brain

3

Yellowing of the skin and eyes (jaundice), from cancer spread to the liver

4

Swelling of lymph nodes (collection of immune system cells) such as those in the neck or above the collarbone


With the help of an excellent team of highly qualified staff, we at CAN-C are here to provide the highest-quality lung cancer treatment in Bangalore.

A number of factors may increase your risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. And other factors can't be controlled. Risk factors for lung cancer include:

1

Smoking: Your risk of lung cancer increases with the number of cigarettes you smoke. Quitting at any age can significantly lower your risk of developing lung cancer.

2

Exposure to secondhand smoke: Even if you don't smoke, your risk of lung cancer increases if you're exposed to secondhand smoke.

3

Exposure to radon gas: Radon is produced by the natural breakdown of uranium in soil, rock and water that eventually becomes part of the air you breathe. Unsafe levels of radon can accumulate in any building, including homes.

4

Exposure to asbestos and other carcinogens: Workplace exposure to asbestos and other substances known to cause cancer.

5

Exposure to radon: Radon is a colorless, scent-less radioactive gas that is found in some houses and is a leading cause of lung cancer.

6

Breathing in other people's smoke (passive smoking): This slightly increases the risk of lung cancer.

7

Exposure to air pollution: Air pollution may increase lung cancer risk. But this depends on how much a person is exposed to. For most people, the risk is very small.

8

Family history: Genetics may predispose certain people to lung cancer. Individuals with an immediate family member who has or had lung cancer (and who does not or did not smoke) may be more prone to developing the disease.

There are 2 main types of lung cancer.

1

Non-small cell lung cancer (NSCLC)

About 80% to 85% of lung cancers are NSCLC. The main subtypes of NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. These subtypes, which start from different types of lung cells are grouped together as NSCLC because their treatment and prognoses (outlook) are often similar.

Adenocarcinoma: Adenocarcinomas start in the cells that would normally secrete substances such as mucus. This type of lung cancer occurs mainly in current or former smokers, but it is also the most common type of lung cancer seen in non-smokers.

Squamous cell carcinoma: Squamous cell carcinomas start in squamous cells, which are flat cells that line the inside of the airways in the lungs. They are often linked to a history of smoking and tend to be found in the central part of the lungs, near a main airway (bronchus).

Large cell (undifferentiated) carcinoma: Large cell carcinoma can appear in any part of the lung. It tends to grow and spread quickly, which can make it harder to treat. A subtype of large cell carcinoma, known as large cell neuroendocrine carcinoma, is a fast-growing cancer that is very similar to small cell lung cancer.

2

Small cell lung cancer (SCLC)

About 10% to 15% of all lung cancers are SCLC and it is sometimes called oat cell cancer.

This type of lung cancer tends to grow and spread faster than NSCLC. About 70% of people with SCLC will have cancer that has already spread at the time they are diagnosed. Since this cancer grows quickly, it tends to respond well to chemotherapy and radiation therapy.

Other types of lung tumors

Along with the main types of lung cancer, other tumors can occur in the lungs.

Lung carcinoid tumors: Carcinoid tumors of the lung account for fewer than 5% of lung tumors. Most of these grow slowly.

Other lung tumors: Other types of lung cancer such as adenoid cystic carcinomas, lymphomas, and sarcomas, as well as benign lung tumors such as hamartomas are rare.

Symptoms and the results of certain tests may strongly suggest that a person has lung cancer, but the actual diagnosis is made by looking at lung cells in the lab. Tests to diagnose lung cancer may include:

1

Sputum cytology: If you have a cough and are producing sputum, looking at the sputum under the microscope can sometimes reveal the presence of lung cancer cells.

2

Tissue sample (biopsy): A sample of abnormal cells may be removed in a procedure called a biopsy. A biopsy sample may also be taken from lymph nodes or other areas where cancer has spread, such as your liver.

3

Imaging tests: An X-ray image of your lungs may reveal an abnormal mass or nodule. A CT scan can reveal small lesions in your lungs that might not be detected on an X-ray.

5

Needle biopsy (Fine needle aspiration (FNA) biopsy, Core biopsy, Transthoracic needle biopsy)


Tests to find lung cancer spread in the chest:

If lung cancer has been found, it's often important to know if it has spread to the lymph nodes in the space between the lungs (mediastinum) or other nearby areas. This can affect a person's treatment options. Several types of tests can be used to look for this cancer spread.

1

Endobronchial ultrasound

2

Endoscopic esophageal ultrasound

3

Mediastinoscopy and mediastinotomy

4

Thoracoscopy

CAN-C is amongst the renowned centres for lung cancer treatment in Bangalore.

After someone is diagnosed with lung cancer, doctors will try to figure out if it has spread, and if so, how far. This process is called staging. The stage of a cancer describes how much cancer is in the body. It helps determine how serious the cancer is and how best to treat it.

The staging system most often used for lung cancer is TNM (Tumour, Node, Metastasis) system, which is based on 3 key pieces of information:
The size and extent of the main tumor (T): How large is the tumor? Has it grown into nearby structures or organs?
The spread to nearby lymph nodes (N): Has the cancer spread to nearby lymph nodes?
The spread (metastasis) to distant sites (M): Has the cancer spread to distant organs such as the brain, bones, adrenal glands, liver, or the other lung?

T stands for your tumor's size and where it's located in your lungs or body.
N stands for node involvement. This means whether or not your cancer has spread to your lymph nodes near your lungs.
M stands for metastasis. This means whether or not your cancer has spread. Lung cancer can spread to your other lung or your liver, bones, brain, kidneys, adrenal glands, or other parts of your body.

CAN-C – Most preferred cancer centre for lung cancer treatment (in Bangalore).

There's no proven way to prevent lung cancer, but there are steps to lower the risk of getting lung cancer. You can help lower your risk of getting lung cancer in the following ways:

1

Don't smoke: If you've never smoked, don't start. Quitting reduces your risk of lung cancer, even if you've smoked for years and avoid secondhand smoke.

2

Avoid carcinogens at work: Take precautions to protect yourself from exposure to toxic chemicals at work.

3

Eat a diet full of fruits and vegetables: Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best.

4

Exercise most days of the week: If you don't exercise regularly, start out slowly. Try to exercise most days of the week.

5

Lower your exposure to radon: If you live in an area where radon is a known problem, get the radon levels in your house checked and take measures to reduce exposure.

6

Lower exposure to workplace risk factors: Follow your employers' precautions to protect yourself from toxic chemicals at work.

"CAN-C: Highly specialized centre for lung cancer treatment in Bangalore."

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How Lung Cancer is treated?

It's important to get the right treatment as well as getting treatment quickly. As with most types of cancers, the best results of treatment are seen the earlier the cancer is found. If you have lung cancer, treatment for lung cancer depends on: the stage of the disease, the location of the cancer, the severity of symptoms, your general health and wishes. When it comes specifically to technologically-advanced lung cancer treatment in Bangalore, CAN-C is the best choice.

Surgery to remove the cancer might be an option for early-stage non-small cell lung cancer (NSCLC). It provides the best chance to cure the disease.

Types of lung surgery:
Different operations can be used to treat (and possibly cure) NSCLC. With any of these operations, nearby lymph nodes are also removed to look for possible spread of the cancer.

1. Pneumonectomy: This surgery removes an entire lung. This might be needed if the tumor is close to the center of the chest.
2. Lobectomy: The lungs are made up of 5 lobes (3 on the right and 2 on the left). In this surgery, the entire lobe containing the tumor(s) is removed. If it can be done, this is often the preferred type of operation for NSCLC.
3. Segmentectomy or wedge resection: In these surgeries, only part of a lobe is removed. This approach might be used if a person doesn't have enough normal lung function to withstand removing the whole lobe.
4. Sleeve resection: This operation may be used to treat some cancers in large airways in the lungs.
5. Video-assisted thoracic surgery (VATS): Video-assisted thoracic surgery (VATS), also called thoracoscopy, is a procedure being used more frequently by doctors to treat early-stage lung cancers. It uses smaller incisions, typically has a shorter hospital stay and fewer complications than a thoracotomy.
6. Robotically assisted thoracic surgery (RATS): In this approach, the thoracoscopy is done using a robotic system. The surgeon sits at a control panel in the operating room and moves robotic arms to operate through several small incisions in the patient's chest.

We at CAN-C are well-known for high-quality lung cancer care and treatment in Bangalore.

Radiation therapy uses high-energy rays or particles to kill cancer cells. Depending on the stage of the non-small cell lung cancer (NSCLC) and other factors, radiation therapy might be used:

1. As the main treatment (sometimes along with chemotherapy), especially if the lung tumor can't be removed because of its size or location, if a person isn't healthy enough for surgery, or if a person doesn't want surgery.
2. After surgery (alone or along with chemotherapy) to try to kill any small areas of cancer that surgery might have missed.
3. Before surgery (usually along with chemotherapy) to try to shrink a lung tumor to make it easier to operate on.
4. To treat cancer spread to other areas such as the brain or bone.
5. To relieve (palliate) symptoms of advanced NSCLC such as pain, bleeding, trouble swallowing, cough, or problems caused by spread to other organs such as the brain.

Types of radiation therapy used are:
1. External beam radiation therapy
2. Brachytherapy (internal radiation therapy)

Chemotherapy (chemo) is treatment with anti-cancer drugs that may be injected into a vein or taken by mouth. These drugs travel through the bloodstream and reach most parts of the body. Chemo drugs for lung cancer are typically given into a vein (IV), either as an injection over a few minutes or as an infusion over a longer period of time.

When is chemotherapy used?
1. Before surgery (neoadjuvant chemotherapy): Neoadjuvant chemo may be used (sometimes with radiation therapy) to try to shrink a tumor to remove it with less extensive surgery.
2. After surgery (adjuvant chemotherapy): Adjuvant chemo may be used (sometimes with radiation therapy) to try to kill any cancer cells that might have been left behind or have spread but can't be seen even on imaging tests.
3. For locally advanced NSCLC: Sometimes, chemo along with radiation therapy is given as the main treatment for more advanced cancers that have grown into nearby structures so that surgery is not an option or for people who aren't healthy enough for surgery.
4. In people with advanced lung cancer, chemotherapy can be used to relieve pain and other symptoms.

We are well-known for providing lung cancer treatment in Bangalore with a fast and thorough treatment plan.

Targeted drugs work differently from standard chemotherapy (chemo) drugs. Targeted therapies are a type of treatment that targets specific molecules that are essential for cancer cells to grow and divide uncontrollably. They differ from standard chemotherapy in that they block the cancer cells' growth and division rather than, as chemotherapy does, kill the cancer cells directly. Targeted therapies are more precise than chemotherapy drugs and do not affect healthy cells. At this time, targeted drugs are most often used for advanced lung cancers, either along with chemo or by themselves.

1. Drugs that target tumor blood vessel growth (angiogenesis): For tumors to grow, they need to form new blood vessels to keep them nourished. This process is called angiogenesis. Some targeted drugs, called angiogenesis inhibitors, block this new blood vessel growth:
Bevacizumab (Avastin), Ramucirumab (Cyramza)

2. Drugs that target cells with EGFR gene changes:
Epidermal growth factor receptor (EGFR) is a protein on the surface of cells. Drugs called EGFR inhibitors can block the signal from EGFR that tells the cells to grow. Some of these drugs can be used are: Erlotinib (Tarceva), Afatinib (Gilotrif), Gefitinib (Iressa), Osimertinib (Tagrisso), Dacomitinib (Vizimpro)

3. Drugs that target cells with ALK gene changes:
The ALK gene rearrangement produces an abnormal ALK protein that causes the cells to grow and spread. Drugs that target the abnormal ALK protein include:
Crizotinib (Xalkori), Ceritinib (Zykadia), Alectinib (Alecensa), Brigatinib (Alunbrig), Lorlatinib (Lorbrena)

4. Drugs that target cells with ROS1 gene changes:
The ROS1 gene rearrangement is similar to the ALK gene rearrangement, and some drugs can work on cells with either ALK or ROS1 gene changes. Drugs that target the abnormal ROS1 protein include:
Crizotinib (Xalkori), Ceritinib (Zykadia), Lorlatinib (Lorbrena), Entrectinib (Rozlytrek)

5. Drugs that target cells with BRAF gene changes:
In some NSCLCs, the cells have changes in the BRAF gene. Cells with these changes make an altered BRAF protein that helps them grow. Some drugs target this and related proteins:
Dabrafenib (Tafinlar) is a type of drug known as a BRAF inhibitor, which attacks the BRAF protein directly.
Trametinib (Mekinist) is known as a MEK inhibitor, because it attacks the related MEK proteins.

Immunotherapy is the use of medicines to stimulate a person's own immune system to recognize and destroy cancer cells more effectively.

Immune checkpoint inhibitors
An important part of the immune system is its ability to keep itself from attacking normal cells in the body. To do this, it uses "checkpoints" - proteins on immune cells that need to be turned on (or off) to start an immune response. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. But drugs that target these checkpoints can be used to treat some people with non-small cell lung cancer (NSCLC).

1. Nivolumab (Opdivo) and pembrolizumab (Keytruda) target PD-1, a protein on certain immune cells (called T cells) that normally helps keep these cells from attacking other cells in the body. By blocking PD-1, these drugs boost the immune response against cancer cells. This can shrink some tumors or slow their growth.
2. Atezolizumab (Tecentriq) targets PD-L1, a protein related to PD-1 that is found on some tumor cells and immune cells. Blocking this protein can also help boost the immune response against cancer cells.
3. Nivolumab, pembrolizumab and atezolizumab can be used in people with certain types of advanced NSCLC whose cancer starts growing again after chemotherapy or other drug treatments. Pembrolizumab and atezolizumab can also be used as part of the first treatment (with or without chemo) in some people with advanced disease.
4. Durvalumab (Imfinzi) also targets the PD-L1 protein, but this drug is used a little differently than the other immunotherapy drugs.

CAN-C, being one of the best centre for lung cancer treatment in Bangalore has the latest technologies to treat lung cancer and give the patient a new life.

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Dr. Dinesh M G

Specialty: Surgical Oncologist & Laparoscopic Oncosurgeon

Dr. Dinesh M G, is an efficient surgeon specialized in oncology committed to the care and improvement of quality of life of cancer patients. His exceptional surgical skills, teamwork and knowledge are laudable. He is skilled in performing various minimal access oncologic surgeries and has mastered complex open surgeries in the field of oncology.

Completing MBBS from KIMS, Bangalore followed by MS - General Surgery from JJM Medical College, Davangere and M. Ch - Surgical Oncology from Kidwai Memorial Institute of Oncology, he has a Fellowship in Minimal Access Oncology from Basavatarakam Indo American Cancer Institute.

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