MBBS (AIIMS), MS (Surgery, AIIMS), MNAMS, FACS (USA), FICS (USA), FUICC
Fri, 15 Dec 2023
Lung Cancer is the number one cancer in males in India. In the Early Stage, Lung Cancer may not produce any symptoms. That is why only about 10% of the cases are diagnosed when still confined to lungs and a majority have the disease spread beyond lungs by the time diagnosis is made.
If the Lung Cancer spreads to other parts of the body, the patient may feel symptoms in other parts of the body including lungs, lymph nodes, bones, brain, liver, and adrenal glands etc.
Lung Cancer Surgery and Treatment Program
Dr. (Prof.) Arvind Kumar based in Delhi currently at Medanta Hospital Gurgaon offers the only comprehensive Lung Cancer Treatment Program in the country providing A-Z of Lung Cancer management all under one roof.
Symptoms of Lung Cancer in Advanced Stage
There are a wide range of tests and diagnostic procedures that can be done to diagnose Lung Cancer. These include:
Early diagnosis of Lung Cancer is a big challenge in India because of a high incidence of Tuberculosis. Most of the symptoms of Early Lung cancer mentioned above are also the symptoms of Tuberculosis of the Lung. In a large percentage of cases, patients presenting with these symptoms are labelled as Tuberculosis (without any tests) and given treatment for many months till symptoms increase and tests are done which reveal Cancer. We must remember that "Every shadow on Chest X-Ray is not Tuberculosis". It is important to be aware of Lung Cancer also and do appropriate tests to diagnose it. Diagnosis in a late stage, as is the case in majority, leaves the patient with limited treatment options and limited survival.
Lung cancer was non-existent in the pre-industrialization era. Industrialisation and smoking led to an exponential increase, making it the number one cancer in the western world. The same stats stand valid and true for the Indian sub-continent as Lung Cancer is becoming the number one cancer in males and increasing rapidly in females too.
In Lung Cancer, the survival is directly related to the stage at diagnosis. Stage 1 i.e. when the disease is still confined to within the Lung, has the best survival. However, over 90% of the cases in India are diagnosed in Stage 3 or stage 4 with very poor survival. In the absence of any magical molecule for treating advanced Stage disease, diagnosing Lung Cancer early and operating it remains our best chance to achieve cure. Thus, it is vital to diagnose Lung Cancer early to be able to make a dent in the survival figures. Unfortunately, it is not possible to achieve so in the "symptomatic" stage as symptoms either do not appear or are very non-specific in the early stage making diagnosing impossible. The best way to diagnose Lung cancer early is to catch it even before it produces symptoms. This is where "Screening" (i.e. doing a test in normal people with no symptom to detect a disease before it produces symptoms) comes into the picture.
Lung Cancer is one of those few cancers in the body where the causative agent is definitely known i.e. smoking. It is also known that the risk of Lung Cancer in smokers increases in proportion to the duration (no. of years of smoking) and severity of smoking exposure (i.e. no. of cigarettes smoked per day). Thus, there is an "AT RISK" population whose chance of getting Lung Cancer increases with increasing exposure. This provides us the "Target" population for applying any screening tool for Early diagnosis of Lung Cancer.
In the recent past, the "National Lung Cancer Screening Trial" in America showed a 20% reduction in Lung cancer mortality because of earlier diagnosis by using "Low Dose CT Scan" as a screening tool in the "at risk" population i.e. Older people with over 30 years history of Cigarette smoking. This landmark trial had led to acceptance of "Low Dose CT Scan" as an effective screening tool for early diagnosis of lung cancer in America.
In India, there has been no such study. It is feared that high incidence of Tuberculosis and other infectious diseases in our country will reveal many "suspicious lesions" in the screening CT Scan. Differentiating "Lung Cancer" from other causes in the "suspicious lesions" will be a challenge. As, tissue diagnosis is the gold standard, it may lead to lot of biopsies or resections with its attendant risks. Whether, this risk is worth taking or not has been a subject matter of intense debate in medical circles and the final answer will only emerge when such a study is carried out.
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License Number: U.P State Medical Council (India) No. 27637