Reducing Mortality

New treatment options like the Cyberknife technique have helped lung cancer patients, writes Dr. Tejinder Kataria.

Mr. Patel, 68, complained of constant and mild breathlessness. He was being treated for a smoker’s cough without bronchodilators and had been advised to quit smoking. But the cough persisted  even after four weeks of treatment. He had no appetite, was fatigued and had lost about two kg in two weeks. He also complained of a mild headache. He had been on hypertension medication for 10 years.

A clinical examination, blood investigations and a contrast – enhanced CT scan of his chest was done for suspected chest infection. His scan showed a small peripheral nodule from which a biopsy was ordered. Mr. Patel had stage IV oligometastatic  lung cancer.

Lung cancer is hard to treat. According to the World Health Organization statistics, lung cancer accounted for 18.2 per cent of cancer mortalities in 2010. Survival rates are poor partly because it goes undetected till it is in an advanced state.

As the lung cancer does not contain nerve endings, the occurrence of a tumor does not cause direct pain. This is experienced when the tumor reaches the pleura or the tissues surrounding the lungs, or when it pressure on nerve structures in proximity. The tumor can also compress or invade other organs and cause other symptoms.

A clinical examination followed by a chest x-ray or a CT scan are the first steps in diagnosis. This is then confirmed by a biopsy. A PET-Ct is the best to pick up distant metastases in lung cancer as it can detect tumors as  small as 3-4 mm in any part of the body except the brain.

There are two main types of lung cancers classified according to the size and appearance of malignant cells, namely, non-small cell lung cancer (NSCLC) and small-cell lung cancer(SCLC).

Traditional treatment options are surgery, chemotherapy and radiation therapy. New developments in imaging and radiation techniques have helped treatment of lung cancers.

One such innovation is the Radiosurgery- Cyberknife  technique. Little known in india, it is an advanced method of robotic radiosurgery for lung tumors, whether primary and early stage, recurrent, or secondary, central or peripheral. The technology delivers high doses of radiation  exposure and side effects as compared to traditional radiotherapy procedures.

Because of their anatomical location, lung tumors “move a lot” with respiration. The new technique’s image guidance capability, coupled with software that predicts the tumor’s location according  to the respiratory cycle, allows for a correction of the radiation beam during the sessions, unlike other image guided conventional radiation techniques.

Compared to invasive surgical methods, the healing process involves fewer complications. The system’s advanced technology enables treatment to be tailored for the needs of the individual.

Early detection is the best defence against cancer. According to the National Cancer Registry Project, India, more than 60 per cent of patients are diagnosed late due to poor awareness of symptoms.

 Symptoms :

Chronic cough

Abnormal shortness of breath

Repeated lung infections

Coughing up blood

Change in voice

Persistent thoracic pain and

Permanent swelling of neck and face.

Lung cancer can also manifest through general symptoms such as fatigue, weight loss, prolonged fever, headache, nervous disorders, progressive swelling of fingers.

 Causes :

Chronic exposure to tobacco smoke, including passive smoking.

Other risk factors include occupational hazards, exposure to contaminated drinking water, breathing polluted air and a family history of the diseases.

Thanks,

TheHindu- Well Being,

03/02/2013