Lung Cancer Treatment in India - Are you aware that it is the leading cause of cancer death in the world?
The high incidence of lung cancer and the poor survival rate make lung cancer a very important public health problem, and the leading cause of cancer death in the world. Most patients have locally advanced lung cancer at the time of diagnosis. As per the Madras Metropolitan Tumour Registry (MMTR) Chennai, in 2006-2008, cancer of the lung was the most common among males, and was ranked among the top ten in females.
Lung cancers are classified into:
Spread can occur along bronchus into lung parenchyma, to mediastinum or pleura causing pleural effusion. Diaphragm and chest wall involvement are not uncommon. 50 per cent have nodal metastasis at resection. Distant spread commonly involves adrenals to 50 per cent, liver to 30 percent, apart from brain, bone opposite lung, pericardium and kidneys.
Cough, weight loss, chest pain, shortness of breath, blood in the sputum, superior vena cava syndrome, ulnar nerve and Horner's syndrome (Pancoast tumour) are common symptoms of lung cancer.
Screening for lung cancer
At present, screening for early detection of lung cancer is not recommended, probably because of the failure of early studies to demonstrate any mortality reduction from lung cancer evaluation based on sputum cytology and/or chest radiography. With the introduction of helical computerised tomography, a new imaging modality that can detect nodules as small as a few millimetres, the potential benefits of lung cancer screening is being re-examined.
Imaging in lung cancer
Clinical and radiological findings should guide the diagnostic approach, depending on the size and location of the tumour, the presence of metastatic disease, and the clinical status of the patient. Diagnostic and staging work is taken up concomitantly.
Sputum cytology, flexible bronchoscopy for biopsies, brushings and washings, CT guided transthoracic needle aspiration, oesophageal endoscopic ultrasound guided fine needle aspiration/trucut biopsy of the mediastinal nodes, anterior mediastinoscopy to assess lymph nodes, are the aids used to establish the histopathological diagnosis. Distant metastatic sites need to be documented with microscopic diagnosis.
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