Lung cancer: Is surgery a treatment option for everyone?

The mortality rate due to lung cancer is increasing and one reason for this is a late diagnosis. "The survival in breast cancer patients is much higher than lung cancer because they are often diagnosed early, slow growing and treated effectively, whereas lung cancer is usually diagnosed late and it's a rapidly spreading tumour that leads to high fatality ratio," says Dr Arvind Kumar, Director, Inst. of Robotic Surgery, Sir Ganga Ram Hospital, New Delhi.

However, once the cancer is detected treating it the right way becomes utmost important. Lung cancer is typically categorized into four stages: stage 1 and 2 are where the disease is still confined within the lungs, stage 3 where it spreads from lungs to the glands within the chest and stage 4 where it is spread beyond the lungs to other organs like opposite lung, or brain, or bone etc.

"The best way to treat lung cancer is to do a surgery to remove the diseased part and then offer other forms of therapy -- chemo and radiation. The basis of surgical treatment in lung cancer is that you should be able to reset the entire disease in toto. There is a term called debulking, in which you do not remove a whole tumour, but you remove part of a tumour as it leads to increase survival rate and follow it up with chemo or radiation. But debulking doesn't lead to increased survival every time. So we need to select a patient carefully. We offer surgery for people who suffer from stage 1 and 2 and in select cases stage 3 of the disease," says Dr Kumar.

He further adds, "The paradox in lung cancer is that although it's increasing and it is killing more and more people it is one of those cancers which is 100% preventable. In the past, it was said that it occurs only because of smoking but today may be pollution is also adding to it, or replacing it. If we can take care of smoking and population, so if we can go back to the era where there was no smoking and pollution there was no lung cancer at that time. Thus lung cancer is preventable, but achieving this will remain a distant dream, as I don't think we will be able to eradicate smoking or eradicate pollution." So he suggests that the screening for lung cancer should be done as early as possible so it is not detected in stage 4, where surgery is not an option to treat the same.

"For people who had been smoking for around 30 years a low dose of CT scan can help to detect nodules or cancerous growth in the lungs. The earlier it is detected the better as a surgery can be offered to such patients, which ensures better survival rates," says Dr Kumar.

Image source: Shutterstock