World Lung Cancer Day Special: Know from the Expert (Part 2)
Published On: August 01, 2020
World Lung Cancer Day: Here are your FAQs, answered by our Expert: Part 2
So, you read from Dr. Udaya Kumar Maiya’s responses in Part 1 of this interview, about the symptoms, causes, and types of lung cancer. We also tried busting some myths with doctor’s help. Let’s now understand how we can manage this critical illness, emotionally, physically, psychologically and financially. Over to the second part of the excerpt: In conversation with the expert on the occasion of World Lung Cancer Day.
Depending on the stage and type, what are the treatment options available in lung cancer management for the patients? How long would it take?
Depending upon the stage of the illness one determines the type of treatment. Commonly, in early stages of lung cancer, surgery and radiation therapy play a predominant role, sometimes followed by chemotherapy. In late stages, chemotherapy plays a major role, with radiation and surgery used as supplementary functions.
Radiation therapy is commonly used for symptom control in late stages, to treat disease spread to bone and brain. Of late, in addition to chemotherapy, targeted therapy using new molecules is used, such as Tyrosine Kinase Inhibitors and mono-clonal antibodies.
There are a host of other less commonly used treatment modalities like radio frequency ablative techniques, immunotherapy, etc.
Typically, a full primary treatment of lung cancer may take about 6 months or more, with surgery, radiation and periodic chemotherapy.
What are some of the medical advancements that are available now in India as well as globally to treat lung cancer?
There have been numerous advances in the management of lung cancer across all specialities. These new treatments are revolutionary as they improve the accuracy of therapy and its outcomes, and reduce treatment side effects. There have been very gratifying results with the use of these new treatments, along with improved compliance and outcomes for this dreaded disease.
In surgery, the use of minimal invasive techniques like VATS (Video Assisted Thoracic Surgery) have been successfully adopted.
In Radiotherapy, accuracy using Intensity Modulated Treatment (IMRT), Image Guided Radiation (IGRT), Gating techniques (to offset lung movement due to breathing during radiation) have all contributed significantly.
In medical oncology, treatments with chemotherapy using newer molecules, use of Tyrosine Kinase Inhibitors and mono-clonal antibodies have contributed to better outcomes and reduction of side effects. Immunotherapy is also poised to take off as a success in lung cancer.
Are there any side effects of these treatments and how patients can adapt to it, say, by making some lifestyle and dietary changes or any other?
All cancer therapies unfortunately have some degree of side effects. As mentioned earlier, with newer techniques, we have, to a great extent, reduced the quantum of treatment induced morbidity, some still exist.
Patients generally do well in tolerating treatment by adhering to instructions given by their treatment team. These include:
Proper medication adherence
Undergoing counselling for a positive frame of mind
Yoga, meditation and respiratory exercises
How to minimise the chances, the risk of getting lung cancer?
Don’t smoke. Smoking causes lung cancer. Quit the habit if you smoke. Avoid secondhand smoke. Smoke from other people’s cigarettes, cigars, or pipes is called secondhand smoke. Make your home, workplace and car smoke-free.
Be careful at work. Health and safety guidelines in the workplace can help workers avoid carcinogens—things that can cause cancer. Special precautions for factory workers, chemical handlers, shop floor staff, etc should be taken.
Lead a healthy life: good nutrition, adequate rest, good exercise and mental peace can all make a world of difference to your health.
Have well-ventilated homes. Use air filters if necessary.
What are the different tests available for diagnosis?
There is a whole gamut of tests available for diagnosis of lung cancer. Chest X-rays, CT scans, MRI scans and PET CT scans give doctors radiological evidence of the anatomical location, size and extent of disease. Biopsy, Fine needle aspiration cytology, Sputum cytology, will give us histological evidence about lung cancer and its sub typing. Bronchoscopy, Mediastinoscopy and Thoracoscopy will help actually look at the disease in the chest and lungs and for taking biopsies. Pulmonary Function Tests (PFT) are lung function assessments to quantify the health of the lung. This is useful to find out for example, the capacity of the lungs to withstand treatment or assess the benefits of treatments.
Molecular tests for gene changes:
In some cases, doctors may look for specific gene changes in the cancer cells that could mean certain targeted drugs might help treat the cancer. For example:
EGFR (Epidermal Growth Factor Receptor), KRAS and ALK, ROS1, RET, BRAF and MET gene tests. These molecular tests can be done on tissue taken during a biopsy or surgery for lung cancer.
Cancer in itself is a disease dreaded by one and all. It puts emotional, physical, psychological and needless to say, financial strain on everyone battling the condition. To top it all, what do you think is the biggest challenge for the patient and the family that's having to deal with lung cancer?
Accepting the diagnosis: it is indeed a traumatic experience for the patient and his/her family. The implications of the diagnosis can have far reaching consequences on the family’s integrity.
Maintaining the mental balance: learning to manage the psychological stress and fears about the illness.
Financial implications: availability and accessibility to resources for undergoing treatments, as also finding a balance between medical costs and day-to-day financial commitments.
Fear of suffering and death: this is ever-present and inevitable. It needs expert handling, effective counselling and stress busting.
Being ostracized at work and neighbourhood: co-workers, supervisors, neighbours, family members etc. may avoid interacting with the patient and his/her family, be over sympathetic, offer unnecessary and overbearing advice, etc. making life even more stressful for the patient and the family.
What can the treatment costs be like in lung cancer? Can you share some thoughts on how a modern, new-age, easy, fast, hassle-free and low-cost healthcare financing option like crowdfunding on ImpactGuru helps such patients when they are in need?
Treatment costs for any cancer, especially lung cancer can be prohibitive. This is even more true if treatments are taken in a private tertiary care hospital where effective and efficient treatments are available but at a cost. Insurance cover may be non-existent or meagre to meet continued expenses.
Any system which allows for mitigating the patients’ financial burden will definitely go a long way in his/her physical and mental well-being. Crowdfunding platforms like ImpactGuru will indeed be a boon for many such patients.
Team ImpactGuru thanks Dr. Udaya Kumar Maiya for his insightful responses to the FAQs on Lung Cancer. And to our ImpactGuru Fam, keep following this space for more such enriching conversations with experts from different fields. Till the next blog, if you, your loved one or any one in your circle is in need of funds for treating his or her lung cancer, or any other critical illnesses and medical emergencies, start a fundraiser for them right now on ImpactGuru. Click here to know more.