Lung Cancer has the most common Cancer related and tobacco related mortality worldwide (1.38 million patients i.e 18.2 % of the total cancer death). It is also one of the commonest cancers in Males in developing countries so much that it is going to be an epidemic of Lung cancer in near future. However there has been advancements in medical science right from the preventive strategies to therapeutic strategies which bring a ray of hope in such a dismal scenario.
Preventive strategies in lung cancer: India is home to the world's second largest number of tobacco users (around 275 million). The Government of India had last year set a target of reducing tobacco use by 20 per cent by 2020 and 30 per cent by 2025.Initiatives like increase in size of warning pictures on cigarette packaging and launch of Mobile app support to Quit tobacco have been important initiatives by the health ministry.
A study of low dose CT scan carried out as a screening program in smokers did show some benefit of catching lung cancer early but in Indian scenario where tuberculosis is prevalent the relevance of such a screening practice becomes challenging.
Advancements in therapeutic strategies :
The core advancement is in understanding the whole of cancer genome either by obtaining the cancer tissue bit by a conventional biopsy or by drawing patient’s blood and analyzing the cancer cells in the same (liquid biopsy).
Better understanding regarding genetic changes in cancer cells has led to the development and introduction of medicines known as “targeted therapy”. Though these drugs are used to treat lung cancer, they work differently than the traditional “chemotherapy” agents. Targeted therapy causes disruption of the process of carcinogenesis i.e. conversion of normal cell to cancer cell.
The major advantage of the targeted therapy is their ability to act more specifically on cancer cells resulting in lesser risk of damage to the normal cells. Targeted therapy helps to prevent growth and spread of the cancer cells. The examples of targeted therapy include enzyme inhibitors (e.g. tyrosine kinase inhibitors, mTOR inhibitors), apoptosis inducing agents which causes cancer cells to die due to change in the protein of the cancer cells and angiogenesis inhibitors which inhibits the process of formation of new blood vessels in the tumor and stops the blood supply to the tumor resulting in death of cancer cells. Many of these agents are taken as a pill and therefore a patient can continue with his normal lifestyle. Since they have a specific target to act upon these targeted therapies have lesser side effects as compared to chemotherapy and therefore the quality of life during treatment is far better.
Another ray of hope has been Immunotherapy which reactivates patient’s own immune system and have much better effects in treating advance stage lung cancers.
Radiation and surgery are the other two non-pharmacological treatment options for the lung cancer. The choice of treatment is usually decided based on the stage of the cancer and patient’s overall health status.
Thus, with availability of options of radiotherapy, surgery and targeted therapy and Immunotherapy many patients today can be treated without chemotherapy.
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