Common types of lung cancer are-
A, Small cell lung cancer
B, Non-small cell lung cancer

How is lung cancer diagnosed?

A, Imaging which includes Chest X-Ray, CT Scan or PET-CT Whole body which gives us information about staging.
B, Biopsy- Different ways to do biopsy depending on feasibility

• CT Guided.
• Bronchoscopy.
• EBUS-Endobronchial ultrasound-guided.

How to stage Lung cancer?

• Stage I Lung cancer– Treated with surgery in most of the patients with 80% cure rates
• Stage II Lung cancer-Treatment of choice is surgery for this stage also unless patients general condition is poor where options of Radiation and SBRT can be considered. Cure rates are 50% for this stage.
• Stage III lung cancer-Stage 3 lung cancers are treated with radiation and chemotherapy (CCRT) followed by Immunotherapy for 1 year.
• Stage IV ling cancer-Is broadly divided into 2 categories:

A, Driver mutation-negative Lung cancer-Disease can be controlled by targeted therapy. More and more drugs including newer and better-targeted drugs are now available and these drugs can control the disease for some time.
B, Driver mutation-positive lung cancer –If we go a decade back, chemotherapy was the only option and survival for such patients was 1 year but now with the advent of Immunotherapy treatment of stage 4 lung cancer has changed and we see long term survivors which were never seen before.
Lung cancer is not a single disease or entity so we need multidisciplinary management which consists of Medical oncologists, Radiation oncologists, and surgical oncologists.
By giving more chemotherapy to patients does not increase survival. We need to look at biomarkers that can guide us and predict response to a particular treatment.

Types of Treatment for Lung cancer?

Lung cancer is treated in several ways, depending on the type of lung cancer and how far it has spread. People with non-small cell lung cancer can be treated with surgery, chemotherapy, radiation therapy, targeted therapy, or a combination of these treatments. People with small cell lung cancer are usually treated with radiation therapy and chemotherapy.
Surgery. An operation where doctors cut out cancer tissue.
Chemotherapy. Using special medicines to shrink or kill cancer. The drugs can be pills you take or medicines given in your veins, or sometimes both.
Radiation therapy. Using high-energy rays (similar to X-rays) to kill cancer.
Targeted therapy. Using drugs to block the growth and spread of cancer cells. The drugs can be pills you take or medicines given in your veins.
Doctors from different specialties often work together to treat lung cancer. Pulmonologists are doctors who are experts in diseases of the lungs. Surgeons are doctors who perform operations. Thoracic surgeons specialize in chest, heart, and lung surgery. Medical oncologists are doctors who treat cancer with medicines. Radiation oncologists are doctors who treat cancers with radiation.

What has changed in recent years?

• Better targeted therapies.
• Better supportive care.
• Immunotherapy.
• Better diagnostic modalities.

What is immunotherapy and how does it work in Lung cancer?

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We know cancer cells find a way to trick immune cells into thinking that they are normal cells. This allows them to grow and spread. Immunotherapy activates the body’s own immune system and helps immune cells to recognize the cancer cells and kills them.