Lung Cancer Treatment in India - Symptoms, Stages & Costs in India

Cancer is a disease caused when the normal cells become abnormal due to a mutation in the genetic material (DNA) present in those cells. There are many types of cancer named by the location or an organ of the body where it starts from. For example, if the cancer has developed in the prostate gland or breast, we call it prostate cancer and breast cancer respectively. Similarly, when cancer develops in the lungs, we call it lung cancer.

The cancer that starts in the lungs is known as primary lung cancer. However, sometimes the cancer begins from any other part of the body and then spreads to the lungs. If this is the case then it is known as secondary lung cancer or metastatic cancer in the lungs. Lung cancer is the second most common cancer worldwide. It is the leading cause of cancer death all around the globe. Studies show that there were 2.2 million new lung cancer cases reported in the year 2020. It is more common in men as compared to women.

In Africa, lung cancer is the 5th leading cause of death. About 1.1 million new lung cancer cases were reported in Africa in the year 2020. The studies show that, if proper action is not taken, then the cases of lung cancer in Africa will rise to 2.1 million cases with 1.4 million deaths by the year 2040. African countries like Ghana have reported that the cancer of the lungs is the 3rd most common cancer in men and Ethiopia has an incidence rate of 1.9%.

With the increasing cases of lung cancer, the diagnostic and therapeutic facilities and resources are inadequate in many African countries making it difficult to provide the medical care that the people need. In addition, there is a shortage of healthcare providers in these countries due to a lack of proper training for healthcare providers and low patient awareness.

It is due to this reason that many African lung cancer patients decide to travel to other countries for the proper diagnosis and treatment options. Medical care in developed countries is costly. On top of that, the travel and stay costs are also added making it highly unaffordable to receive the medical care in these countries.

However, in India, the treatment cost along with the travel and stay costs can be covered with just a fraction of the cost of only the treatment in developed countries. That is why, anyone can get a super affordable option to get medical care from India. In addition, the quality of healthcare service in India is world-class with the most experienced and skilled healthcare providers. The Indian hospitals have the latest technology and state-of-the-art infrastructure which makes it a luxurious treatment experience at a meager cost.

Types of Lung Cancer

Actually, there are many types of cancer that affect the lungs. We call all of them lung cancer because it is easier to pronounce and understand. There are two main types of lung cancer which are again of different types. The different lung cancer types are listed below.

1. Small Cell Lung Cancer (SCLC):

The SCLC is a type of cancer that grows faster and is often harder to treat as compared to other lung cancer types. It mostly affects the people who smoke a lot. Small cell lung cancers are also sometimes known as neuroendocrine tumors which occur in the neuroendocrine system. The origin of the SCLC is neuroendocrine cells that are present in the lungs.

2. Non-Small Cell Lung Cancer (NSCLC):

The NSCLC is the most common type of cancer of the lungs. About 80% of people diagnosed with lung cancer have this type. It is further divided into three types.

• Adenocarcinoma: It is a cancer that starts from the mucus glands that are made up of epithelial cells in the lungs. It is more common in women than in men.
• Squamous Cell Carcinoma: It is a cancer that starts from the flat cells known as squamous cells that are present at the inside of the lungs. It affects the main bronchus (airways) of the lungs in the central part.
• Large Cell Undifferentiated Carcinoma: It is a cancer that spreads quickly and is harder to treat. It can occur in any part of the lungs.
• Large Cell Neuroendocrine Carcinoma (LCNEC): It is actually a subtype of a large cell carcinoma which is a lot similar to small cell lung cancer (SCLC).
• Besides these, there are some other rare subtypes of NSCLC which are Adenosquamous Carcinoma and Sarcomatoid.

3. Some other lung cancer types:

There are some other uncommon cancers related to the lungs. These are very rare but still possible to get one. These cancers include Adenoid Cystic Carcinomas, Lung Carcinoid Tumors, Lymphomas, Sarcomas, Hamartomas, etc. Some of the cancers are not really a cancer that starts in the lungs. There are many cancers that start in the other organs such as the Breast, Kidney, Pancreas, Skin, etc. Then, they spread to the other different organs one of them being the lungs. These are known as metastatic cancer to the lungs or secondary lung cancer.

Lung Cancer Stages

Most cancers have different stages according to the size of the tumor It forms and whether it has spread to other parts of the body such as the surrounding tissues, the lymph nodes, bone marrow, the liver, etc. Based on this, the different stages of lung cancer are as follows.

• Stage 0 lung cancer: If the cancer is only present in the lungs and has not spread to other parts or outside the lungs then it is at stage 0.
• Stage 1 lung cancer: When the cancer starts to spread outside of the lungs, it is stage 1 of lung cancer.
• Stage 2 lung cancer: In this stage, the cancer has formed tumors in only one lobe of the lung and it may have spread to the lymph nodes.
• Stage 3 lung cancer: In this stage, the cancer has formed tumors in different lobes of the same lung and it may also have spread to the lymph nodes.
• Stage 4 lung cancer: When the cancer has spread to the other lung or the fluid present around the lungs, heart, or other organs, it is known as stage 4 lung cancer.

Lung Cancer Symptoms

Sometimes, lung cancer does not cause any symptoms unless a chest X-ray is done to visualize the lungs. But if you have the following symptoms, it is recommended that you get a chest X-ray done after consulting with your doctor. Following are the common lung cancer symptoms listed below.

• Worsening cough
• Blood in the sputum
• Loss of appetite
• Unexplained weight loss
• Fatigue
• Trouble while swallowing
• Swelling in the neck or the face
• Phlegm or blood in a cough
• Breathlessness
• You may also easily catch respiratory infections like pneumonia or bronchitis.

If the cancer spreads from the lungs to the different other organs of the body, then you may have some additional symptoms at the site where the cancer has spread. For example,

• Whether the cancer has spread to the lymph nodes, then you will see the lumps in the neck or the collarbone
• If it has spread to the bones then you will have pain in the bones, hips, ribs, etc.
• If the cancer has spread to the brain or the spine, then you might experience balancing problems, headache, dizziness, and numbness in the body.
• If it spreads to the liver, then you will notice that your skin is becoming pale and yellow (jaundice-type symptoms).

Causes of Lung Cancer

The normal cells have a limited lifespan. Once their role in the body is over, they become senescent (stop dividing) and then they die (apoptosis). But when the cell becomes cancerous, the cells keep on dividing and they don’t die either. This happens when there is a mutation (change) in the DNA (genetic material) of the cell. Hence, the cancer cells are the normal cells that have changed DNA (mutated DNA) that keeps the cell multiplying.

These cancer cells can travel in the body through the blood or the lymph nodes and then establish in the other organs of the body. The exact reason why some people get lung cancer disease while some people don’t is not yet known. However, it is reported that people who have a habit of smoking and consuming tobacco products have a higher risk of damaging the DNA of the cells and causing lung cancer. About 70% of lung cancer is caused by smoking. Some of the other factors that can cause lung cancer are listed below.

• Exposure to second hand tobacco smoke.
• Exposure to harmful substances like radon, asbestos, air pollution, diesel exhaust, uranium, coal products, silica, etc.
• Previous exposure to radiation such as treatment for breast cancer, etc.
• A family history of cancer related to the lungs.

Diagnosing Lung Cancer

The first step your doctor does after diagnosing you with lung cancer is to determine the starting point of the cancer. A lot of times it happens that the cancer has started in the lymph nodes but then it spreads to the lungs. In this case, the cancer is still known as lymphoma (cancer of the lymph nodes). Only if the cancer starts in the lungs and spreads to other parts of the body, it is known as lung cancer.

As you tell them about your symptoms to your doctor, he/she may also take into consideration your medical history, family history, your overall health, etc. First, your doctor will do a physical exam and then recommend some tests to confirm cancer and the extent of cancer. There are many tests available to diagnose cancer. Following are the diagnostic tests that can help your doctor diagnose cancer and plan your treatment.

■ Imaging tests:

Imaging tests such as Ultrasound, CT Scan, MRI Scan, PET Scan, Bone Scan, etc. are used to see where the cancer cells are present and whether they have spread to the other body parts or not. These tests create images of the internal organs of the body. The doctor uses these images to visualize any abnormalities and damages present in particular organs. While some of these imaging techniques show normal images, a few show a detailed view. Some can even create a 3D view of the organs.

■ Bone Scan:

In this method, the substance known as a tracer is injected into the veins of a patient. It will get collected in the different areas of the bone. A special camera is used to visualize the tracer. The normal and healthy bones appear lighter in the camera whereas the damaged or injured bones will appear different. They stand out when visualized in the camera.

■ Biopsy:

The biopsy requires a small tissue sample of the affected area to examine under the microscope. After taking the sample of the patient’s affected organ, it is sent to the laboratory for testing. The pathologist visualizes the sample under the microscope and differentiates the cancerous and normal cells.

■ Bronchoscopy:

This diagnostic method is performed by experts known as a pulmonologist. The Pulmonologists are the doctors who are lung specialists. To perform this test, the pulmonologist first passes a flexible, thin tube that has an attached light from the patient’s mouth and moves it to the lungs through the windpipe. The tube helps the doctor in viewing the internal parts of the patient’s lungs. It can also be used to collect samples of the lung tissue or the fluids that can be further sent to the lab for testing.

■ Thoracoscopy:

It is a procedure that requires the patient to be asleep during the procedure. Once the patient is asleep, the surgeon makes a small cut/incision on the chest and inserts a medical instrument through this cut to examine the internal organs of the chest. This procedure can also be called a video-assisted thoracoscopy or a robotic-assisted thoracoscopy depending upon the approach used to perform this procedure.

■ Needle Aspiration Biopsy:

This procedure is performed by specialists known as interventional radiologists. The radiologist will use either a CT scan or a special X-ray machine which is known as a fluoroscope. It helps visualize the chest and guides the needle to collect the sample of the infected area. This sample will be sent to the laboratory for testing to check the presence of abnormal cells.

■ Mediastinoscopy:

This is a procedure used to take a sample of the lymph nodes that are present underneath the breastbone at the center of the chest. To perform this procedure, the patient will be given general anesthesia first. After that, the surgeon will make an incision on the chest on top of the breastbone and collect the tissue sample. Then, the sample is sent to the laboratory for further testing.

■ Thoracotomy:

This is a surgical procedure where the surgeon directly visualizes the lungs by making an incision on the chest. This procedure can be done for the diagnosis as well as surgery to remove the lung. During this procedure, the samples of the lungs and other organs are also taken for testing in the laboratory.

■ Sputum Cytology:

In this procedure, your sputum, or the mucus that comes from the lungs when you cough is collected and then tested in the laboratory. It is the most used method to find out the presence of cancer in the main airways of the lungs such as squamous cell lung cancer.

■ Thoracentesis:

This is a procedure in which the doctor will collect the fluid present between the lungs and the chest wall. This is done by numbing the skin on the chest, then inserting a needle through the chest wall and up to the space between the chest wall and the lungs.

■ Biomarker testing:

Also known as genetic testing or molecular testing. In this test, the genetic material of the tumor cells is examined to identify the specific proteins, genes, and other components of the tumor. These components are specific to the cancer cells only and absent in the normal cells. Hence, it is easy to differentiate the two of them.

■ Liquid Biopsy:

The liquid biopsy is a kind of blood test in which the specific DNA known as circulating tumor DNA is looked for. Sometimes, the cancer cells break down and they are released into the bloodstream. With the liquid biopsy, we can detect these small pieces of circulating tumor DNA.

Besides all the mentioned diagnostic tests, there are many other tests for the diagnosis of lung cancer such as a navigational bronchoscopy, robotic bronchoscopy, autofluorescence bronchoscopy, core biopsy, endoscopic esophageal ultrasound, and blood tests like CBC Count, Blood Chemistry Test, etc. Your doctor will recommend diagnostic tests for you depending on your symptoms.

Treatments for the Lung Cancer in India

There are many types of treatment options for lung cancer in India. Based on the diagnosis, your doctor will recommend the best treatment approach to you. If the severity of your cancer condition is low then the lighter treatment method will be used. However, if the cancer has damaged a major portion of the lungs then surgery is needed to remove the lungs from the body. The different types of cancer treatments are listed below.

■ Chemotherapy:

This is a treatment approach that uses anti-cancer drugs with the aim of destroying the cancer cells without causing major damage to the normal and healthy cells. This drug stops the cancer cells from multiplying rapidly and then kills them. In many cases, chemotherapy can be combined with radiotherapy or surgery. The chemotherapy may be given to the patient before or after the surgery.

■ Radiation therapy:

This treatment procedure uses radiation (high energy beams) to attack the cancer cells and destroy them. Doing this will shrink the tumors. There are many new approaches available for radiation therapy in India. These new approaches are IMRT (Intensity Modulated Radiotherapy), IGRT (Image Guided Radiotherapy), GRT (Gated Radiation Therapy), etc. The new approaches make sure that the tumor receives the maximum radiation while protecting the normal tissues and organs from the adverse effects of the radiation.

■ Targeted therapy:

Targeted therapy is a drug-mediated therapy. It targets the proteins and the components specific to the cancer cells. These components and proteins are only present in the cancer cells and the normal, healthy cells don’t have these components. These drugs identify the proteins and the chemicals/components present in the cancer cells and then attack to destroy these cancer cells.

■ Immunotherapy:

Immunotherapy is a treatment that strengthens our immune system to fight against cancer cells and destroy them. Our immune system is designed in a way that it detects any unusual activity or presence in the body and destroys it. But when the cells in the body become cancerous, they hide from the immune cells to protect themselves.

■ Surgery:

If the cancer has damaged the major portion of the lungs and it has not spread to any other organs in the body then the best option is to remove the affected lung before it spreads the cancer to the surrounding tissues, lymph nodes, or any other organ of the body. On the basis of what portion of the lungs is removed, the surgery is of different types which are listed below.

■ Lobectomy:

It is the most commonly performed surgery for lung cancer. It involves removing the affected portion of the lungs.

■ Pneumonectomy:

It is a surgical procedure used to remove the whole lung (the body has two lungs on either side of the body, in this procedure, the side of the lung that has developed lungs is removed).

■ Sleeve Resection:

It is a tricky surgical procedure where only the affected portions of the lungs are removed. The unaffected portion of the lung is kept as it is. This procedure is used when we want to preserve as much of the lungs as possible.

■ Segmented Lung Resection:

This is a surgical procedure that is used to remove either the part of the lung’s lobe or the segment of the lungs. Many times, this procedure is also used to extract the tissue sample for testing the tumor or the cancerous tissue in the laboratory.

■ Chest Wall Resection:

This procedure is used to remove the lung cancer that has spread to the nearby tissues like the chest muscles and the ribs. The cavity that is created in the chest after this procedure is then filled with muscles and flesh along with prosthetic material like bone cement, mesh, or titanium implants.

The surgery is performed by placing the patient under general anesthesia so that the patient is unconscious during the surgery so that they don’t feel pain.

Recovery After the Treatment of Lung Cancer

After the successful treatment of lung cancer, you will have to visit the hospital for regular checkups every 2 to 3 times a year for at least 2 years to 5 years depending on the severity of your condition and your overall health. During these visits, your doctor makes sure that the cancer is not reoccurring with some imaging tests or lab tests like Blood tests, CT Scans, etc. If you have any symptoms that you think are a possible side effect of the treatment, talk to your doctor during these after-treatment appointments.

Right after the surgery, you will be taken to the recovery room to monitor your heart rate, breathing, and blood pressure. After the effect of anesthesia wears off, you will see that there are some tubes and drains attached to you.

You will feel a little discomfort and pain after the surgery for a few days. It is manageable with the medicines that your doctor will prescribe. When you are discharged from the hospital, your doctor will give you some guidelines to follow. It also gives you instructions to take care of the incision site (surgical wound). You will need to eat light food for a few days and then you can start eating regular food as you heal.

Your doctor will give you follow-up appointment dates and discuss every detail with you before you take a leave from the hospital. The rest is important for the initial days after the surgery. However, try to move a little to keep the body active and maintain blood circulation in the body. Little walking is good for the body for the initial days. Once you fully recover you can return to your daily activities, work, regular food, etc.

Cost of Treatment for Lung Cancer in India

On an average, the cost of lung cancer treatment in India can range from 4784.04 USD to 8372.08 USD. The same treatment in the USA can cost about 68,300 USD and in the UK it can cost about 15,000 USD. The average costs of different types of treatment for lung cancer in India are listed below.

• Chemotherapy for lung cancer in India: 300 USD to 1,000 USD per cycle.
• Radiation Therapy for lung cancer in India: 3,800 USD to 5,800 USD.
• Immunotherapy for lung cancer in India: 1794.02 USD to 5382.05 USD.
• Targeted Therapy for lung cancer in India: 1794.02 USD to 3588.03 USD.
• Surgery for lung cancer in India: 2,700 USD to 15,000 USD.

The cost of the treatment is so low that it is most affordable for the patients visiting from low-middle income countries as the total cost of lung cancer treatment in India is just a fraction of only the cost of treatment in high-income countries. If any patient requires Lung Transplant, the average cost will be USD 65,000. Know more about Lung Transplant in India.

Conclusion

Lung cancer is one of the most common cancers worldwide and it is the 5th leading cause of death in African countries. Due to insufficient diagnostic and therapeutic services in their healthcare system, most people are unable to receive the correct and early diagnosis, which results in delayed and many times wrong treatment. Due to this, a lot of African patients decide to travel to other countries seeking the correct diagnosis and treatment protocols.

The treatment for lung cancer is highly expensive in high-income and developed countries, they cannot afford it because the travel costs and the treatment costs combined are a lot. Whereas, India provides international quality treatments at a very reasonable cost. The cost of treatment in India is much more affordable to them and they can cover the total cost (including travel, treatment, and stay) at just a fraction of the cost of treatment (only treatment) in the developed countries.

Lung Cancer FAQs