Treatment of Lung cancer

Content

1. Types of lung cancer
2. About lung cancer treatment options
3. Surgery
4. Radiation therapy
5. Chemotherapy
6. Immunotherapy
7. Stage 4 lung cancer treatment
8. How to choose the right hospital?
9. Cost of treatment abroad
10. Is it possible to organize treatment abroad yourself?

Lung cancer is a malignant tumor originating from the bronchi epithelial cells. Unfortunately, it’s a very common oncological disease that is diagnosed in about 100 people out of 100,000.

Types of lung cancer

Lung cancer, or, as it is also called, bronchogenic cancer, is a malignant neoplasm of the lungs originating from the epithelial tissue of the bronchi. Depending on the place of formation, lung cancer can be central, peripheral, or mixed.

The major types of lung cancer are distinguished as small cell lung cancer, which is detected in about 13% of patients, and non-small cell lung cancer, detected in about 87% of patients. They are not only different in structure but also in how they’re treated. Mesothelioma is sometimes also considered a form of lung cancer. Mesothelioma develops from the chest inner lining.

Adenocarcinoma is a type of lung cancer (namely, non-small cell lung cancer) originating in cells that produce mucin. It is detected in about 50% of all patients.

Most often, several foci appear on the lung surface at once. Interestingly, such lung cancer is most observed in nonsmokers and women. Squamous cell carcinoma is identified in about 30% of non-small cell cancer cases.

Large cell carcinoma, sometimes called undifferentiated neoplasm, belongs to rare types of lung cancer (about 10% of cases). But, again, sometimes, cancer of several types is present at the same time.

However, it’s a small cell form that’s responsible for terrifying lung cancer statistics. It’s characterized by an advanced progression, early metastasizing, and poor prognosis.

About lung cancer treatment options

Many physicians of various medical specialties are involved in lung cancer treatment. These are surgeons, radiologists, chemotherapists, psychotherapists, specialists in pain therapy, etc.

Lung cancer treatment scheme depends on lung cancer types and biological characteristics, the location of the tumor, the presence or absence of distant metastases, and whether the disease is found for the first time or has relapsed after treatment has already been carried out.

Lung cancer treatment can include several combined treatment options (i.e. combination therapy).

Various lung cancer treatment options, determined by a multidisciplinary team of doctors after confirming the diagnosis of lung cancer, provide either a complete cure or control over the disease (this means that it is possible to restrain the further cancer progression for a certain time). In some cases, doctors use only treatment options for symptoms management, without using methods aimed directly at the destruction of tumor focus. This is the so-called "symptomatic lung cancer treatment".

The cancer treatment options for lung cancer that are often used together in order to improve outcomes are surgery, radiotherapy, chemotherapy, and other specific targeted treatments.

Surgery

Surgery for lung cancer treatment is indicated when the tumor can be excised along with the regional lymph nodes and other affected tissues. Besides, the localization of the process, its type and stage, along with general health condition of the patient and his age are considered.

Depending on listed factors, surgery for lung cancer treatment may be either radical or palliative.

Radical and partly radical lung cancer treatment pursues similar purposes, which is eliminating pathology and achieving remission. On the contrary, palliative therapy is aimed just at relieving the severity of the patient's condition.

In a radical operation, the entire neoplasm is excised, including the primary focus, metastatic lesions, and regional lymph nodes. At the initial stages, a lobectomy is performed (a lung lobe removal).

With a locally advanced process, pneumonectomy is performed, i.e. the entire lung is removed with regional lymph nodes of different groups. Besides, combined operations involving resection of the chest wall, pericardium, diaphragm, esophagus wall, or tracheal bifurcation are possible.

Radiation therapy

Significant technical progress in lung cancer treatment is associated with the introduction of conformal radiation therapy technologies and irradiation with modulation of the beam intensity, under the control of images. The use of PET data combined with images obtained with computed tomography in planning irradiation has improved the quality of many patients' lives. As a result, the role of radiation therapy in the treatment of lung cancer has increased. Considering the localization of the process, radiation therapy was earlier only a palliative method. Now it is used in a number of clinical situations, e.g. localized forms of lung cancer can be treated with stereotactic radiation therapy, where local control is achieved in 90% of patients.

In the case of lung cancer, radiation therapy is used for therapeutic purposes or for relieving symptoms, since short time irradiation reduces bone pain, hemoptysis, and has other favorable effects.

Radiation therapy is the local therapy of choice for cancer treatment if the tumor isn’t resectable for objective medical reasons.

Chemotherapy

Chemotherapy is performed both to decrease the duration of combination therapy and improve the treatment outcomes.

A chemotherapy protocol usually includes a specific cycle quantity. The subtype of lung cancer determines the choice of chemotherapy medications and dosages, as well as the duration of their administration.

Chemotherapy before radiation therapy or surgery helps reduce the tumor volume so that it becomes possible to remove it without difficulties. Chemotherapy before radiation therapy damages undetected malignant cells, which makes the radiation therapy more effective.

A combination of several drugs (polychemotherapy) or monochemotherapy is practiced for lung cancer treatment.

It’s been proved that postoperative chemotherapy might prevent recurrence of the disease, which is especially important for patients with second and third cancer stages.

If it is impossible to remove the neoplasm with surgery, then chemotherapy with subsequent radiotherapy is indicated to patients with stage 3 lung cancer. Chemotherapy is usually the main treatment for stage 4 lung cancer. Radiation therapy alone is used only to manage symptoms in patients with stage 4 lung cancer.

Immunotherapy

Immunotherapy has been introduced into the clinical practice relatively recently. Although many other cancer treatments may be accompanied by severe side effects, immunotherapy is tolerated well, partly thanks to the way it targets abnormal cell growth. Immunotherapy activates a person's immune system and enables it to fight against cancer.

Stage 4 lung cancer treatment

In stage 4 lung cancer, neoplasm of a large size is detected with the affection of distant organs by metastases.

There is an uncontrolled spread of cancer throughout the body. Tumor foci appear in nearby and distant organs. Often, metastases are detected in bones, brain, liver, kidneys, and organs of the abdominal cavity.

Unfortunately, in stage 4 lung cancer, there is usually no question of treating the malignant neoplasm itself. As a rule, palliative lung cancer treatment is performed instead, aimed at alleviating the patient's symptoms and maintaining body functioning. The therapy for stage 4 lung cancer limits the spread of cancerous process, slows down tumor growth, prevents complications, and prevents cachexia.

Chemotherapy for stage 4 lung cancer is indicated for any type of the neoplasm. Up to six cycles of chemotherapy are performed in patients with stage 4 lung cancer.

To reduce the pain and other stage 4 lung cancer manifestations, palliative radiation therapy is carried out. If metastases affect the pleura, resulting in pleurisy, thoracocentesis is indicated, during which excess fluid is pumped out.

How to choose the right hospital?

In regard to oncology treatment, it’s essential to get help of experienced specialists. Much is influenced by the correct choice of the lung cancer treatment tactics. For this to happen, it's important to select the best hospital for treatment among specialized hospitals.

Compared to many hospitals outside the EU, European hospitals are known for:

• Ultra-precise diagnostic methods and excellent training of the specialists.
• Regular monitoring of the response of the neoplasm to the cancer treatment, which allows clinicians of the European hospitals to adjust the treatment regimen, adding more effective methods, which, in turn, ensures a high percentage of patient survival.
• Well-coordinated and well-organized work of a medical team consisting of highly qualified experienced specialists in various fields: diagnosticians, radiologists, scientists, surgeons at the hospitals. This cooperation ensures the most effective treatment.
• Sparing and least traumatic technologies for oncology treatment are used in the European hospitals.
• The exclusive usage of high-quality medications. In foreign hospitals, prescribing generics, which are considered the cheaper analogs of expensive medications, is avoided.
• Individual approach to each case.

In addition, the latest technology in European hospitals improves the cancer prognosis even in patients with advanced cancer stages. The same applies to timely diagnosis making and the initiation of treatment abroad. When the tumor hasn’t metastasized yet, the recovery rate reaches 80%. At the same time, lung cancer is thought to be one of the most potentially preventable tumors.

Cost of treatment abroad

Prices for diagnostic measures or conservative lung cancer treatment in the hospitals abroad are calculated individually, since they depend on the stage of the disease, the histological type, molecular and genetic characteristics of the neoplasm, the volume of surgery, and subsequent cancer treatment.

Lung cancer treatment abroad always requires high-tech therapeutic techniques and expensive medicines, so the cost of treatment doesn’t differ significantly in different countries.

• The cost of treatment with extended pneumonectomy starts at 29,101 EUR
• The minimal price for treatment with segmental resection is 21,583 EUR
• The minimal price for treatment with da Vinci lobectomy is 28,510 EUR
• The cost of treatment with chemotherapy starts at 2,265 EUR
• The minimal price for treatment with embolization is 8,170 EUR

If you’d like to know more about lung cancer treatment costs or about lung cancer treatment in European hospitals, leave a request on the Booking Health website.

Is it possible to organize treatment abroad yourself?

The answer is yes. First, one needs to contact a foreign clinic and make an appointment for a preliminary consultation. Then a visa to enter the country is required, and that’s basically it. Although, there are some things to double-check:

• You must be sure that medical records are translated correctly
• Your request for a visa may be declined
• You must be able to communicate with your doctors in their language 
• You must be able to find another clinic abroad, if any sort of disagreement arises

And there are other little, but extremely troublesome issues related to treatment abroad. 

If you feel like you don’t have the energy to deal with it all, you can always use the option of turning to Booking Health for help. Here’s what Booking Health can assist you in:

• Booking Health provides quality translation of medical documents
• Booking Health facilitates receiving visa, even during the lockdown
• Booking Health negotiates with a hospital for you
• Booking Health provides the services of a personal interpreter 
• Booking Health takes care about accommodation, flight tickets, and transfers
• More importantly, Booking Health provide support throughout the whole period of treatment abroad

Contact Booking Health for more information about lung cancer treatment abroad.

Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed