Lung cancer is one of the most common types of cancer in India, but there are several methods of treatment as well which are used to save many lives. Some of the methods of treatment are:
Surgery is the standard treatment for patients with stage I non-small cell lung cancer (NSCLC). In some cases, chemotherapy may accompany surgery to boost survival chances.
There are many different types of surgeries that can be performed depending on what kind of tumor is present. Types of surgery include lobectomy, pneumonectomy, wedge resection, segmental resection, and subsegmental resection.
A lobectomy involves removing both lung lobes while a pneumonectomy removes all four lungs. Wedge resections remove only 1/4th of a lung lobe at a time, while segmental resections take out a section of one or both lung lobes.
Subsegmental resections remove less than 1/4th of one lung lobe. Lobectomies typically require two to three weeks of hospitalization following surgery and most patients experience pain and difficulty breathing while recovering.
Pneumonectomies may take 4 to 6 weeks to heal and may cause respiratory problems after surgery. Wedges and segmental resections require 2-3 months of recovery before returning home and most patients have no trouble walking afterwards.
Subsegmental pulmonary resections do not normally require hospitalization. Most patients recover fully within a week of surgery and return to their normal activities.
2. Radiation Therapy
Radiation therapy uses high doses of radiation to kill cancer cells. Different techniques and treatments exist for different cancers, including external beam radiotherapy, intracavitary brachytherapy, and stereotactic radiosurgery (SRS).
External beam radiotherapy relies on using a machine outside of the body to send beams of intense radiation directly to the tumor site.
Radiation sources deliver extremely precise doses of radiation to small areas inside the body, killing cancer cells in those spots.
All these therapies work well for certain kinds of cancer, but they can also damage surrounding healthy tissue.
Chemotherapy uses drugs to attack rapidly dividing cancer cells, especially ones that multiply quickly. These drugs are often toxic to the rest of the body’s cells, so proper dosage is critical.
Chemotherapeutic agents are given orally, intravenously, or injected under the skin. They are administered alone or can be combined with other treatments like radiation therapy or surgery.
Commonly used chemotherapeutics include alkylating agents, antimetabolites, anthracyclines, taxanes, epipodophyllotoxins, topoisomerase inhibitors, and vinca alkaloids.
Alkylating agents interfere with DNA replication and transcription. Antimetabolites stop cancer cells from producing substances necessary for their growth. Anthracycline antibiotics inhibit enzymes involved in mitosis.
Taxanes prevent microtubule formation, stopping cells from constructing themselves properly. Epipodophyllotoxin derivatives block the enzyme that controls the breakdown of the tubulin protein.
Topoisomerase inhibitors prevent the cell from uncoiling its chromosomes. Vinca alkaloids disrupt microtubules and stop cells from assembling correctly.
4. Targeted Therapies
Targeted therapies focus specifically on inhibiting or killing cancer cells rather than damaging healthy ones. They target specific molecules called receptors that are expressed on the surface of cancer cells.
Examples of receptor targets are EGFR and HER2 in lung cancer and KRAS in pancreatic cancer. Specific targeted therapies include tyrosine kinase inhibitors (TKIs), monoclonal antibodies, peptide vaccines, antibody-drug conjugates (ADCs), and RNA interference (RNAi) therapies.
Tyrosine Kinase Inhibitors bind to specific proteins known as tyrosine kinases, preventing them from activating other proteins.
Monoclonal antibodies attach to antigens on the surface of cancerous cells and prevent cancer cells from spreading.
Peptide Vaccines bind to cancer antigens and stimulate immune system responses to fight off the disease. ADCs consist of monoclonal antibodies attached to toxins or radionuclides that selectively travel to and kill cancer cells.
Finally, RNAi therapies use short strands of RNA to silence genes responsible for causing cancer.
5. Hormonal Therapies
Hormone therapies help control cancer by either suppressing the production of hormones in the body or blocking hormone receptors found on cancer cells.
Progestin contraceptives like synthetic estrogen and progesterone act as anti-cancer medications by suppressing ovulation and menstruation.
Tamoxifen blocks estrogen receptors on breast cancer cells. Raloxifene prevents breast cancer by acting as an antioxidant. LHRH agonists suppress testosterone production, while aromatase inhibitors like letrozole reduce estrogen.
Gonadotropin releasing hormone antagonists decrease testosterone production and gonadotropin synthesis. Abiraterone decreases androgen production and acts as an anti-androgen.
Flutamide suppresses estrogen production and works as an antagonist. Medroxyprogesterone inhibits progesterone receptor expression, which stops precancerous cells from multiplying.
Lung Cancer Treatment Cost: $12,000 – $50,000
The average cost of lung cancer treatment varies between $12,000-$50,000. In addition to the initial costs associated with diagnosis and surgery, patients may have to pay additional costs for drugs, radiation therapy, hospitalization, medical equipment, and supportive care after their treatments end.
These amounts do not represent how much insurance companies or Medicare or Medicaid cover, but rather what it would cost out-of-pocket without any coverage at all.
Treatment Costs depends on various factors:
Inpatient treatment: If necessary, patients who need chemotherapy, radiation therapy, and/or palliative care may require stays in the hospital.
Hospital stays vary from 1 day to several weeks depending on the type of treatment and are billed directly to the patient’s insurance company. Patients may also have to stay overnight if they receive chemotherapy and/or radiation therapy.
Radiation therapy: Radiation oncologists use either external beam radiotherapy machines or radioactive seeds (brachytherapy) to deliver targeted doses of high-energy x-rays to tumors.
External beam radiotherapy takes place outside the body, while brachytherapy uses implanted seeds to deliver therapeutic doses of radiation deep inside the human body. Most patients receive both types of therapies.
Chemotherapy utilizes drugs to treat cancer cells. There are two basic categories of chemotherapies: cytotoxic agents and targeted agents.
Cytotoxic agents kill cancer cells indiscriminately, whereas targeted agents target specific molecules that drive tumor growth. Targeted agents often block a specific gene mutation or protein involved in cancer cell growth.
Palliative care is designed to relieve symptoms and improve quality of life for people with serious illnesses, including cancers.
People who receive palliative care may experience less pain, nausea, anxiety, depression, shortness of breath, fatigue, decreased appetite, and insomnia.
Outpatients frequently visit the doctor’s office, where a nurse practitioner might administer intravenous medications or injections; this service is billed directly to the patient’s insurance plan.
Medical tests, consultations, and follow-up visits are performed outside the hospital, so these services are generally not covered under insurance plans, and patients may incur out-of-pocket expenses.
Home Health Aides:
Home health aides help patients manage various daily activities and provide companionship, such as bathing, dressing, eating, toileting, and transferring from bed to wheelchair.
They also teach patients to manage their own medication and assist them with home safety issues, such as locking doors. Home health aides are commonly paid hourly wages and bill directly to the patient ‘s insurance carrier.
Follow-up visits ensure that cancer has been treated effectively and safely, and monitor for potential side effects.
Aftercare appointments occur regularly for months or years following active treatment, and may involve physical exams, blood work, imaging studies, and psychological assessments.
Medications are a huge expense for many cancer patients.
Even though some medications are covered by insurance, there are still copays or coinsurance fees. Drugs used for palliative care may incur co-pays or deductibles.
Supportive Care: Supportive care is tailored to meet the individual needs of each person with cancer. It includes counseling, financial planning, and information about community resources.
Supportive care does not cure cancer, and should always be discussed with a physician.
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