Lung Cancer Treatment

How is Lung Cancer Diagnosed?

Lung cancer is diagnosed using a combination of imaging, laboratory tests and tissue examination. A doctor may recommend a chest X-ray or CT scan after reviewing symptoms and medical history. If a suspicious area is found, a biopsy may be performed using bronchoscopy, a needle or another procedure to obtain tissue for examination. The biopsy helps determine the type of lung cancer.

Additional scans such as PET-CT or MRI may be used to assess whether the cancer has spread. Molecular and biomarker testing may also be performed to identify genetic changes that could make targeted therapy or immunotherapy appropriate.

Types of Lung Cancer and Their Treatment

Lung cancer is broadly divided into two major types, such as

Lung Cancer Treatment Based on Stage

The treatment approach for lung cancer varies according to the stage and the patient's overall health. The commonly used treatment options at different stages are as follows:

Other Treatments for Lung Cancer

Lung cancer treatment may involve a combination of therapies to control the disease, relieve symptoms and improve outcomes. Depending on the patient's condition, doctors may recommend other treatment approaches for lung cancer, such as:

• Surgery: Surgery removes the cancerous portion of the lung. Depending on the tumour, this may involve removing a small section, a lobe of the lung or, in more extensive cases, an entire lung.

• Radiation Therapy: Radiation uses high-energy beams to destroy cancer cells. It may be used after surgery, alongside other treatments or to control tumours that cannot be removed surgically.

• Chemotherapy: Chemotherapy uses medicines that destroy or slow the growth of rapidly dividing cancer cells. Drugs such as cisplatin, carboplatin, pemetrexed, paclitaxel and etoposide may be used in different combinations depending on the type of lung cancer.

• Targeted Therapy: Targeted medicines are designed to act on specific genetic changes or proteins that help cancer cells grow. Depending on the tumour's test results, treatment may target changes involving EGFR, ALK, ROS1, BRAF, MET, RET, KRAS or other molecular pathways.

• Immunotherapy: Immunotherapy helps the immune system recognise and attack cancer cells. Medicines known as immune checkpoint inhibitors may be used for certain patients with advanced lung cancer and, in some situations, as part of treatment for earlier-stage disease.

• Ablation: In selected patients, techniques such as radiofrequency ablation or other local ablative procedures may be used to destroy tumour tissue, particularly when surgery is not suitable.

• Palliative Procedures: Advanced lung cancer can sometimes cause problems such as airway blockage or fluid around the lungs. Procedures such as airway stenting or drainage of pleural fluid may help relieve symptoms and improve comfort.

• Chemoradiation: Chemoradiation combines chemotherapy and radiation. It may be recommended for certain locally advanced lung cancers when surgery is not appropriate or as part of a planned treatment strategy.

Medications for Lung Cancer Treatment

Several lung cancer medicines are prescribed by oncologists as per the stage of cancer. Common medications may include:

• Chemotherapy: Medicines such as cisplatin, carboplatin, pemetrexed, paclitaxel and etoposide may be used to destroy or slow the growth of cancer cells. The combination depends on the type and stage of lung cancer.

• EGFR Inhibitors: Medicines such as osimertinib, afatinib, erlotinib and gefitinib may be used when testing shows certain EGFR mutations in non-small cell lung cancer (NSCLC).

• ALK Inhibitors: Medicines including alectinib, brigatinib, lorlatinib, crizotinib and ensartinib may be prescribed for advanced NSCLC with an ALK gene rearrangement.

• Anti-Angiogenesis Medicines: Bevacizumab and ramucirumab may be used in selected patients with advanced or metastatic NSCLC. These medicines work by interfering with the formation of new blood vessels that help tumours grow.

• HER2-Directed Medicines: Certain medicines, including trastuzumab deruxtecan and other HER2-directed treatments, may be considered for NSCLC with specific HER2 changes.

• TRK Inhibitors: Larotrectinib, entrectinib and repotrectinib may be used for rare NSCLCs with NTRK gene fusions.

• Antibody-Drug Conjugates (ADCs): Medicines such as fam-trastuzumab deruxtecan, telisotuzumab vedotin and datopotamab deruxtecan combine an antibody that targets cancer cells with a cancer-killing drug and may be used for selected tumours with specific biomarkers.

Note: You should always take proper treatment for cancer on the recommendation of your doctor.

Ayurvedic and Alternative Treatment for Lung Cancer

The following approaches may be used in Ayurveda to help manage symptoms of lung cancer:

• Chyawanprash: Chyawanprash contains ingredients such as Amla and is used as a rejuvenating formulation. Its antioxidant content may support overall health and help maintain energy and general well-being during periods of illness or recovery.

• Triphala: Triphala is prepared using Amalaki, Bibhitaki and Haritaki. It is commonly used to support digestion and bowel health and may help maintain overall digestive well-being while a person is undergoing cancer treatment.

• Guggulu Preparations: Guggulu preparations like Kanchanar Guggulu and Triphala Guggulu are common in Ayurvedic care because of their anti-inflammatory and supportive effects. People often use them as part of a larger plan to help the body stay balanced and healthy.

• Sattvic Diet: Fresh fruits, vegetables, whole grains, legumes, nuts and seeds can provide a balanced source of nutrients and support overall health during treatment.

• Pranayama: Breathing exercises may promote relaxation and help patients practise controlled breathing. They should be performed gently and only when considered suitable by the oncologist.

Note: Always discuss herbal or Ayurvedic products with the oncologist because some supplements can interfere with cancer medicines.

Home Care for Lung Cancer

Taking a few extra precautions at home can help patients stay comfortable, maintain their strength and manage day-to-day challenges during lung cancer treatment. Some useful home-care tips include:

• Keep the room well-ventilated and maintain a comfortable indoor environment.

• Follow any breathing exercises recommended by your doctor or pulmonary rehabilitation team.

• Keep water, medicines and frequently used items within easy reach to avoid unnecessary exertion.

• Take short rest breaks between activities if you feel tired or breathless.

• Use pillows to support your upper body if lying flat makes breathing uncomfortable.

• Keep your surroundings smoke-free and avoid strong fumes or other respiratory irritants.

Latest Treatment for Lung Cancer in India

Lung cancer treatment is advancing with newer therapies that aim to target cancer cells more precisely while reducing the impact on healthy tissues. Some of the recent developments include repotrectinib, a targeted therapy for advanced NSCLC with ROS1 gene fusions, and sotorasib, which targets NSCLC with the KRAS G12C mutation. Newer approaches such as BiTE therapy, including tarlatamab for certain cases of extensive-stage small cell lung cancer, are also being explored to help the immune system recognise and attack cancer cells.

Researchers are further studying inhalable therapies using exosomes to deliver treatment directly to lung tumours and FLASH radiotherapy, which aims to deliver radiation extremely quickly while potentially reducing damage to surrounding healthy tissue. While some of these treatments are already available for selected patients, others are still being evaluated through clinical research.

How Long Does Lung Cancer Treatment Take?

Treatment duration varies significantly depending on the type of lung cancer and the treatment approach. The duration of each therapy is included in the table below:

Side Effects of Lung Cancer Treatment

The side effects you might experience depend on the lung cancer treatment and can be different for each person. Some side effects go away on their own, while others might need special care. Here are some possible side effects:

• Fatigue

• Nausea and vomiting

• Reduced appetite

• Hair loss with some chemotherapy regimens

• Mouth sores

• Changes in bowel habits

• Skin changes

• Shortness of breath

• Tingling or numbness in the hands and feet

• Increased risk of infections

Lifestyle Changes During Lung Cancer Treatment

Healthy habits can help the body cope with lung cancer treatment and recovery. Useful measures include:

• Stop smoking and avoid tobacco exposure.

• Eat a balanced diet with adequate protein and calories.

• Stay physically active according to your doctor's advice.

• Maintain a healthy weight.

• Limit alcohol.

• Get adequate sleep.

• Practise stress-management techniques.

• Keep all follow-up appointments.

• Follow vaccination and infection-prevention advice provided by your doctor.

Triggers that Can Worsen Symptoms of Lung Cancer Treatment

Certain triggers may worsen lung cancer symptoms or make treatment-related side effects more difficult to manage. These may include:

• Smoking or exposure to second-hand smoke

• Air pollution, dust and strong chemical fumes

• Respiratory infections

• Strenuous physical activity during periods of weakness or breathlessness

• Poor nutrition and inadequate fluid intake

• Stress and anxiety

Lung Cancer Treatment Cost in India

The cost of lung cancer may depend on whether surgery, chemotherapy, radiation therapy, targeted therapy, immunotherapy or a combination of treatments is required. For lung cancer surgery, including lobectomy or VATS, the cost generally ranges from ₹2.5 lakh to ₹5.5 lakh. Chemotherapy may cost around ₹50,000 to ₹2 lakh per cycle, while a full course of radiation therapy may range from ₹1.5 lakh to ₹4 lakh.

Whereas targeted therapy may cost approximately ₹80,000 to ₹3 lakh per month, depending on the medicine prescribed. Immunotherapy can cost around ₹1.5 lakh to ₹4 lakh per cycle, while SBRT or stereotactic radiotherapy may range from ₹1.5 lakh to ₹3.5 lakh. The initial diagnostic workup may cost approximately ₹67,000 to ₹1.5 lakh. These are indicative figures and the actual cost may vary depending on the hospital, location, treatment protocol, medicines, diagnostic requirements and individual medical needs.

Does Health Insurance Cover Lung Cancer Treatment in India?

Yes, many health insurance policies provide coverage for eligible lung cancer treatment, subject to the policy terms and conditions. Health insurance for lung cancer can help cover eligible medical expenses incurred during treatment, including hospitalisation, chemotherapy, radiation therapy and surgery, subject to the policy terms and applicable waiting period. There are also cancer-specific health insurance plans available that may offer coverage across different stages of cancer.

Critical illness health insurance plans may also provide a lumpsum payout upon diagnosis of the disease. These plans may have a 2-3 year waiting period and a specified survival period before the benefit is paid, depending on the policy terms. The coverage, waiting periods, exclusions and benefits can vary between plans. For comprehensive financial protection, you may consider a minimum sum insured of ₹25-30 lakh for complications, depending on your healthcare needs and budget.