Lung Cancer: An In-Depth Analysis of Its Biology and Treatment Options

Lung cancer has been one of the top causes of cancer-related death in women as well as men worldwide. More than 90-percent of lung cancers are caused due to the usage of tobacco-based products and smoking. However, there could be other causes as well, including exposure to air pollution, chronic infections, asbestos or radon gas. 

Broadly, lung cancer is classified into two histologic categories:

• Non-Small Cell Lung Carcinoma (NSCLC)
• Small-Cell Lung Carcinoma (SCLC)

In spite of the advancements in diagnosis and lung cancer treatment options over the years, the prognosis for lung cancer patients is still not satisfactory. The response to the present standard treatments is poor except in cases where the cancer is highly localised. Having  a better understanding of lung cancer biology might result in the development of more specific and more efficient drugs. In this article, let’s summarise the latest developments in lung cancer biology and treatment options. 

Lung Cancer Biology

There are defects present in the regulatory circuits of lung cancer cells, which govern homeostasis and normal cell proliferation. A normal cell changes to a malignant cancer cell in the lungs in multiple steps through a sequence of epigenetic and genetic changes. Ultimately, it evolves into an invasive cancer through clonal expansion. 

After the primary cancer develops, persistent accumulation of epigenetic and genetic abnormalities that are acquired in the process of clonal expansion control the process of metastasis, invasion and resistance to therapies administered for cancer treatment. 

The characterisation and identification of such molecular modifications are of great significance for early detection, disease prevention and treatment methods. The knowledge of the genetics and characteristics of the lung tumour will considerably progress the personalised prognosis and appropriate treatment for every patient. 

Also Read: SIGNS AND SYMPTOMS OF LUNG CANCER

• Genomic Alterations

A molecular profiling that was done on around 230 lung adenocarcinomas showed high rates of somatic mutation from whole exome sequencing. Genomic alterations include rearrangement (transitions and transversions), point mutations (slicing site alterations, frameshift and nonsense & missense mutations), and somatic copy number modifications. 

• Molecular Pathology

Many targetable genetic changes have been seen in lung cancer, including:

1. Structural rearrangement
2. Activating mutations in several proto-oncogenes
3. Proto-oncogene amplification
4. Improved telomerase activities that contribute to cellular immortality

The scores of these aberrations correspond with the smoking history of patients and their gender & racial differences. This suggests that genetic makeup has a potential role in lung cancer. 

Lung Cancer Treatment Options

Doctors from multiple disciplines, including pulmonologists, thoracic surgeons, medical oncologists and radiation oncologists, work together to devise the right treatment plan for lung cancer for each patient. Depending on the kind of lung cancer and its stage, the treatment plan varies. 

Patients diagnosed with NSCLC are generally treated with surgery, radiation therapy, targeted therapy, chemotherapy or a combination of these. Patients suffering from SCLC are generally treated with chemotherapy and radiation therapy. 

• • Surgery: This is an operation that is done to remove the cancer tissues from the lungs. The surgical procedures used to treat lung cancer include wedge resection (for removing a small lung section that has the tumour), segmental resection (for removing a larger lung portion but not a whole lobe), lobectomy (for removing the whole lobe of a lung) and pneumonectomy (for removing a whole lung).

• • Chemotherapy: Special drugs are used for killing or shrinking the tumour. The drugs are administered to patients either in the form of pills or through veins. 

• • Radiation Therapy: High-energy rays such as X-rays or proton rays are used for killing the cancer cells. If surgery is not an option for your individual condition, you may be advised to undergo a combination of chemotherapy and radiation therapy as the main treatment. 

• • Targeted Therapy: The drugs used in targeted therapy help in blocking the spread and growth of cancer cells. Before advising this therapy, doctors will prescribe a few tests to check if targeted therapy is right for your condition. 

Also Read: TREATMENT CHOICES FOR NON-SMALL CELL LUNG CANCER, BY STAGE

All these lung cancer treatments are given in the best cancer hospitals in Delhi. Follow your doctor’s advice for the treatment plan given. 

We hope you have now got a good idea of lung cancer biology and treatment options available. Wish you or your loved one a speedy recovery from the disease so that you can lead a healthy life again!