Comprehensive Guide to Lung Cancer Treatment in India

Lung cancer is cancer that begins in the lungs and may spread to other organs and lymph nodes.  According to studies, approximately 2,10,958 new cases of lung cancer are diagnosed in the year 2022, in India. Lung Cancer Treatment cost in India ranges from USD 4872 to USD 8527. Lung cancer grows through various stages and has a variety of symptoms. The curability of lung cancer is around 80% to 90%.

What is Lung Cancer?

Lung cancer is a disease that is caused by uncontrollable cell division in the lungs leading to the formation of tumors. This affects the functioning of the lungs. The lungs are two spongy cone-shaped organs located in the chest for the exchange of gases, oxygen, and carbon dioxide. The left lung has 2 lobes and 3 lobes in the right lung. The lungs consist of bronchi or bronchioles (airways) and alveoli (air sacs for gaseous exchange). They are surrounded by pleura (a membrane). They are separated by the mediastinum which consists of the trachea, esophagus, and lymph node.

Cost of Lung Cancer Treatment in India

Treatment Options for Lung Cancer in India and Their Cost

1. Surgery: In this, the surgeon will remove the tumor and a small amount of surrounding healthy tissue. The kind of surgery used depends on the stage and size of the cancer.

• Wedge Resection– It is done in the case of early-stage cancers. The margin of healthy tissue and the tumor is removed. It costs USD 4265  to USD 14625.
• Segment Resection– It removes a larger part of the lungs but not the entire lobe.
• Lobectomy– An entire lobe affected by a tumor is removed.
• Pneumonectomy– An entire lung is removed in this.

2. Radiation Therapy: In radiation therapy, high-powered energy beams of protons and X-rays are used. It may be administered after or before the surgery for patients with locally advancing lung cancer. It may be a primary treatment option along with chemotherapy if surgery is not possible. It can also help in easing symptoms. It costs USD 158 to USD 243.

3. Chemotherapy: In this, strong and potent medicines are used to destroy cancer cells. It is administered intravenously or can be taken orally. It shrinks the tumor cells so that they can be removed by surgery, and relieve pain. It costs USD 816  to USD 4265.

4. Targeted Therapy: In this, medicines target particular vulnerabilities of cancer cells. These medicines affect these and inhibit them. It is recommended for patients who do not respond to other available treatment options and have advanced-stage cancer. It costs USD 2437  to USD 3656.

5. Immunotherapy: In this, the patient’s immune system is stimulated to fight off cancer cells. This therapy boost the natural process of the immune system to attack cancer cells. This too is used for advanced-stage cancers. It costs USD 1830 to USD 5550.

Diagnostic Test for Lung Cancer in India 

• Chest X-ray: It is often the first test the doctor prescribes to check for abnormalities in the area of the lungs. It costs USD 6-85.
• Computed tomography or CT Scan: In this, more than 1 picture is taken through x-rays that show a slice of the body part through a combination of these pictures. It shows the presence of tumors, their shape, and size, and helps lymph nodes that are enlarged. It can also detect masses of tissues in the liver, adrenal glands, brain, and other organs that are affected by spreading lung cancer. A guided CT scan is used for needle biopsies of deeper structures in the lungs.
• Magnetic resonance imaging (MRI) Scan: It shows detailed images of soft tissues in the body. It utilizes strong radio waves and magnets for imaging. They are used to detect the spreading of lunger cancer to other organs like the spinal cord or brain. It costs USD 18-304.
• Positron emission tomography or PET Scan: In this, a somewhat radioactive form of sugar is injected into the patient, where it accumulates in cancer cells. It has higher radioactivity and gives a more clear and more detailed image. If cancer has spread and the doctor does not know where this scan shows its spread to other organs except for the spinal cord or the brain. It costs USD 121-426.
• Bone Scan: In this, a small amount of low-grade radioactive substance is injected into the bloodstream of the patient, and accumulates in the abnormal areas of the bones. It is not needed often as PET scans can show this spread to the bones. It costs USD 60-85.

Tests for detecting lung cancer

• Sputum cytology: A sputum sample is checked for lung cancer cells. A sputum sample is taken early in the morning for 3 consecutive days. It helps in detecting cancer that begins in the major airways of the lungs like squamous cells.
• Thoracentesis: In this, the fluid that has collected around the lungs or pleural effusion is checked for the presence of cancer cells to find out the spreading of cancer in the lining or pleura of the lungs. It can also detect heart conditions or infections. A hollow needle is inserted in the numbed skin between the ribs to drain the collected fluid. It costs USD 1029-4860.
• Needle Biopsy: In this, a hollow needle is inserted in the suspicious area to get a small sample. It does not require surgical intervention. It costs USD 48-121.
  • Fine needle aspiration or FNA biopsy– A very hollow and thin needle to withdraw cells (aspirate) and a small amount of fragment tissue. It may be used to check cancer cells in the lymph nodes in the lungs.
  • Transtrachel or transbronchial FNA– In this, a needle is passed through the wall of the trachea or bronchi.
  • Core biopsy– In this, a larger needle is inserted to take out one or more small core tissues.
  • Transthoracic needle biopsy– If the tumor is in the outer portion of the lungs, the needle can be inserted through the numbed chest wall skin. The needle is guided into the chest with either CT Scan or fluoroscopy.
• Bronchoscopy: It aids in finding out blockages and tumors in the larger airways. It costs USD 97-121.

Tests for checking cancer spread in the chest:

• Endobronchial ultrasound and Endoscopic Esophageal ultrasound (goes through the esophagus) are used to check the lymph nodes for the presence of cancer cells. It costs USD 182-426.
• Mediastinoscopy: In this, a lighted tube is inserted behind the chest bone or sternum and in front of the trachea or windpipe to observe and take out samples of tissues from the lymph nodes. If the lymph nodes cannot be reached, this procedure can remove the biopsy sample directly through a slightly wider incision of about 2 inches between the second and third left rib.
• Thoracoscopy: It is done to check the spread of cancer between the spaces in the lungs and the wall of the chest. It can also be used to check tumors on the outer portion of the as well as in the fluids and lymph nodes nearby. It can also remove a small portion of the lungs in early-stage cancer.
• Lung (or pulmonary) Function Tests (PFTs): They aid in finding out the functioning of the lungs after the diagnosis of lung cancer. This gives the doctor idea of whether surgery is a good option or not, and how much of the lung can be removed safely. Sometimes these tests are combined with the Atrial Blood Gas test (in this, the blood is removed from the artery to check the levels of carbon dioxide and oxygen). It costs USD 9-12.
• Molecular tests of changes in genes: The sample taken is tissue taken in the biopsy or surgery for lung cancer. If the sample is not appropriate, this test can be done through a regular drawing of blood. The bloodstream consists of dead tissues from cancer in advanced stages. It costs USD 243-670.

NOTE: Blood tests are done to check the overall health of the person.

• Medical and non-medical staff in Indian private and government hospitals provide premium care and the highest quality treatment for lung cancer care. The hospitals consist of modern operations theatres, comfortable beds, special care units like ICUs, 24×7 ambulatory facilities, etc.
• The medical professionals are well-experienced, highly skilled, and qualified. The doctors interact with the patients one-on-one, making them understand the procedure and risks of the surgery. A patient-doctor trust is built.
• The cost of lung cancer treatment in India is affordable as compared to other countries. The cost of treatment, transportation, and extra expenses are less.

Stages of Lung Cancer

There are two major types (their stages) of lung cancer.

Small-Cell Lung Cancer stage: This type of cancer is assessed through the TNM system.

• Limited stage– Cancer is present in only one lung and may also spread to nearby lymph nodes. Cancer does not grow out of the lungs.
• Extensive stage– The tumor spreads to other areas of the lungs and the chest. It may spread to the pleura, fluid around the lungs, and other organs like the brain.
• Non-Small Cell Lung Cancer Stages: It is detected on the bases of the location, size, and spreading of the tumor (to lymph nodes and/or other organs).

>>Stage 0– It is known as in situ disease i.e., cancer has not spread to surrounding lung tissues or outside of the lungs.

>>Stage I– In this, a small tumor has not spread to any of the lymph nodes.

• Stage IA tumors are less than 3 centimeters in size. This stage can further be divided into IA1, IA2, and IA3 stages based on the size of the tumor.
• Stage IB tumors are more than 3 centimeters but less than 4 centimeters in size.

>>Stage II: It is divided into two substages

• Stage IIA– In this, the tumor has not spread to the lymph nodes and is larger than 4 centimeters but less than 5 centimeters.
• Stage IIB– In this, the tumor is less than 5 centimeters, and has spread to nearby lymph nodes. Also, the tumor may be less than 5 centimeters in size and may not spread to the lymph nodes.

NOTE: Stage II tumors can be removed through surgery usually. But additional treatments may be required.

>>Stage III: In this, the cancer is classified on the basis of size and to which lymph nodes cancer has spread. The lymph nodes my extensive cancer spread but it has not reached other organs.

• IIIA and IIIB cancers are difficult to treat and remove through only surgery.
• IIIC cancers cannot be removed with surgery and may require a combination of radiotherapy and chemotherapy followed by immunotherapy.

>>Stage IV: If cancer reaches stage 4, it means that more than a single area is affected in the lungs, the fluid surrounding the heart or the lungs, and other distant organs in the body through the bloodstream. Once it is in the blood, any organ can be affected. However, NSCLC is most likely to spread to organs like the liver, brain, bones, and adrenal glands.

• Stage IVA– cancer has spread in the chest and/or to one organ outside the chest
• Stage IVB– cancer has spread in the chest, to more than one organ, and more than one area in the organ.

NOTE: stage IIIB, IIIC, and IV lung cancer cannot be removed by surgery. It is difficult to remove cancer from the lymph nodes located above the collar bones and vital structures in the chest.

Types of Lung Cancer

• SCLC: It accounts for 13% of all types of lung cancers. It is a more aggressive type of lung cancer that tend to grow rapidly and reach other parts of the body or metastasize quickly. It is usually diagnosed after cancer has metastasized throughout the body, making recovery less favorable. It is also called oat cell cancer and oat cell carcinoma.
• NSCLC: It is the most common type of cancer and accounts for approximately 85% of all cases. There are 3 types of NSCLC:
  • Adenocarcinomas– It is associated with smoking but is also found in non-smokers, especially in women. Most of these form in the outer or peripheral regions of the lungs. They have a tendency to affect the lymph nodes and other organs. A subtype of this spreads that develops at various sites in the lungs, and looks like pneumonia in a chest X-ray scan.
  • Squamous cell carcinomas– This accounts for 25-30% of all lung cancer cases. They frequently form in the central chest region in the bronchi. This type of cancer usually stays in the lungs, grows to be quite large, spreads to lymph nodes, and forms a cavity.
  • Large cell carcinomas – It is sometimes called undifferentiated carcinomas, and is the least common type of lung cancer. It accounts for 10-15% of all lung cancers. It rapidly spreads to lymph nodes and other organs.
• Other types of lung cancers: This accounts for 5% of all lung cancers. The tumors are generally 3-4 cm in size and are seen in people under 40 years of age. It is unrelated to cigarette smoking and metastasizes to other organs. A small part of these cancers can secrete substances like hormones.

Symptoms of Lung Cancer

• Long lasting cough or cough that gets worse over time
• Chest pain that hurts when one laughs, take deep breaths, or coughs.
• Voice changes or hoarseness
• Raspy and harsh sounds when breathing
• Shortness of breath
• Unexplained weight loss
• Wheezing
• Increased risk of heart-related diseases
• Swelling of the face
• Coughing up blood or blood-containing mucus
• Feeling tired or weak
• Persistent lung problems like bronchitis

NOTE: If cancer spreads to other organs symptoms like bone pain, dizziness, numbness, headache, and yellow eyes or skin.

Causes of Lung Cancer

• Smoking is the major cause of lung cancer. It causes approximately 90% of all types of lung cancers. Former smokers have decreased risk of lung cancer. Non-smokers can be affected by lung cancer as well.
• Radon exposure comes after smoking as a cause of lung cancer. It is a colorless and odorless radioactive gas that naturally occurs in the soil. It can reach homes through cracks and gaps.
• Hazardous chemicals increase the risk of lung cancer. Working with chemicals and materials like uranium, chromium, cadmium, arsenic, nickel, etc. Particles in solid and liquid form can also increase the risk.
• Genetics can also be related to lung cancer. A family history of lung cancer can increase the risk of developing lung cancer.

Complications and Side Effects of Lung Cancer Treatment

• Problems with bones
• Risk of blood clot formation is increased
• Dental and mouth problems
• Fatigue
• Hair loss from various areas of the body
• Vomiting and nausea
• Pain and rashes
• Edema
• Neuropathy
• Weight changes
• Diarrhea
• Increased risk of infection
• Difficulty in functioning and thinking (brain fog)

Survival Rate of Lung Cancer Treatment in India

Patients that are diagnosed with early-stage lung cancer through CT Scan with a 20-year survival rate of 80%. However, the survival rate drops as the stage of lung cancer increases.

Top Hospitals for Lung Cancer Treatment in India

Max Smart Super Speciality Hospital has been accredited with NABH. It consists of 250 multispeciality bed facility. It also has 12 modular operation theatres. It has modern equipment like 3.0 Tesla digital brand MRI, 256 Slice CT Angio, etc. Also, international patient assistance and 24-hour emergency services are available.

2. Wockhardt Hospital, Mumbai

Wockhardt Hospital has been accredited with NABH. It has the first paperless ICU in Mumbai along with a 350-bed facility. Also, it has eight operation theatres like Cardiac, Oncology, Neurology, Joint Replacement, Organ Transplantation, etc. An interpreter is available for foreign patients.

3. Aster Medcity, Kochi

Aster Medcity is accredited with NABH certification. It has a 24×7 robotic pharmacy and special at-home care services. It has excellent centers for oncology, cardiac sciences, gastroenterology, multi-organ transplant, nephrology, etc. ORI Fusion Digital Integrated Operation Theatres are also present in the hospital.

4. Fortis Hospital, Bengaluru

Fortis Hospital is accredited with ISO and NABH certifications. It is a 250-bed facility. Excellent pre-operative and post-operative care services are available at the hospital. Apart from usual blood tests, specialized tests like X-rays, cardiac testing, and Echo are also performed.

5. Jaypee Hospital, Noida

Jaypee Hospital is accredited with NABH and ISO credentials. It has 525 operational beds and 18 modular operation theatres. It is equipped with modern technologies like 2 MRI (3.0 Tesla), 64 Slice PET CT, Gamma Camera, True Beam STx Linear Accelerator, etc. It also provides foreign exchange facilities.

Top Doctors For Lung Cancer Treatment in India

Qualification: MBBS, MS

• He is a member of IMA, DMC, and ISO
• He has successfully treated breast, cervical, lung, larynx, and uterine cancers.
• He has published research papers and journals on indications of tumor staging and Neoadjuvant Chemoradiotherapy.

Qualification: MBBS, MS

• He is a member of ESSO, IASO, ISO, ASI, EUSOMA, IHPBA, IASG, AMASI, and IAGES
• He is certified by BRA Institute, AIIMS, and Rotary Cancer Hospital
• He has successfully treated breast, colorectal, stomatch, oral, and pancreatic cancer.

Qualification: MBBS, MD, DM

• She is a member of IJSPRO, ESMO, ASCO, and MASCC
• She has treated diseases like lung cancer, liver cancer, uterine cancer, endometrial cancer, rectal cancer, lymphomas, and thyroid tumors.
• She has published many papers in reputed journals.

Qualification: MBBS, MD

• He is a member of ESMO, ISO, and ISTH
• He has published 11 articles and chapters on hematology
• He has successfully treated symptoms like persistent fever, fatigue, unexplained bruises and bleeding, changes in bowel habits, hoarseness, etc.

Qualification: MBBS, MD, DNB

• He is a member of DMC and certified by Dr. Satya Gupta Memorial Award
• He is treated several diseases like brain, cervical, pancreatic, ovarian, prostate, uterine, and stomach cancer.
• He has treated many cancer symptoms successfully.

Qualification Required for Doctors to perform Lung Cancer Treatment in India

• Training in Surgical Oncology (G.I. Oncology)
• Junior Residency Training Program (Surgical Oncology)
• DNB – Surgical Gastroenterology
• MCh – Surgical Gastroenterology/G.I. Surgery
• Senior Residency Training Program (Surgical Oncology)
• Fellow (Surgical Oncology)
• MCh – Oncology
• DNB – Surgical Oncology
• MCh – Surgical Oncology
• DNB – Radiotherapy
• MD – Radiotherapy
• Ph.D. – Radiotherapy
• Diploma in Radio Therapy

Facilities provided by hospitals for Lung Cancer Treatment

• 24×7 emergency services
• One-on-one consultations with the doctor
• Experienced and trained staff
• Advanced and modern facilities and infrastructure
• Facility for foreign exchange
• Private suites for staying
• Food and accommodation for the patient and their families

Frequently Asked Questions

References:

• https://www.healthline.com/health/lung-cancer-small-cell
• https://www.webmd.com/lung-cancer/non-small-cell-lung-cancer