Treatment of Lung cancer has dramatically improved in the last decade. There are several pioneering precision drugs that we use for management of lung cancer however it remains the leading cause of cancer-related death worldwide. These are few of several reasons for this.
1. Late Detection or cancer is the single most case of poor outcome and mortality in patients
Symptoms often appear late: Lung is an inflatable organ, and the cancer symptoms only appear when the cancerous lump is reasonably large. By the time symptoms like coughing, weight loss, or chest pain occur, the cancer may have already spread, making it harder to treat.
Lack of early screening: In India we do not have a dedicated screening program for lung cancer. There have been advancements in screening (such as low-dose CT scans for high-risk populations), however this facility is underutilised.
2. Challenges in Treatment
Resistance to treatment: Precision oncology is leading the way in effective management of Lung cancer. However, cancer has the ability to develop resistance to many types of treatment, including chemotherapy and radiation and even precision therapy. These resistances are due to several genetic and biological parameter which are difficult to control at present
Limited availability of effective treatments for advanced stages: We do have excellent treatment options in form of targeted therapies and immunotherapy for certain types of lung cancer, However these treatments may not be available due to cost constraints or may be ineffective for patients, especially those in the later stages of the disease.
3. Increasing Life Expectancy
Aging population: Unfortunately a largen number of patients are diagnosed with lung cancer in advanced age. They might have other comorbidities due to which they may not be able to tolerate the intensive types of treatment and mortality increases.
4. Lack of knowledge and awareness
Public awareness: There is general lack of awareness in public about the preventive measures that can be easily adopted. The field of cancer medicine has evolved rapidly and unfortunately there is a knowledge gap that leads to delay in decision making and directing the patient to the right cancer centre.
Even though the efforts to raise awareness about smoking cessation continues, many people still don't fully understand the risks of lung cancer. Therefore the incidence continues to rise.
There are several reasons that lead to poor survival in patient s of lung cancer. However majority of patients can do really well now as compared to before provided they present to the right oncology team and have access to the latest diagnostic and therapeutic option.
Dr. Sachin Trivedi, Director- Medical Oncology, HCG Cancer Centre, Colaba
