Lung cancer is one of the deadliest types of cancer that affected nearly 229,000 people and killed nearly 136,000 in 2020. The common treatments for lung cancer are surgery, radiation, or a combination of chemotherapy drugs. But in advanced stage and small cell lung cancer (SCLC) require aggressive treatment to be abolished. Thus, oncologists recommend advanced treatments like targeted therapy, chemotherapy, brachytherapy, etc. to eradicate malignant cells and lessen problems associated with the disease. These days, the best cancer treatment hospitals in India are offering the latest and advanced cancer treatment in India that has improved the long-term survival rates of advanced carcinomas.
Let’s take a look at some of the innovative lung cancer treatment methods for advanced-stage cancer.
Targeted Lung Cancer Treatment
As the name suggests, this therapy only targets cancerous cells and bypasses wholesome tissues. Targeted therapy is less harmful to normal cells as compared to chemotherapy or radiation therapy. Targeted therapy is only suitable to treat advanced cancers. Generally administered intravenously or via pill, this type of treatment is matched to cancer’s specific gene mutations, proteins, or other substances that encourage the growth of cancer. The prime objective of targeted therapy is to inhibit the growth and spread of cancer cells. Targeted therapy works by,
· blocking or turning off chemical signals that are responsible for the growth and divide of cancer cells
· Changing proteins inside cancer cells causing them to die
· Interfering with the development of blood vessels to feed cancer cells
· Carrying toxins to cancer cells to destroy them
Targeted therapy aims at biomarkers that are commonly found on the surface of the cells or in the genes that program cells. Oncologists may conduct tests to determine if a biomarker is present in the tumour or the body. Based on this, a more targeted approach may be needed to kill it. Different types of targeted therapy may be used alone or in combination with chemotherapy or immunotherapy.
Several studies from the Lung Cancer Mutation Consortium, an association of more than 20 cancer centres focused on understanding genetic changes that inspire lung cancers, have shown that identifying and targeting cancer-causing changes in certain genes may improve the survival rate. One study published in 2018 in Clinical Cancer Research enrolled over a thousand patients with advanced lung cancer who had at least one of 14 cancer-related genes. Patients with mutations in certain genes who were treated with targeted therapy lived 1.5 years longer than those who did not receive targeted therapy.
Side Effects of Targeted Therapy
Side effects of targeted therapy are minimal as compared to other treatments. Common side effects are,
· Nausea and vomiting
· Diarrhoea or constipation
· Mouth sores
· Shortness of breath
· Vision problems like blurred vision, double vision or increased floaters
· Allergic reactions (while getting an IV drug)
· Second cancers
· Skin rashes, dry skin, itching, sores around fingernails and toenails
· Swelling of hands, feet, ankles, arms, legs, face
· Hair loss
· High blood pressure
· Low white blood cell
· Bleeding or clotting problems,
· Heart damage, especially when administered with chemotherapy
Immunotherapy is another prime treatment method that improves the body’s immune system to recognize and extirpate cancer cells. Immunotherapy can be used as targeted therapy or to boost up your immune system naturally. Immunotherapy drugs called checkpoint inhibitors are ideal for treating two types of lung cancer, small cell (SCLC) and non-small cell lung cancer (NSCLC). Nearly 85% of lung cancers are NSCLC. IV infusion is used to give checkpoint inhibitors. They target and inhibit checkpoint proteins present in immune cells. But cancer cells can influence these checkpoints to prevent attack by the immune system.
Some checkpoint inhibitors target a protein that is produced by cancer cells called PD-L1. PD-L1 binds to a receptor protein on T cells called PD-1. When PD-L1 connects to PD-1, the connection blocks the immune system from destroying the cancer cell. By targeting either the PD-L1 protein or the PD-1 receptor protein, checkpoint inhibitors disturb this connection. Once this connection is disrupted, T cells can recognize and respond to cancer cells. By hindering checkpoint proteins, checkpoint inhibitors encourage immune responses to destroy cancer cells.
Checkpoint inhibitors that improve immune response against cancer cells are,
· Opdivo (nivolumab)
· Keytruda (pembrolizumab)
· Tecentriq (atezolizumab)
· Imfinzi (durvalumab)
A study from UCLA has claimed that with pembrolizumab, the five-year survival rate for patients with advanced disease went from an average of 5% in 2012 to more than 15%.
Sometimes, radiation is used to shrink the size of the tumour. New methods are used for pinpointing tumours to shrink them as well. The procedure is known as brachytherapy that is useful in treating tumours in the lungs.
By inserting catheters directly into infected tissue, brachytherapy is performed. With a bronchoscope, the small catheters are placed and then adjusted after each session. You can combine this treatment with other methods to improve the patient’s results.
Tomo therapy operates in combination with a 3D CT scan to obtain the exact size and location of distant tumours. Tomo therapy delivers targeted doses of radioactive energy with minimal or no damage to wholesome tissue.
Lung cancer research is thriving at a rapid pace. Since 2018 there have been more than 20 lung cancer treatment methods approved and new drugs will come for patients whose tumours grow after getting treatment with the first-line of therapy.
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