What is Lung Cancer?
Lung cancer is a type of cancer that begins in the lungs and can spread to other parts of the body.
There are two main groups of lung cancer:
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Non-small cell lung cancer (NSCLC) is the most common type, accounting for about 80-85% of all cases;
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Small cell lung cancer (SCLC) is a less common but more aggressive type, with an incidence rate of 15%.
The NSCLC has a few subtypes outlining the cell structure and the overall prognosis.
| Subtype | Description | Ability to grow and spread |
| Adenocarcinoma (the most common subtype, is diagnosed in 57% of cases in women and 39$ in men). | Begins in the epithelial cells of the lung, which are responsible for producing mucus.Begins in the epithelial cells of the lung, which are responsible for producing mucus. | Moderate |
| Squamous cell carcinoma | Starts in the squamous cells, which are flat cells lining the inner surfaces of the lung airways. | Moderate |
| Large cell carcinoma | Large cell carcinoma can develop in any lung area | Fast |
What Causes Lung Cancer?
Lung cancer often develops due to genetic mutations caused by exposure to harmful substances or lifestyle factors. Common causes include:
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Smoking is the leading risk factor, contributing to about 85% of lung cancer cases.
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Exposure to Radon Gas, which can accumulate in buildings, poses a risk.
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Air Pollution means long-term exposure to polluted air, especially in urban areas.
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Asbestos and other carcinogens, such as asbestos.
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Family History raises the probability of getting lung cancer.
What Are the First Signs of Lung Cancer?
Many symptoms of lung cancer can be easily misinterpreted for something else. The treatment is more effective at the initial stages. That's why recognizing "red flags" can lead to early lung cancer diagnosis and developing successful treatment strategies.
Common symptoms of lung cancer include:
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Coughing up blood or rust-colored spit;
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Chest pain that worsens with deep breathing or laughing;
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Shortness of breath;
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Hoarseness;
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Loss of appetite;
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Unexplained weight loss;
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Frequent lung infections like bronchitis or pneumonia.
If lung cancer spreads to other areas, it causes location-specific symptoms.
How Does the National Cancer Institute Stage Lung Cancer?
The National Cancer Institute (NCI) uses the TNM system to stage lung cancer, which takes into account:
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Tumor's size and location;
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Presence in the nearby lymph nodes;
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Metastasis to distant organs.
There are four main stages for lung cancer patients:
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Occult (hidden) cancer. The so-called "0" stage is when the doctor cannot assess cancer for several reasons. For example, when the blood tests show the presence of oncological markers, but the imaging tests are negative.
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Stage I. The tumor is 1-3 cm, and it doesn't invade the nearby lymph nodes.
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Stage II. The tumor is 4-5 cm, and the cancer spreads into the thoracic lymph nodes.
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Stage III. The tumor is 5-7 cm, and the cancer may grow into the chest wall.
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Stage IV. The cancer can be of any size, and it spreads to either (the lining around the lungs) or the pericardium (lining around the heart).
How to Confirm a Patient Has Lung Cancer?
To diagnose lung cancer, doctors perform various tests:
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Chest X-ray and CT Scans to visualize tumors;
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A biopsy is performed to examine a tissue sample and confirm the presence of cancer cells.
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Bronchoscopy to check for abnormalities and take samples from the bronchi.
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Molecular Testing to detect specific mutations (e.g., EGFR or ALK) that guide targeted therapy.
What is the Lung Cancer Treatment?
Lung cancer treatment depends on the stage and type of cancer, as well as the patient’s overall health. Treating lung cancer involves various options, including:
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🔷Surgery. For early-stage NSCLC, surgery may remove part of the lung.
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🔷Radiation Therapy for both NSCLC and SCLC to target cancer cells.
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🔷Chemotherapy. A standard option for SCLC and advanced NSCLC.
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🔷Targeted Therapy. Targeted drugs (e.g., EGFR inhibitors) can improve cancer outcomes with specific mutations.
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🔷Immunotherapy uses the body’s immune system to fight cancer cells, becoming a leading option for advanced lung cancers.
Radiation oncologists are integral members of the multidisciplinary teams involved in developing personalized treatment plans for lung cancer.
What Are the Types of Lung Cancer Surgery?
Surgery is often the first line of treatment for early-stage lung cancer. The goal of surgery is to remove the tumor and surrounding tissue while preserving as much lung function as possible.
Types of surgery for lung cancer include:
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Lobectomy removes one of the 5 lung lobes where the cancer has spread;
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Segmentectomy (or wedge resection) eliminates a part of a lobe;
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Pneumonectomy removes the entire lung. This is an option if the tumor is close to the chest;
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Sleeve resection aims to "re-connect" the airways if the cancer blocks them.
The best lung cancer doctors perform lung surgery in two main ways: open surgery (thoracotomy) or minimally invasive surgery. The second one includes:
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Video-assisted thoracoscopic surgery (VATS);
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Robotic-assisted thoracoscopic surgery (RATS).
What Is the Lung Cancer Treatment Cost?
Lung cancer costs vary by country and the type of therapy required, with different treatment strategies significantly impacting these expenses. Treatment costs can range from $15,000 to $60,000, depending on the case’s complexity.
| Country | Surgery costs | Chemotherapy costs | Immunotherapy costs |
| Israel |
$25,000-$40,000 |
$8,000-$15,000 |
$60,000-$100,000 per year |
| Turkey |
$12,000-$25,000 |
$5,000-$10,000 |
$40,000-$80,000 |
| Spain |
$20,000-$35,000 |
$12,000-$18,000 |
$50,000+ |
How to Find the Best Hospital for Lung Cancer Treatment?
Here’s how to find the best lung cancer hospitals:
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Accreditation. Look for hospitals accredited by organizations like the Joint Commission International (JCI), ensuring high standards of care;
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Multidisciplinary Team. Choose a hospital with a team of specialists (oncologists, surgeons, radiologists) working together on personalized treatment plans;
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Advanced Technologies. Ensure the hospital offers technologies like the Da Vinci Robotic System for surgery and cutting-edge treatments like immunotherapy and targeted radiotherapy;
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Top Hospitals. Consider leading facilities like Sourasky Medical Center in Israel or Anadolu Medical Center in Turkey, which are known for advanced lung cancer care.
If you are ever in doubt, submit a request on Bookimed to receive a personalized treatment plan from the top-rated lung cancer treatment centers.
What Are the Comprehensive Cancer Centers?
Comprehensive Cancer Centers are elite institutions designated by the National Cancer Institute (NCI) for their exceptional lung cancer diagnosis, treatment, and research expertise.
These centers are renowned for their multidisciplinary approach, bringing together specialists from various fields, such as:
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☑️Medical oncology;
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☑️Surgical oncology;
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☑️Radiation oncology;
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☑️Pathology.
A hallmark of Comprehensive Cancer Centers is their strong emphasis on research and clinical trials, offering lung cancer patients access to the latest and most innovative treatments. Combining cutting-edge research with patient care ensures lung cancer patients receive the most advanced and effective therapies available.
What Is the Best Lung Cancer Hospital in the World?
Bookimed has ranked the best lung cancer hospitals for treatment based on patient reviews, success rates, and technology. Cancer hospitals, particularly those designated as Comprehensive Cancer Centers by the National Cancer Institute, play a significant role in providing high-quality care for difficult-to-treat cancers. Some of the leading centers include:
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Centro Médico Teknon, Spain;
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Sourasky Medical Center, Israel;
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Anadolu Medical Center, Turkey.
Centro Médico Teknon
The medical center, accredited by the Joint Commission International, provides top-quality care for lung cancer patients. It uses the Da Vinci Robotic System for accurate, minimally invasive surgeries (the size of incisions is 1-2 cm). Treatments include comprehensive options like lobectomy and lung segmentectomy.
Advanced therapies such as immunotherapy with Keytruda (Pembrolizumab), as well as targeted radiotherapy and chemotherapy, are also available to manage lung cancer effectively.
Sourasky Medical Center
At Sourasky's Safra Onco-Pulmonology Department, patients undergo a complete evaluation to create a personalized lung cancer treatment plan. This includes:
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🩸Blood tests;
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🩻PET-CT scan;
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🔬Review of biopsy results;
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👩🏻⚕️Consultation with a top-rated pulmonologist oncologist.
The length of treatment depends on the stage of lung cancer and the tumor size and is tailored to each patient.
Anadolu Medical Center
The leading oncologist, Bülent Karagöz, has over 31 years of experience in lung cancer treatment. Specialists thoroughly examine the tumor type, size, and stage before creating a personalized treatment plan. The diagnostic process usually takes 7-10 days.
Anadolu Medical Center provides modern lung cancer treatments. Anadolu Hospital is one of Turkey's few medical centers offering advanced radiation therapy tools:
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CyberKnife. A minimally invasive procedure that irradiates a tumor with up to 0.5 mm accuracy (compared to standard methods, which are more likely to damage healthy tissues);
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TrueBeam. This radiotherapy system uses advanced imaging for accuracy, enhancing effectiveness and patient comfort. TrueBeam provides detailed, real-time images of the tumor and surrounding areas. This allows for accurate targeting and adjustments during treatment.
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VarianEdge. The Varian Edge moves around the patient to quickly target a tumor from multiple angles. This increases accuracy and protects healthy tissue. It takes 2-4 times less time than other radiotherapy methods, so treatment is completed 50% faster.
How to Choose the Right Lung Cancer Specialist?
Selecting a lung cancer specialist involves focusing on critical factors, such as:
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Credentials and Experience. Specialists with board certification in oncology or thoracic surgery, particularly those with fellowships in lung cancer, demonstrate a strong foundation in advanced care. Those working at comprehensive cancer centers are often more current with cutting-edge treatments.
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Success Rates. Specialists with high cases, particularly in specific lung cancer types and stages, tend to have better treatment outcomes.
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Access to Advanced Treatments. The availability of advanced therapies such as immunotherapy, targeted treatments, and robotic-assisted thoracic surgery highlights a specialist’s capability to offer leading-edge care options.
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Patient Reviews and Referrals. Insights from patient reviews reveal details about the specialist's communication, treatment effectiveness, and patient care. Recommendations from other healthcare providers or former patients offer valuable guidance.
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Involvement in Clinical Trials. Specialists engaged in clinical trials provide access to experimental therapies, offering cutting-edge options for treatment. This involvement reflects a commitment to ongoing research and innovation in lung cancer care.
Carefully evaluating these factors ensures a specialist is well-equipped to handle complex lung cancer cases with advanced knowledge and experience.
Exclusive interview with Dr. Ofer Merimsky, Israel’s leading oncologist for lung cancer treatment
What Is the Cost of Immunotherapy for Lung Cancer?
Immunotherapy costs can be high, but it has revolutionized treatment for advanced lung cancer. Prices vary depending on the therapy and region. For example:
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Keytruda (Pembrolizumab) costs $22,674.72 for each indicated dose when given every 6 weeks;
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Opdivo (Nivolumab) with the price for a treatment course of $22,293 (3 cycles of therapy).
What’s New in Lung Cancer Treatment?
In 2024, new advancements in targeted therapy and immunotherapy continue to improve survival rates for patients with stage IV lung cancer. The City of Hope Comprehensive Cancer Center, recognized for its excellence in cancer treatment, is at the forefront of these innovations.
Emerging treatments, such as CAR-T cell therapy and combination therapies, are showing promising results in clinical trials.
Exclusive Interview with Dr. Ari Raphael TOP Israel’s oncologist for lung cancer
References
Cancer Staging. Comprehensive Cancer Information - NCI. URL: https://www.cancer.gov/about-cancer/diagnosis-staging/staging (date of access: 12.09.2024).
Global variations in lung cancer incidence by histological subtype in 2020: a population-based study. Zhang, Yanting, et al. The Lancet Oncology, Volume 24, Issue 11, 1206 - 1218
Lung Cancer Statistics | How Common is Lung Cancer? Information and Resources about Cancer: Breast, Colon, Lung, Prostate, Skin | American Cancer Society. URL: https://www.cancer.org/cancer/types/lung-cancer/about/key-statistics.html (date of access: 12.09.2024).