Articles on lung chancer

Lung Cancer: Survival Guide

Dr. Kaushal Yadav, Surgical Oncologist
LUNG CANCERSecond most common cancerLeading cause of cancer death. About 1 out of 4 cancer deaths are because of lung cancerDespite poor prognosis, lung cancer is curable in early stages.Two main types: -Non-small cell lung cancer: 85-90%-Small cell lung cancer: 10-15%Risk Factors:Tobacco smoking:- Smokers have 20 fold increase of lung cancer compared to non smokers- Tobacco smoke contain thousands of chemicals which include >70 chemicals are proven carcinogens- Quitting smoking is beneficial. Former smokers are at 9 fold increased risk while current smokers are at 20 fold increased risk of lung cancer  compared to non smokers.- Environmental tobacco smoke exposure to non smokers through passive smoking from smokers also increase the riskAsbestos and other chemical carcinogensRadiation exposureEnvironmental pollution Screening for Lung Cancer:Age group 55-80 yrs with a history of smokingUnited States Preventive Services Task Force (USPSTF) recommend annual screening for lung cancer with low dose computed tomography in adults aged 55-80 years who have a 30 pack year smoking history and currently smoke or have quit within past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.Alarming signs of carcinoma lung:Cough that is persistent or gets worseChest pain that is often worse with deep breathing, coughing, or laughingHoarseness of voiceCoughing out blood or rust-colored sputum (spit or phlegm)BreathlessnessInfections such as bronchitis and pneumonia that don’t go away or keep coming backNew onset of wheezingIf lung cancer spreads to distant organs, it may cause Bone pain, headache/ seizures, jaundiceTreatment for lung cancer:Multidisciplinary management involving surgical oncologist, medical oncologist and radiation oncologist improves treatment planning and better cure.Non small cell Lung Cancer:Surgery: Surgical resection play pivotal role in management of early stage cancer. Complete resection (Lobectomy/Pneumonetomy), systemic mediastinal lymph node dissection in suitable candidates is fundamental of surgical management. Videoassisted thoracic surgery is now done in many centres for early stage ling cancer because of associated low morbidity rate.Surgery for lung cancer is a major operation and can have serious side effects, which is why surgery isn’t a good idea for everyone. While all surgeries carry some risks, these depend to some degree on the extent of the surgery and the person’s health beforehand. Possible complications during and soon after surgery can include reactions to anesthesia, excess bleeding, blood clots in    the legs or lungs, wound infections, and pneumonia. While it is rare, some people may not survive the surgery.Chemotherapy: Depending on the stage, chemotherapy may be used as       - Before surgery (sometimes along with radiation therapy) known as neoadjuvant therapy.       - After surgery (sometimes along with radiation therapy) known as adjuvant therapy.       - Along with radiation therapy (concurrent therapy) for some cancers that can’t be removed by surgery because the cancer has grown into nearby important structures       - As the main treatment (sometimes along with radiation therapy) for more advanced cancers or for some people who              aren’t healthy enough for surgery.Radiation Therapy: Depending on the stage radiation therapy might be used as:- As the main treatment (sometimes along with chemotherapy), especially if the lung tumor can’t be removed because of its size or location or person isn’t healthy enough for surgery, or doesn’t want surgery.- After surgery (alone or along with chemotherapy)- Before surgery (usually along with chemotherapy) to try to shrink a lung tumor to make it easier to operate on.- To relieve (palliate) symptoms of advanced NSCLC such as pain, bleeding, trouble swallowing, cough, or problems caused by spread to other organs such as the brain.Targetted therapy:  eg Gefinib, erlotinib, crizotinibThey sometimes work when chemo drugs don’t, and they often have different (and less severe) side effects. At this time, they are most often used for advanced lung cancers, either along with chemo or by themselves.Small Cell Lung Cancer:Very aggressive cancer and spread very fast, so only rarely very early stage is detected for which sugery can be planned. Most patients are treated with chemotherapy or radiation therapy or both.Prognosis: for non small cell lung cancer                                                Stage                                                            5 year survival                                                    I                                                                        45-50%                                                    II                                                                       30-35%                                                    III                                                                      10-15%                                                    IV                                                                         1%

Your Fat Chance at Glowing Skin!

Ms. Tehzeeb, Dietitian/Nutritionist
Perhaps you’ve heard this before but not all fats are bad. Fat has been in the bad press for the last few decades now but before you go fat-shaming again, below are some fun facts about fat:Fat is a nutrient. Yes! Not just a nutrient, but a MACRO-nutrient. This means that the body needs it in a fairly large amount for a host of functions (insulation and cushioning, temperature regulation, protecting your internal organs, transporting your fat-soluble vitamins into body cells amongst other things).Nutrition science teaches us that 15-25% of our daily energy needs to come from a fat source.Fats can be divided into types, categories and chain-length: i) Types: Monounsaturated Fats (MUFAs), Polyunsaturated Fats (PUFAs) and Saturated fats ii) Categories: Essential and Non-essential iii) Chain-length: Short-chain, medium-chain and long-chainWhile each gram of protein and carbohydrates has 4 calories, each gram of fat has 9 calories. The fact that fat is almost double the amount of calories for each gram bears testimony to the fact that you need a smaller amount to feel full. This also means that if you eliminate fat from your diet, you end up eating more carbohydrates. Don’t believe us? Next time, try eating a bowl of ‘fat-free’ pasta and a bowl of regular pasta and notice the difference in quantity consumption yourself. Post the fat-free pasta, you will also find yourself unsatisfied, restless and hungry within 40 minutes -1 hourNow perhaps you and people around you refer to yourself and each other as ‘fat’ in jest, but this does not necessarily mean that you’re getting enough good fat in your diet. Health industry experts went insane a few years ago when an epiphany struck us all — “Fat does not make us fat!”. Here are some warning signs that your fat intake may be inadequate:Dry, flaky, itchy skinChapped lipsExperiencing random bouts of feeling coldFeeling hungry due to lack of satiety and fullnessMental slugishness/lack of concentrationJoint painBrittle hair and nailsGoing back to our previous topic of categories of fat, Omega-3 and Omega-6 fatty acids come under the category of essential fats because our bodies aren’t able to produce them naturally. The focus of this article is to elucidate the strong associations between essential fat consumption and good looking skin. Read on to learn more about how adding omega-3 and omega-6 onto your diet can affect your skin:Omega-3 and Omega-6 are two types of PUFA’s which are the building blocks of a healthy cell membrane. Think of the cell membrane as basically a wall with some holes punched allowing for things to go in and out. The membrane allows nutrients and waste products to get in and out of the cell. A good membrane (which you can create by eating your omega-3’s and 6’s) won’t allow water to leave the skin cells thereby giving you moist, soft, subtle, hydrated and wrinkle-free skin.Foods rich in omega-3 fatty acids help reduce the body’s production of inflammatory compounds — natural chemicals involved in the aging process, which affect how healthy the skin looks and feels.Omega-6 Fatty Acids help prevent skin drynessOmega-3 Fatty Acids nourish your skin, are important for radiance and add softness to your complexion.Omega-3s also seem to offer the skin protection against sun damage.Essential fats help prevent acne which tends to occur when glands over produce the substances keratin and sebum. They clog skin pores and result in skin infections. Essential fatty acids have a two-fold benefit for acne. First, they cause healthy cell transference, which helps dissolves the fatty deposits that block pores and cause acne. They also work to repair the skin damaged by pimples and blemishes.There is evidence to suggest that the healthier and more supple your skin cells, the less intense the appearance of cellulite. Consuming plenty of essential fatty acids will give your skin cells more fullness and flexibility, and thereby possibly reducing the appearance of cellulite.Food sources: Omega-3s: Ghee, Flaxseeds, Safflower oil, Walnuts, Soy and soybeans, Fortified eggs, Oily fish, Canola oil, Palak or Spinach, Pomogranate, Blackberries, Watermelon Omega-6s: Ghee, Cooking oils, Poultry, Grains, Seeds, Nuts, Green leafy vegetables and Avocado Long story short: we are asking (pleading almost) for you to include fat in your diet in moderation! Why then would you go out and torture yourself with detoxes and scams? Are you a fan of dry skin and looking older than your actual age? We didn’t think so. So add 1-2 tsps of ghee to your roti and make the transition back to full-fat milk guilt-free. We assure you that this won’t make you fat! You can hunt us down and thank us later at your own time.

Like TB,This Lung Disease Is Not Communicable-COPD

Dr. Neelam Nath Bhatia, General Physician
Pollution after festivals has crossed Limits. Some areas of Delhi have recorded Suspended particles>1000(normal is 60+).COPD is one of the illnesses caused by pollution & low levels of oxygen in the blood.Simply put COPD is narrowing of passages and baloons (bronchi &alveoli) within lungs. Breathing becomes measured and Difficult as these fibrosed elements carry oxygen we breathe in,resulting in coughing and breathlessness.COPD is Not Reversible like Asthma. It progresses slowly. Both of these respiratory illnesses can be Controlled but Not Cured Permanently.COPD-Chronic Obstructive Pulmonary Disease can be deadly if associated with Heart illness as-Both heart and lung is One Unit and cause Breathlessness ,confusing the Treating doctors.Before an open heart surgery getting clearance from Lung doctor is a Must.Heart function is Measured by Echo and Lung Function is measured by Spirometry machines.Both machines are expensive and every GP cannot have them in Routine GP Clinics.Health Ministry will soon release "New Delhi declaration on mitigating effects of air pollution" and it has decided to declare COPD in Non Communicable disease (NCD) programme.We as Doctors can keep a Breathometer in our clinics to measure Lung Capacity of every person suspected to be at Risk, like we check BP as a Routine.Yes it is that simple. Cost of 'machine' is just 300/-(three hundred) only. One has to breathe in and breathe out with full force.Calibrations are on equipment,which is of the size of a baby feeding bottle.It gives a reading about functions of lung in a similar way the mother knows about milliliters of milk drunk by baby !This Breathometer is easily available and it is worth keeping in clinics as Some among others can have good lung functions too.WHY SEND EVERY Person for expensive lung tests? (So that Doubts can be Put to rest or treatment started on time so that illness does not progress to next dangerous level) Disease Grows Slowly like Cancer.We do have a choice to FIGHT pollution, learn to Live with it till the time some measures are taken up by Government and Individuals.This Means that our government is serious and want to screen people like other NCD diseases like Diabetes, Hypertension,Cancer and others.Reason to make COPD as NCD.Assistance will be provided to have Spirometers ,Nebulizers, Bronchodilators and Relevant medicines Available.This type of programme was launched to eradicate Polio and Small Pox and was Successful in Eradication of these 2 illnesses.Despite Awareness and programmes,there is No Reduction in TB cases but an Awareness has been Generated.Our Patients themselves ask for TB tests in Private Charitable Clinics if they have no time for government hospitalsRemember Non Smoking women are as Vulnerable to get COPD. Stress aggravates. Medicines to carry out MTP at advanced stage has COPD and low grade fever as side effects. If given once, the effect wanes, if given every year, the effect stays for life.And Women Too Breathe the Same Polluted Air as Men

6 Frequently Asked Questions About Rheumatoid Arthritis

Dr. Pravin Patil, Rheumatologist
Arthritis is a broad term that describes inflammation of the joints (pain, swelling and redness). Rheumatoid arthritis (RA) is a disease of immune system. Patient with Rheumatoid arthritis suffer from multiple joint pains and swelling. In severe cases RA can affect eyes, lungs, heart, nerves or blood vessels.1. What are the symptoms of Rheumatoid arthritisThe most common symptoms of RA are:· Pain in multiple joints · Stiffness on getting up after a period of inactivity or in the morning · Swelling in one or more joints · Joint pains worse with rest, better with use· Fatigue /difficulty in performing routine activitiesThe most common joints involved are the hands, wrists and feet. The stiffness in the morning generally lasts longer than 45 minutes.2. How common is rheumatoid arthritis?In the general population about a 1 in 100 people develop RA. It is three times more common in women than in men. 3. What causes rheumatoid arthritis?RA is an autoimmune disease. An autoimmune disorder occurs when the immune system mistakenly attacks patient’s own healthy body tissue. In Rheumatoid arthritis body's immune system attacks normal joint tissues, causing swelling of the joint lining. Once the disease begins the joints become inflamed and, if untreated, the joints, cartilage, and bone can be damaged.4. Is rheumatoid arthritis hereditary?If you have a td family member with RA then your risk of developing RA is higher than the general population.You should see a rheumatologist if you have joint symptoms.5. Is RA a disease of old people?No. RA is most common in young and middle-aged adults but can also affect children and the elderly.6. Is there any relation with climate?Many people think that weather in winter may aggravate the arthritis. This is a misconception. Cold weather may cause more stiffness in the joints, but it will not aggravate or precipitate the arthritis.

Breathe Your Troubles Away

Mrs. Anju Chandna, Yoga and Naturopathy
Imagine yourself in a desert, surrounded by hot hills of dry sand and your throat parched with not a drop of water to drink. Suddenly you spot an oasis. You rush to quench your thirst and keep gulping water till your body is satiated.We call this human instinct. The craving and the urge for satiation. Same rule applies to food, air and so many other bodily needs that need no mention here. Since I deal with a therapy primarily related to breathing, maybe I can restrict myself to air for the moment. Have you ever noticed a baby sleeping? Notice how its tummy moves up and down to the rhythm of its heart beat. Rhythm is so inherent to nature, everything in nature from the sky to the stars, from the nights and days to the seasons, from the wind to the water, everything follows a rhythm. The rhythm of movement. The biggest testimony to this rhythm is the human body. With each and every part and even the smallest curve and crevice blended together in perfect harmony and rhythm. Yet as we grow older, we somehow lose that rhythm in our body. At the risk of sounding far-fetched, I would say we forget to breathe. Breathing becomes just another mundane chore that our body is doing for the sake of living. Just like so many other things that we do mechanically throughout the day. We basically lose the rhythm of life.Real breathing is real living. Where every part of your body awakens to the gush of oxygen right into your lungs. And with every exhalation your tummy digs into the diaphragm. Where you see and feel your breath every moment of the day.Breath is held with great reverence in the Indian culture, its called the ‘Pran-Vayu’. ‘Pran’ meaning life and ‘Vayu’ meaning air, so literally speaking the air of life. ‘Pran’ also refers to the life giving force of nature, an embodiment of God himself in his most diminutive form present inside each human body. Ancient scriptures lay great stress on the simple exchange of air in our body and have prescribed various simple yet scientific breathing techniques called 'Pranayam'. An hour long ‘Pranayam’ session can do to your lungs what let’s say a one hour of jogging time will do to your leg muscles.Scientific wisdom tells us that the oxygen we inhale is carried though blood to each and every living cell of our body. And the air that we exhale cleanses the body. Simply put, breathing is the internal cleaning mechanism of our body. An efficient system of cleaning will ensure to remove all toxins and ‘bad’ air.That’s we do at our salt therapy clinic. Make you breathe. As you breathe in the pure salt aerosol it enters your lungs to cleanse them of all toxins, accumulated mucous and impurities. You feel fresh, rejuvenated and cleansed. That’s what breathing is all about!

Smoking and Coping With Copd

Dr. Vandana D.Prabhu, Pulmonologist
Mr. X was a smoker and knew it was bad for his lungs. But he was more scared about having a heart attack. So he took an ECG every year but it was always normal, and his chest x-rays were clear. Even though he was getting breathless and coughing a lot, he thought it was a normal smoker’s cough. He ignored it till he reached a stage where he couldn’t walk far without breathing difficulty.Now he has given up smoking, and is on treatment for COPD. It was tough to quit smoking, but with will power he succeeded. He now feels much happier and goes for his morning walk comfortably.COPD is the short form for Chronic Obstructive Pulmonary Disease. “Chronic” means that it will not go away. “Obstructive” means partly blocked. “Pulmonary” means in the lungs. This means that you need long-term treatment for a disease that is causing some blockage in your lungs. The air tubes which carry air in and out of the lungs become narrower, so the amount of air that goes in is much less. Also, air cannot get out of the lungs properly. Because of this, the patient feels breathless, his lungs feel very full, and his chest feels tight. These are the symptoms of COPD.Smoking is the most commoncause of COPD. People who get COPD are usually smokers over 40 years of age. Theymay be ex-smokers who have quit, but already have lung damage. Even non-smokerscan get COPD if they keep breathing in second-hand smoke. Constant exposure tofumes from burning firewood or charcoal is a risk factor. That is how women inrural India get COPD from their cooking stoves {“chula”} or room heaters[“sigri”]. Asthmatics can get COPD if their asthma is not properly controlled.Occupational exposure to dusty or smoky air like coal mines; or otherindustries like cement, textiles and chemicals may also cause COPD.The patient is asked to doa breathing test called spirometry; by which the doctor grades COPD as mild, moderateor severe; and decides on the treatment plan accordingly. Newer inhaledmedications are safe and effective for long-term treatment. The most importantadvice is to stop smoking and take the prescribed medicines regularly.The patient’s condition canget worse even if he smokes just two cigarettes a day. Cigarette smoke reducesthe lungs’ immunity against infections. It irritates the airways which getnarrower and produce excess mucus that blocks them. If the patient’s willpowerto quit smoking is not enough, the doctor may recommend a nicotine patch/chewing gum. This nicotine substitute reduces withdrawal symptoms like anxiety,restlessness and craving for tobacco smoke.To QUIT Smoking:Set a definite date when you will stop smokingcompletely.Tell your friends and family that you are tryingto stop. They will support and motivate you.Take one day at a time. Mark off each successfulday on a calendar.Avoid people who smoke and places that make youwant to smoke.Remove all ashtrays, cigarette packs andlighters from your home.Keep your hands busy. Whenever you feel likepicking up a cigarette, pick up a pencil instead.If you feel an urge to smoke, chew some nicotinegum instead.If you start smoking again, don’t give up onyour goal. On an average, people make 3-4 attempts to quit before they stopsmoking permanently.Keep the air clean in your home. Avoid smoke,fumes, and strong smells. If your house is being painted or pest-controlled,stay away.If you are cooking, keep the kitchen windowsopen and use an exhaust fan.On days when there is lot of pollution and dustoutside, stay at home and keep the windows closed.If you are overweight, it is harder to breathe.Try to lose weight.If you become breathless while eating, eatslowly and talk less.Eat fresh fruits and vegetables; in smallamounts but more frequently.Drink lots of water. This helps make the mucusin your lungs thinner, so that you can cough it out easily.Do breathing exercises. Walk slowly for 20 mindaily. If you feel breathless, stop and rest.If your COPD is very bad and you have beenhospitalised, the doctor may advise you to take oxygen at home. You will have toarrange for an oxygen cylinder or an oxygen concentrator.If breathing becomes very difficult, and it ishard to walk and talk, it may be an emergency. Go to the hospital right away.

Regular Exercise Benefits Your Skin

Dr. Madhavi Pudi, Dermatologist
Regular exercises or physical activities keep our heart and lungs in good condition and help t,o reduce weight ; you & we; both will unanimously agree to that. But do you know it is highly beneficial for our skin too? Yeah, that's true. Exercise can make your skin glow, look young and healthy, but how? Let's get a broader picture;Benefits:1. Exercises increase the blood flow to your skin and helps in providing more oxygen and nutrients to the cells through out the body including the skin.2. Increased blood flow also helps to remove the waste products and cellular debris out of the system (Flushed out).3. Exercise reduces stress and in turn helps to improve those skin condition ( acne,psoriasis etc..) which are aggravated by stress.4. Muscle tone is improved with exercise which in turn gives a fimer and overall better looking skin.5. Exercise also promates blood circulation to the hair roots and scalpe, keeping them healthy .6. Exercise increases collagen production which is a protein involved in giving support and suppleness to our skinAre there any risks?1. certain skin conditions can be worsened by physical activity , examples being rosacea, eczema and psoriasis. Rosacea isaggravated by increase in body temperature and the skin flushing. The salt from perspiration can causes flare -ups of eczema and psoriasis.2.Ther is an increased risk of photosensitivity due to excessive sweating which may lead to sunburn and UV related skin damage when you do exercise in the sun. This may increase the risk of skin cancer.3. Tight fitting clothes & perspiration may irritate the skin and produce acne (pimples) which is called acne mechanica.But These are no valid reasons to stop exercise as the benfits outweigh any adverse effects it can cause. Besides , you could always go for some precautions ;1.Exercise in a cool environment (air conditioned room) . If you get over heated ,apply cool compresses to the problem areas soon after the workout . If you have to work out outdoor , use sunscreens liberally and avoid exercising between 10 am-3pm.Also protect the skin by proper clothing & hat.2.Apply moisturizers before workout to protect your skin from the ill effects of sweat . Dont' forget to apply them on the groin and underams.3. Take shower after exercise, but excessive washing need to be avoided. After showering apply a soothing moisturizer to prevent skin irritation .4. Wear loose fitting clothes which can absorb moisture.

5 Priceless Benefits of Salt Therapy for All Your Respiratory Troubles!

Mrs. Anju Chandna, Yoga and Naturopathy
Salt therapy is fast catching everyone’s attention. A therapy that was born within the confines of natural salt caves in the Eastern European countries like Poland and Romania around 150 years ago is now on its way to become one of the most revolutionary treatments of all time for all respiratory allergies like Asthma, Bronchitis,Sinusitis, Allergic cough, Dry cough, COPD and many others. A lot can be attributed to the fact that the treatment is natural.So let me give you a 5 point count as to what makes this therapy different from the conventional methods of treatment that we’ve known all these years. Salt therapy is a 100% natural treatment. The main ingredient that does all the trick is salt. The salt room has around 3-4 tons of salt on the walls, the ceiling, the floor and the aerosol that you inhale while sitting inside this artificial salt cave is also pharma-grade salt. Old age wisdom says that consuming too much salt is not good for our body but what needs to be understood is that this salt does not enter your digestive tract. So any side effect could arise of consuming salt directly is absent here. This salt aerosol enters only the respiratory tract through the nasal passage and goes directly into your lungs. It cleanses the mucous along its way and reaches the smallest bronchioles of the lungs. All naturally with no medicines.Salt therapy is absolutely safe for infants, the elderly and pregnant women. Since there is no medicine involved in the treatment, everyone from a 6 month old baby to an 80 year old adult can take the therapy without bothering about any negative fallout. Even pregnant women who are otherwise not advised medication can take this therapy and get relief from any allergy arising during their pregnancy. Salt therapy has no side effects. There is nothing entering your digestive tract that can possibly cause any side effect. Salt enters the lungs, reacts with the mucous present there and comes out of the body along with that mucous.  Presence of tons of salt in the salt room makes the environment absolutely clean and no allergens can find their way into it. People with respiratory disorders need such a clean atmosphere so that a one hour salt room session helps to cleanse their system and not irritate it. That is the reason why people with very chronic allergic cough can also endure the salt spray and benefit from it.Salt therapy offers long term relief. The basic function of salt therapy is to cleanse your lungs. So once your treatment is complete and your lungs get cleansed, the chances that they will remain that way are very high. But here we cannot ignore the fact that we are living in one of the most polluted regions of the world and you are constant being exposed to allergens. One might need maintenance sessions once every 3 months to keep your lungs clean and healthy.  Salt therapy de-stresses and calms the mind. Salt is inherently negatively ionized. Nature has made it this way.Negative ions are considered to be ‘cleansers of the air’ and salt has the property of negative ionization. Negative ionization of the air relieves stress, so spending an hour inside the salt room not just cleanses your lungs but also relieves your mind of stress. De-stressing the mind is considered to be an important step towards treating any kind of respiratory problem.So what are you waiting for? Come to the salt room and soak in the benefits of this miracle mineral!

Lung Cancer - A Looming Danger!

Dr. Vinod Kumar Reddy Maddi Reddy, Oncologist
Introduction:Lung cancer is the leading cause of death in men in India and fourth leading cause of death in men and women combined. Main reason for the incidence of lung cancer is exposure to tobacco smoke and in some in cases exposure to asbestos (rare these days),arsenic,polycyclic hydrocarbons,radon gas exposure. In selected cases the five year survival ranges between 20 to 80 percent based on the stage. In general the five year survival rate for lung cancer after diagnosis is sixteen percent. The risk is directly related to number packs smoked per day multiplied by number years of smoking it is termed as pack years of smoking. Symptoms:Common symptoms at presentation are cough,blood in cough or sputum ,breathlessness and chest pain. Lung cancer sometimes secreted certain substances which can cause different symptoms at distant sites (paraneoplastic syndromes).Diagnosis:When some one comes to a doctor a detailed history and physical exam are key to the diagnosis.Basic investigations include chest X-ray followed by a CT and then biopsy, which reported by a pathologist who does various tests on tissues to report it. These include H&E staining, IHC, mutation analysis, molecular analysis when available.In a tertiary referral centre like our Continental Cancer Centre we also have advanced imaging and intervention technologies like PET-CT Scan, EBUS (Endobronchial Ultrasound). Once the patient is diagnosed it is also important to stage the disease this so crucial that entire treatment plan is dependent on it. According to stage and tumour characteristics further tests may be required to rule out brain and bone metastasis. Lung cancer is stages using T(tumour size and local extent),N (involvement of nodes which will be locoregional extent) , M (Distant spread).Treatment:Treatment of Non-Small cell lung cancer is based on staging stages I and II surgery is the mainstay of treatment, Radiosurgery can be offered in certain cases. Tumours larger than 4cm may require chemotherapy after surgery. Some cases may require radiation after surgery based on pathology report after surgery. In stage IIIA and IIIB disease the rule of thumb is all the diseases classified as N2, N3 (advanced nodal stages) receive Chemo-radiation and rest of the resectable diseases go for surgery if not they receive Chemo-radiation and these are decisions taken up in multidisciplinary meetings. In stage IV disease chemotherapy is the mainstay of the treatment.In select stage IV diseases Chemo-radiation can still be offered in limited metastatic disease.In lung cancer treatment lung function tests and patients ability to tolerate surgery is considered first. Treatment of Small cell lung cancer is based on limited stage disease and extensive stage disease. This disease requires Chemotherapy ,Radiation to lung and prophylactic cranial irradiation.Though response rates are good but the survival rates are poor with only four percent of patient alive at two years.