Lung Cancer Unit

The Lung Cancer Unit of the Oncological Institute (IOB) treats patients with symptoms of a possible lung cancer who need a diagnosis to confirm or rule out the presence of a tumour, in addition to patients who have already been previously diagnosed in other centres and come to IOB to receive treatment. It also offers a second opinion service to patients who have been seen in other centres, to guide individualised decision making, considering the type of lung cancer in question, the extent of the disease and the genetic and molecular characteristics of the tumour cells.

Patients treated at the Lung Cancer Unit are treated by a multidisciplinary team made up of oncologists, pulmonologists, radiotherapists, surgeons, anatomic pathologists and specialised cancer nursing staff. Likewise, IOB offers psychological or psychiatric care to patients in need of it, advice from nutrition specialists and complementary medicine treatments such as acupuncture and hypnosis to treat anxiety and pain.

Early detection
This multidisciplinary team makes it easier for patients to undergo all the tests and receive all the treatments they need in a coordinated way in the same place and in as little time as possible, without the need to travel and visit different specialists separately. The team is formed by Dr. Enriqueta Felip, oncologist, and Dr. Álex Martínez Martí, Dr. Celia Miralles and Dr. Javier Román.

Lung cancers do not usually produce symptoms that are easily identified in their early phases, and there is currently no early detection test for lung cancer equivalent to mammography for breast cancer. However, there are certain symptoms that can warn of the appearance of lung cancer, and that deserve a medical consultation to get an early detection as soon as possible. Although in many cases these symptoms will be due to causes other than cancer, it is advisable to consult a specialist without delay if one or more of the following symptoms occur:
• occurrence of cough that persists for more than ten days and has no apparent cause, or worsening of a chronic cough.
• appearance of blood in the sputum for several days in a row.
• persistent bronchitis.
• recurrent respiratory infections.
• breathing difficulties.
• chest pain.
• weight loss or fatigue without apparent cause.

Lung cancer can affect anyone, so these recommendations for early detection are applicable to the entire population. However, people who have smoked for years should pay extra attention, even if they have already quit smoking, or it they have been passive smokers, since smoking is the main risk factor for lung cancer.

Rapid diagnosis
A lung cancer diagnosis begins with a chest x-ray to check the origin of the symptoms that make us suspect the presence of a possible tumour. If the chest radiograph confirms the presence of an abnormal cell mass in the lung, additional imaging tests are usually performed to obtain more information about these cells. These additional tests usually include a computerised tomography (CT). To give a final confirmation of the diagnosis, it is necessary to perform a biopsy, which consists in extracting a sample of cells from the potential tumour to be analysed in the laboratory.

The analysis of these cells will clarify whether they are cancerous or not, and if they are, the type of cancer in question. Since there are several types of lung cancers, a detailed analysis of the cells is essential to make an accurate diagnosis. IOB has pioneered the introduction of genetic analysis to determine the molecular characteristics of each tumour and prescribe the most appropriate treatment for each patient.

When a cancer diagnosis is confirmed, a new imaging test (positron emission tomography or PET) must be performed to determine if the tumour is located at its point of origin, if it has begun to invade adjacent tissues or if it has extended to other organs. Also, a comprehensive blood test, including tumour markers, offers additional information to assess the extent to which the cancer has spread.
The IOB rapid diagnostic circuit has made it possible to reduce the average time between the first consultation of a patient newly diagnosed with lung cancer, or with the suspicion of having lung cancer, and the start of treatment, to a period of less than one week.

Personalised treatment
The lung cancer treatment should be decided individually for each patient based on the specific characteristics of each tumour and the degree to which the cancer has spread at the time when the diagnosis was made. Personalising the treatment is essential to achieve maximum therapeutic efficacy. As with other types of cancer, the goal of the treatment can be curative (aimed at completely eliminating the tumour) or palliative (aimed at prolonging life and reducing suffering in cases where complete elimination of the tumour is not possible).

In cases where the cancer is confined to its place of origin, the treatment is based on a surgical intervention with the objective of entirely removing the tumour. After the intervention, a chemotherapy and / or radiotherapy treatment is administered to eliminate the tumour cells that may have remained after the surgery. After the surgery, the patient’s evolution is strictly monitored, especially during the first three years. Medical examinations entail a comprehensive blood test with tumour markers every three months and imaging tests every six months.
In cases where the cancer has spread to other organs and surgery would no longer allow the entire removal of tumour cells, treatment is usually based on chemotherapy and radiotherapy. Many patients can also benefit from new generation medicine that selectively attack tumours or others based on their molecular characteristics.

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