Overview of the Lung Cancer Program

Lung cancer is one of the most common, complex, and aggressive forms of cancer. The multidisciplinary team in Cleveland Clinic Abu Dhabi’s Lung Cancer Program uses the latest available techniques to diagnose and treat lung cancer. The Program also offers screening for lung cancer in high-risk patients – particularly those with a history of tobacco use – to identify and treat cancers at the earliest possible stage, maximizing chances of recovery and survival. The Heart, Vascular & Thoracic Institute, Respiratory Institute and Oncology Institute​  jointly contribute to this program.

Lung cancer is one of the most common, complex, and aggressive forms of cancer. However, today, thanks advances in treatments and a better understanding of the disease, the prognosis for those diagnosed with lung cancer is better than ever. 

ONE STEP AT A TIME, TOGETHER

Click here​ to learn about the importance of lung cancer screening

Why Choose Us?

Our Lung Cancer Program brings together a multidisciplinary team of medical oncologists, radiation oncologists, pulmonologists, thoracic surgeons, pathologists, and thoracic radiologists. Together, they collaborate to provide customized, coordinated care, ensuring the entire team’s expertise is focused on every patient.  

Our team works together to explore the most appropriate approach to diagnosis and treatment for every patient, with treatment customized to ensure they enjoy the best possible quality of life. We also work closely with Cleveland Clinic in the US to discuss patient cases, when necessary, home to some of the most respected lung cancer specialists in the US. 

What We Treat

Lung cancer is the world’s most common cause of cancer-related death for both men and women and is one of the most complex and aggressive cancers to treat. The incidence of lung cancer is strongly linked to cigarette smoking, with about 85% of lung cancers being linked to tobacco use. In the GCC and UAE, this also includes other forms of smoking, such as shisha, cigars, and medwakh pipes.

Most lung cancers begin in bronchi lining (the airways of lungs or breathing tube). Lung cancer can also form in the glands below this lining, and frequently in the outer areas of the lungs. There are two main types of lung cancer; small cell lung cancer or non-small cell lung cancer, which both develop in different ways: 

Non-small Cell Lung Cancer (NSCLC)

NSCLC is the most common form of lung cancer. It often spreads and grows slowly and has three main types (named after the cells within which the cancer develops):   

  • Adenocarcinoma: Usually begins near the edge of the lung. It can vary in its size and the rate at which it grows. It is the most common type of lung cancer in non-smokers.
  • Squamous cell carcinoma: Usually begins in the larger breathing tubes in the middle of the chest.
  • Large cell carcinoma: Usually begins at the edge of the lung, and it grows quickly.

Small Cell Lung Cancer (SCLC)

SCLC is less common than NSCLC, accounting for only around 15% of lung cancers. However, this type of lung cancer grows quickly, and is often advanced and has spread at the time of diagnosis.​

Rare cancers of the chest

There are many other rare tumors which can develop in the chest. These may or may not originate from the lung and include carcinoid tumors (found in large airways) and malignant mesothelioma (found in the lung lining).

Mesothelioma

Mesothelioma affects the membrane that protects most of the body’s organs (mesothelium). It is a rare cancer which often begins in the mesothelium which surrounds the lungs (called the pleura). It can also begin in the pericardium, the membrane that surrounds the heart. Mesothelioma usually develops after long exposure to asbestos.​

 

Symptoms, Causes & Risk Factors 

Symptoms 

Lung cancer usually has no symptoms in its earliest stages. Symptoms and signs of lung cancer typically occur when the disease is advanced.

Signs and symptoms of lung cancer might include:

  • Coughing up blood
  • A new cough 
  • Pain in the cheat
  • Shortness of breath
  • Weight loss
  • Headaches
  • Hoarseness

Causes 

Most cases of lung cancer are caused by smoking. This applies to both smokers and people exposed to secondhand smoke. Smoking (including cigarettes, shisha, cigars, and medwakh pipes) damages the cells lining the lungs as the smoke contains cancer-causing substances. 

Lung cancer can also develop in people who have never smoked or never been exposed to secondhand smoke – the cause of lung cancer in these patients is unknown. 

Risk Factors 

As well as smoking, other factors may increase your risk of developing lung cancer. Some can be controlled, like quitting smoking, and others can’t, such as your family history. Risk factors include:


  • Smoking (quitting will significantly lower your risk of developing lung cancer)
  • Family history (a parent, sibling or child with lung cancer).
  • Exposure to secondhand smoke. 
  • Radiation therapy in the past.
  • Exposure to radon gas. 
  • Exposure to asbestos and other carcinogens. 

Diagnosis of Lung Cancer

How lung cancer is diagnosed is different from person to person. Your doctor may order imaging tests to obtain pictures of the inside of your body, such as a CT scan, supported by several minimally invasive procedures if the results reveal a possible cancer. If a patient requires multiple diagnostic tests (tests used to help diagnose a disease or condition), these can be performed in one setting in Cleveland Clinic Abu Dhabi’s hybrid operating rooms, reducing the need for multiple procedures and multiple patient transfers within the facility.

Diagnostic tests include:

Imaging Tests​

  • Computed Tomography (CT) Scan
  • Positron Emission Tomography (PET) Scan.

Procedures 

  • Bronchoscopy: A procedure in which a hollow flexible tube, or bronchoscope, is used to visually examine inside the patient’s lungs and collect samples for laboratory testing.
  • Endobronchial ultrasound (EBUS): A bronchoscope (a thin, lighted, flexible tube) is used to take ultrasound images of the lungs and airways using soundwaves that make pictures. This is done with numbing medicine (local anesthesia) and sedation.
  • Mediastinoscopy & Mediastinotomy: Both procedures allow a surgeon to look and take samples of the lymph nodes in the area between the lungs.
  • Transthoracic CT guided biopsy: A method of obtaining a biopsy of the lymph nodes.
  • Thoracoscopy: A procedure in which a flexible tube is inserted through an incision in the chest to view the lungs and surrounding area.

These important tests and procedures can help determine whether cancer is present, help tell how advanced the disease is and provide information that will help our specialized team to identify and treat lung cancers at the earliest possible stage, maximizing chances of recovery and survival. 

The Stages of Lung Cancer

Staging lung cancer is the next step in the lung diagnosis process. Staging allows doctors to understand the extent of the cancer to make the best decisions for treatment. Different types of lung cancer are staged differently and have specialized words and categories. A general way to describe lung cancer staging is:

  • Localized: The cancer is only in the lung.
  • Regional: The cancer has spread to the lymph nodes in the chest.
  • Distant: The cancer has spread to other parts of the body.  

Lung Cancer Treatment

Lung cancer treatment decisions are made by the patient and your specialized Thoracic Cancer team together. At Cleveland Clinic Abu Dhabi our multidisciplinary tumor board will meet to discuss each Lung Cancer patient. This team of specialists will sit together to talk through the best treatment options, including clinical trials, for each individual. This approach ensures each patient gets the benefit of several expert opinions for their treatment plan.

Treatment options for Lung Cancer are usually based on the types of cancer you have, the stage of the cancer and your lung cancer treatment goals. Treatment options usually involve:

Surgery​

  • Surgery is usually required for the removal of cancerous tumors. Where possible, treatment is performed using a minimally invasive technique called Video Assisted Thoracic Surgery (VATS), whereby a camera and endoscopic instruments are inserted into the chest through one or more small incisions. One of the main benefits of VATS is that it causes less post-operative pain and offers a faster recovery than open surgery (thoracotomy).

The type of surgery performed can vary depending on the size, localization, and extent of the cancer. Some additional surgical treatment options include:

  • Segmentectomy or lobectomy: A surgery in which part of the lung is removed.
  • Pneumonectomy: A surgery in which the lung is completely removed.
  • Fluid removal: A procedure in which a thoracic surgeon uses minimally invasive techniques to remove fluid buildup from malignant pleural effusion. Alternatively, fluid can be drained via the placement of small-bore catheters by an interventional pulmonologist. 
  • Complex surgeries:

o  When cancer affects the chest wall, diaphragm, or blood vessels, surgery is performed using large incisions (thoracotomy) to ensure that the tumor is completely removed.

o If a tumor is in located in the patient’s airway, a surgeon may need to place a stent to prevent that airway from closing. 

All the above surgeries can be performed by Cleveland Clinic Abu Dhabi’s experienced team of Lung Cancer surgeons.

Additional treatment options also include:

Radiation Therapy

o A form of high energy x-ray that kills cancer cells. It can be used on its own, or as part of a treatment plan. 

Chemotherapy

o The use of medications that are designed to kill rapidly growing abnormal cells, such as cancer cells. Chemotherapy is injected directly into the veins or given orally in pill form. 

Targeted Therapy 

Immunotherapy

Prevention & Screening

Lung cancer is a complex and aggressive cancer to treat. It often has no symptoms until it is at an advanced stage, when survival rates are lower. But if caught early, lung cancer has a much higher chance of being cured. The best way to detect it early is through a routine screening. 

Cleveland Clinic Abu Dhabi’s multidisciplinary and collaborative approach to Lung Cancer offers screening to anyone at an increased risk for the disease. Screening is performed with a low-dose CT scan of the lungs, which is fast, painless, non-invasive, and accurate. Click here to learn more.

Who Should Attend Lung Cancer Screening?

Anyone considered high-risk for lung cancer should attend regular screening. This includes: 

  • People aged between 50 and 75. 
  • People who smoke or who have quit smoking within the past 15 years
  • People who have smoked at least one packet a day for more than 30 years
  • People who have smoked Medwakh or Sheesha for 20 years

Lung cancer screening saves lives. If you are at risk, book yours today.


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