Paradigm shift in the management of lung cancer by robotic surgery

Interestingly Covid crisis has led to more diagnosis of lung cancers thanks to the usage of HRCT for the management of Covid Pandemic. Globally, Lung cancer is one of the commonest cancers and cause of cancer related deaths. It accounts for almost 15 per cent of all new cancer cases and 20 percent of cancer related deaths worldwide. Over 2 million new lung cancer cases are estimated every year in India. Lung cancer constitutes almost eight per cent of all new cancer cases and 10 percent of all cancer related deaths in India.

The worrisome trend is that majority of lung cancers are detected in late stages (70% in third or fourth stage). Smoking is one of the primary reasons for lung cancer. Others are pollution and inherited lung diseases.

The risk factors for development of lung cancer are smoking of tobacco-Both Active and Passive smoking, Pollution, exposure to Radon, asbestos, lung diseases like copd or a family history of lung cancer.

The presenting symptoms of lung cancer are cough which is persistent and doesn’t resolve with routine medication, associated with blood in expectorated sputum or mucus, respiratory symptoms like wheeze, difficulty in breathing, shortness of breath, pain in the thorax and loss of weight.

Robotic surgery or Robotic assisted thoracic surgery is a newer technique in management of lung cancer and other thoracic malignancies. The patients undergoing surgery by robotic approach have smaller incisions and can minimize the risk of lung complications compared to traditional open surgeries which are done by long incisions and spreading the ribs. The vision is magnified, crisp and three dimensional. Though it is called robotic, the surgeon is the commander for this technology and is always controlling the machine by hand and foot movements which in turn is mimicked by the robot. By this paradigm shift in management of lung cancer by robotic technology, the recovery is earlier, pain lesser and hospital stay is shorter.

The use of CT scan annually for early diagnosis of lung cancer has been recommended in high risk patients which is called as screening. However the awareness is limited in our country and it is not being routinely used. If detected early the management of such lung cancers can be curative by surgery and as the disease advances it can be managed by addition of chemotherapy, Immunotherapy and radiation. The surgical stress of patients can be minimized by newer technologies like robotic surgery which has proven to be a boon to patients undergoing surgery for lung cancer.