Lung cancer is a common oncological disease found largely in developed countries. There are about 50-80 people suffering from this disease in every 100 thousand people. Peak of the incidence occurs at the age of 55-65.
Smoking is the main risk factor for the development of lung cancer. This bad habit is the reason for lung cancer in about 80% of males. Smoking also contributes to the unfavourable course of the illness. The mortality rate is 15 times higher among smokers than among non-smokers.
If a person quits smoking, this leads to a gradual reduction of the risk of lung cancer. In approximately 20 years after a person stops smoking the chance of cancer will be the same as for a person who have never smoked.
Other risk factors:
The highest risks of lung cancer are males who smoke and are constantly exposed to asbestos. These factors work in synergy that significantly increases the possibility of the malignant pathology.
The illness is asymptomatic during the early stages and it is hard to detect the pathological process. Since the moment the tumour first appears up until the first clinical signs; this can take 2-3 years.
Symptoms depend on the number of factors:
Central lung cancer is diagnosed, if the malformation is growing from the mucous membrane of the large bronchi. In this case, the pathological process manifests itself much earlier. The larger the diameter of the bronchus, the more pronounced the symptoms.
The main clinical manifestations are:
Other symptoms depend on the growth forms of the tumour:
Peripheral lung cancer has similar symptoms. This type of cancer is developing from the small bronchi. But the symptoms appear much later.
Sometimes peripheral cancer can have the same process as pneumonia. In this case it has the characteristic features of the inflammation process in the lung tissues:
When the location of the peripheral lung cancer is on top of the lung, brachial plexus and the sympathetic nerve are affected. This is accompanied by soreness in the shoulder or upper arm.
Horner's syndrome might occur which manifests itself:
There are other atypical forms of lung cancer, when the tumour is small in size, but it metastasizes into other organs. In this case, brain or bone damage can get at the forefront of clinical picture.
As with any cancer, the occurrence of malignancy in the lung provokes a number of common symptoms. This can be evident through a fever, weakness, poor appetite, rapid weight loss, headache.
Early diagnostics of the lung cancer is complicated. 70% of patients only see a doctor when the disease in not curable anymore. The reason is the absence of pain as there are no nerve endings in the lungs.
Main diagnostics methods are radiography and sputum cytology or bronchus lavage (this way abnormal cells can be identified). Computed tomography is used as an alternative to X-ray as a more informative study.
To assess the stage of the pathological process and determine the histological forms of cancer, bronchoscopy with biopsy is normally used. It is the most informative method for the central cancer diagnosis because small bronchi are not available for the introduction of a bronchoscope.
Other diagnostic methods include:
Only 20% of patients are curable with the help of surgery, including patients with late diagnosis. The others are contraindicated surgery due to one of the reasons:
The amount of surgery depends on the stage of the pathological process, tumour growth form, its size, presence and location of metastases. Following parts can be removed in the course of surgery:
Simultaneously, the regional lymph nodes, parts of the chest wall, blood vessels, pericardium pieces, diaphragm, trachea, oesophagus, and other tissues, which are germinated by the tumour, can be removed if necessary.
Chemotherapy and radiation therapy can slow the malformation’s growth down and reduce its size making the patient’s life easier. But these techniques are additional. If they are applied without any surgery, there will be no influence on the patient’s survival.
Parallel with the main treatment methods, new therapeutic techniques are introduced and they will help to lengthen the patients’ lives.
Dendritic cellsis an immunotherapy method. Dendritic cells are prepared from blood or bone marrow. Then cultured and injected subcutaneously so that the patient's immune system begins to fight the tumour.
The main advantages of the treatment of lung cancer with the help of dendritic cells:
Targeted therapy presupposes the use of drugs that can selectively affect tumourtissue, without affecting the healthy cells, including those that divide quickly. Only in 2016 two new drugs for targeted therapy of lung cancer appeared. Targeted therapy is significantly superior than chemotherapy, and thus is better tolerated.
Lung cancer is a highly dangerous illness with a negative prognosis. Five year survival is only about a 10% chance . Almost 80% of patients die within a year after the diagnosis was established.
The survival depends on the stage of cancer when it was diagnosed. In case of early diagnosis and surgery the prognosis is conditionally positive and the patient has a 70% chance of surviving for the next five years.
If the surgical treatment is not performed the five year survival is about 5%. It depends on the number of factors such as the location of the tumourfirst of all (prognosis is better if it’s a peripheral lung cancer, not the central) and its histological form.
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