One name – various tumors. Lung cancer is not the same as lung cancer. Under this generalized name, different forms of treatment are hidden in treatment and therapy. Lung cancer is a malignant tissue proliferation in the lungs, mainly from the mucous membranes of the bronchi. The medical term bronchial carcinoma hides numerous tumors with different cell types and therefore different forms of therapy and prognosis.

In the case of bronchial carcinoma, a distinction is made between small cell and non-small cell tumors

Non-small cell lung cancer (NSCLC) includes squamous cell carcinoma, which accounts for half of all lung cancers. The tumor cells do not grow as fast as e.g. in small cell bronchial carcinoma. It can usually be operated on well because it is predominantly located centrally in the lungs and more distinct than the small cell lung cancer. Also, the cancer cells grow less quickly, but also do not respond so well to a chemo or radiation therapy.

Adenocarcinoma also belongs to the group of non-small cell lung carcinomas. It has some special status, as it occurs mainly in non-smoking middle-aged women. Otherwise, it can be said that about every tenth cell-type lung cancer is an adenocarcinoma.

The third representative of this group is the rarely occurring large-cell bronchial carcinoma, which accounts for five to ten percent of all malignant lung tumors. All three tumor types grow more slowly compared to small cell bronchial carcinoma and do not form metastases (secondary tumors) as quickly.

Small cell lung cancer (SCLC) is also referred to as oat cell cancer because the tumor cells are very similar to oat grains. This type of lung cancer is extremely fast and invasive and early causes metastases in the lymph nodes, liver, kidneys, brain and skeletal system (predominantly spine). As a form of treatment, a chemotherapy or radiation therapy is available here, under which the tumor size can greatly reduce or reduce due to the cell specificity. Surgery is performed if the cancer is found only in one lung and near lymph nodes. However, as this type of cancer does not usually occur in just one area, surgery as a single treatment is not useful. Often there are also recurrences.

Small cell bronchial carcinomas also have as a special feature the formation of a paraneoplastic syndrome. The tumor cells produce hormone-like substances that can lead to a variety of endocrinological symptoms. Since 80% of all patients already have metastasis at the time of the first diagnosis, this tumor has the worst prognosis.

types-of-lungs-cancer

Special shapes :

  • Pancoast tumor

The tumor sits at a certain point in the lung tip and has just through this situation a typical symptom. The most common symptoms here are unilateral shoulder pain radiating to the arm, ribs, neck, and back. This symptomatology is due to the ingrowth of the tumor into surrounding nerve tracts. Often a Horner syndrome also occurs. Horner’s syndrome is the combination of the drooping eyelid, narrowing of the pupil, withdrawal of the eyeball and reversed perspiration on one side. As a therapy, a combined chemo and radiation therapy followed by surgery is recommended if the condition of the patient allows it and there are no metastases in adjacent lymph nodes or other organs.

  • pleural mesothelioma

This rather rare malignant tumor starts from the pleura, which covers the lungs. Although it can greatly affect the function of the lungs and lead to severe breathing difficulties, it does not formally belong to the group of different types of lung cancer. Causes of the pleural mesothelioma are mostly asbestos contacts. Asbestos is the most important risk factor for this type of cancer. Since 1977, pleural mesothelioma has been recognized as an occupational disease in recent occupational asbestos exposure. It grows quite slowly compared to other tumors. Decades may pass between the inhalation of asbestos-containing dust and the manifestation of a pleural mesothelioma.

In the end, however, it destroys and displaces other organs such as the lungs, heart, and diaphragm and forms metastases. It also comes very often to a pleural effusion. This is an accumulation of often purulent, often bloody fluid in the chest. In the treatment of pleural mesothelioma, the affected tissues are removed and replaced if necessary by artificial sculptures. Accompanying radiation and/or chemotherapy can be used.

Cancer therapies serve the purpose of curing the patient of the disease (“curative” = healing therapy) or to stop the further growth and spread of the tumor as long as possible, to relieve discomfort and to prolong the lifetime (“palliative” = alleviative) Therapy). An indispensable component of oncological care is the so-called “supportive therapy” (supportive therapy). It treats and prevents complications of cancer and survival-related but often aggressive cancer therapies.

How is lung cancer operated?

If the tumor has not exceeded a certain size and has not yet formed distant metastases, surgery is sought with the aim of completely removing the tumor tissue and the lymph nodes affected by tumor cells. The operation plays an important role especially in non-small cell lung cancer – as small cell lung cancer is often diagnosed at a later stage, then other treatments are in the foreground.

The surgical procedure is preceded by extensive research. In particular, it must be ensured that after the removal of part of the lung, the remaining lung sections are able to sufficiently take over the respiratory function. The condition for the operation is a good general condition of the patient; Severe comorbidities often rule out surgery. Furthermore, removal of the tumor should not pose a risk to neighboring vital organs such as large blood vessels or the esophagus. If the expected burdens and restrictions are too great, a different therapy strategy must be chosen.

During surgery, the tumor-bearing lung section and the adjacent lymph nodes are removed. The most common procedure is the removal of a lung lobe (lobectomy). With very large tumors the removal of an entire lung wing may be necessary (pneumectomy). In many cases, however, it is possible to avoid the removal of the entire lung through special, organ-preserving surgical techniques.

Possible side effects:

As a result of the operation, the available breathing area of the patient is reduced. However, if the lung function before surgery is sufficient, it will not be a major problem for the patient, and he will usually be able to compensate well for the loss of lung tissue. Special breathing exercises in rehabilitation also help to improve lung performance after tumor therapy. The first exercises can already be learned in the clinic under the guidance of a physiotherapist and later be continued at home. For smokers, however, they should stop smoking immediately before the operation to improve their lung function.

What happens during an irradiation?

Radiation therapy is the only therapy for non-small cell lung cancer in stages I and II when surgery is not possible and for selected patients in stage III. Otherwise, it is usually combined with chemotherapy in patients with stage III and small cell lung cancer. If cancer has secondary tumors, called metastases, in other organs such as the brain or the bones, they may also be irradiated.

The high-energy ionizing radiation, which is directed from the outside to the tumor, destroys the cancer cells. The total radiation dose is divided into several single doses, which are administered about five times a week. In the so-called hyperfractionated radiation, which can be used in lung cancer, is even twice a day at intervals of several hours, but then irradiated with lower single doses.

In addition to conventional radiotherapy, the so-called stereotactic radiotherapy is also used. Here, the disease is in a few sessions, sometimes in only one, irradiated with a high dose of radiation. This is possible because the beams are directed to the target area from different directions after computer-controlled irradiation planning. There, all the rays meet at one point and add up to the total dose, which is thus maximum at the site of the disease, while the surrounding healthy tissue is largely spared. For this reason, stereotactic radiotherapy is particularly well suited for small tumors and tumors in delicate environments, such as brain metastases.

Possible Side Effects:

Side effects of radiotherapy may be hoarseness and difficulty swallowing. The skin is also sensitive to the treatment. In combination with chemotherapy in particular, mucous membrane inflammation and fungal infections can occur in the oral cavity. A late consequence is a pneumonitis, an inflammation of the irradiated lung tissue. Overall, the severity of side effects depends on the type and intensity of the radiation used.

How does the chemotherapy work?

Chemotherapy uses cell-growth-inhibiting drugs known as cytostatics. They act primarily against fast-growing cells and thus especially against cancer cells. For the treatment of lung cancer several chemotherapeutic drugs are available, which are selected according to individual requirements.

Which medicines are used depends on various factors, including the stage of the disease, the general condition, and concomitant diseases. Usually, two or three substances are combined, with cisplatin or carboplatin as the basic drug in most cases. Commonly used cytostatic drugs in non-small cell

To assist physicians in deciding what type of treatment is more appropriate for lung cancer, there is a recognized numerical staging system that creates benchmarks. At Stage I, the cancer is small and localized in a specific area of the lung. During phases 2 and 3, cancer grows and spreads to the surrounding tissue and possibly the lymph nodes.

Stage 4 of lung cancer is when cancer has spread, or metastasized, from the lungs to other parts of the body. Typically, cancer spreads to the liver, bones, brain or adrenal glands. This is commonly known as secondary or advanced cancer. About 40% of lung cancer patients are diagnosed at stage 4, mainly because the symptoms of lung cancer could include symptoms of other diseases. In Stage 4, the cancer is not curable, but it can be treated. These are some of the symptoms that may help your doctor to diagnose stage 4 of lung cancer.

  • Breathing problems

Lung cancer patients often present with shortness of breath, wheezing, and hoarseness. It is often a persistent cough, and the patient can cough up blood. Sometimes, a chronic cough that the patient may suddenly change for some time may be natural. Because these symptoms may also affect other conditions, they are not sufficient to suggest a diagnosis of lung cancer. However, if a smoker presents with these symptoms, a diagnosis of stage 4 lung cancer is likely to be considered by the doctor.

  • Pain

Patients may experience pain in various areas of the upper body, including the back, chest, arms, ribs, and hips. Deep breathing often intensifies the pain that can be felt in the tissues or bones depending on the spread of cancer. It can also be a pain when swallowing. Some people suffer from frequent headaches, which is an indication that cancer could be affecting the brain.

stage-4-of-lung-cancer

  • Weight Loss

With stage 4 lung cancer, there is often a sudden, unexplained weight loss that is often accompanied by loss of appetite and a general feeling of weakness and fatigue. If this weight loss is significant and you do not have a diet, it should be investigated.

  • “Clubbing”

The nails on the fingers and toes can bulge, and the ends of the fingers change shape. This symptom usually develops in the latter stages of lung cancer, so it is a good indicator of diagnosis.

  • Diagnosis

The diagnostic process for stage 4 lung cancer is usually some form of imaging, such as computed tomography (CAT) or Magnetic Resonance Imaging (MRI). These scans give a detailed picture of the spread of cancer as X-rays, allowing the doctor to determine the cancerous stage. A radionuclide scan can detect if cancer has spread to other organs, while a bone scan will show if the bones are affected.

The doctor may also conduct tests to determine if cancer has spread to the lymph nodes. This involves removing a tissue sample for testing under general anesthesia. This process is called medias or mediastinotomy, depending on whether the tissue is absorbed by the neck or the chest.

While all these symptoms refer to other conditions, if you experience one or more of them for two weeks or more, you should consult your doctor. Lung cancer is particularly dangerous because of it metastases to other parts of the body relatively quickly, making it one of the most life-threatening cancers there is. As with most conditions, the earlier the diagnosis, the more likely that the treatment will succeed. During treatment for stage 4 lung cancer, the condition will not heal, it can prolong life and improve quality of life, so it is important to seek medical advice as soon as possible.

Lung cancer is a malignant neoplasm in the respiratory system (lungs and bronchi). In addition to breast cancer, colon cancer and prostate cancer, it is one of the most common cancers worldwide. Unfortunately, the number of illnesses continues to increase, especially among women.

Short version:

  • Smoking causes 85% of lung cancers.
  • Lung cancer is caused by a change in the genetic material due to chronic damage.
  • Lung carcinomas can be divided into two groups.
  • Because symptoms are unrecognized or misinterpreted, lung cancer is often discovered by accident during examinations.
  • The treatment of a lung tumor depends on the type of cancer.

In Austria, around 2,500 men and almost 1,200 women suffer from bronchial carcinoma each year. Thus lung cancer is second only to prostate cancer in males and third in women after breast and colon cancer. Most cases are detected between the 55th and the 65th year of life. However, patients can be significantly younger.

The main risk factor for the development of lung cancer is cigarette smoking: Around 85% of all cases can be attributed to tobacco consumption. Hereditary predispositions or contact with other harmful substances (such as arsenic, radon or asbestos), on the other hand, play a subordinate role. 3-5% of the diseases are caused by passive smoking.

From surgery to Targeted Therapy: Depending on the type and stage, lung cancer is treated differently.

Anyone smoking a pack of cigarettes every day for over 20 years increases their lung cancer risk 30 to 40 times. By contrast, a familial accumulation only leads to a doubling or tripling of the risk.

How does lung cancer develop?

In the cells of the mucous membranes of the bronchi and in the alveoli, there is a change in the genetic material due to prolonged chronic damage (for example, chronic inflammation from cigarette smoke). After a long time, this change means that the normal control mechanisms for the growth and death of cells are no longer effective and a malignant tumor develops. At an early stage of development, this process can sometimes be reversed, such as when the damaging effects are stopped.

Basically, two groups of lung cancer are differentiated:

  1. Non-small cell lung carcinoma

The non-small cell type accounts for around three quarters of cancers of the lung. It is roughly subdivided into:

  • squamous cell carcinoma
  • the adenocarcinoma
  • the large cell carcinoma
  1. Small cell lung carcinoma

Small cell lung cancer (about 20% of the disease) spreads rapidly through the bloodstream and lymphatics, but is better for chemotherapy.

This distinction is important from a medical point of view, because the therapy is targeted accordingly.

what-are-the-symptoms-of-lungs-cancer

Which symptoms occur?

In those cases of lung cancer that are discovered at an early stage, these are generally incidental findings: pulmonary x-raying is actually done for quite different reasons, e.g. in case of release for surgical procedures or severe infections suggesting pneumonia.

The most significant problem is that the disease remains asymptomatic for a long time. Often, the typical symptoms, such as coughing, shortness of breath, fatigue or back pain, misinterpreted or ignored. Since the majority of sufferers are smokers with chronic bronchitis and often have cardiovascular problems, the symptoms are attributed to them.

A doctor’s visit is therefore often delayed for a long time. Only the appearance of blood in the sputum or severe weight loss are alarming. More than two-thirds of all cases of lung cancer are therefore diagnosed at a local or systemic (i.e., distant metastasis) stage.

Unfortunately, previous large-scale studies on the possibility of early diagnosis have not shown sufficiently satisfactory results to be meaningful to broad sections of the population. A so-called spiral computed tomography (spiral CT) with low radiation dose is therefore recommended as a preventive check only certain risk groups: chronic smokers over 50 years, especially if at the same time a chronic obstructive pulmonary disease (COPD) is present; in addition, in the case of lung cancer in the family or a workplace that is burdened by inhaled carcinogens (carcinogenic substances). However, the last two factors only seem relevant if the person smokes himself at the same time.

How does the doctor make a diagnosis?

If lung cancer is suspected, the patient is referred to a specialized department where a complete examination is made as soon as possible. Among other things, the stage of the disease, the type of tumor and the spread in the body is examined.

For this purpose, different examination methods such as computed tomography, ultrasound, biopsy or a PET scan are performed.

Which treatment methods are available?

The choice of treatment for lung cancer depends largely on the type of cancer and the stage of the cancer. Treatment options range from surgery to radiation and chemotherapy, to molecular biology therapy.

What is the prognosis for lung cancer?

In contrast to other types of cancer, in the case of bronchial carcinoma, there are no meaningful early detection measures or long-term successful treatment methods. Lung cancer is the only cancer in which the rate of new disease is nearly identical to that of deaths.

Taking all the cases together, current treatment methods achieve a 5-year survival rate of only 15%. However, when early-stage non-small cell lung cancer is detected, around 75 out of every 100 people treated surgically are still alive five years later.

At the same time, lung cancer is virtually the only cancer that has a prevalent and avoidable risk factor. Prevention through smoking cessation is therefore at the forefront.

Especially