Lung cancer attacks without warning. Symptoms are usually non-specific or absent. Lung cancer is currently the most common cause of cancer deaths. Its occurrence is favored by cigarette smoking, but it happens that people who have not smoked a single cigarette in their lives suffer from lung cancer. What other causes of lung cancer can? What symptoms should concern you and what is the treatment?
Lung canceronly in the second half of the 18th century it began to be distinguished as a separate disease entity. Previously, lung cancer was completely alien to researchers of human organisms.
Here you can read about all known cancer medicine and their classification!
In autopsy studies conducted at the end of the 19th century, lung tumors were detected in only 1% of the examined deceased. This number increased significantly at the beginning of the 20th century, when lung cancer was diagnosed in up to 15% of the dead.
The incidence of lung cancer has steadily increased over the years, and nowthis disease is the most common malignant neoplasm in men and the second most common (after breast cancer) in women.
Lung cancer: incidence
Lung cancer incidence statistics may be scary. It is estimated thatin 2012 was diagnosed in almost 2 million people worldwide.
Data on Poland are also not optimistic: according to the National Cancer Registry, in 2013 this disease occurred in over 14,000 men and in almost 7,000 women.
It is also disturbing that the incidence of lung cancer is still increasing. Just as in 1980 there were slightly more than 10,000 cases of lung cancer in Poland, 10 years later the disease was diagnosed in over 16,500 people, while in the aforementioned 2013, more than 21,000 patients became ill with lung cancer.
Lung cancer: causes and risk factors
The main cause of lung cancer are mutations in the genetic material, which result in disturbances in the processes of differentiation and death of human cells - they result, among others, in excessive, uncontrolled cell divisions that result in the appearance of a lung tumor in the affected person.
What, thoughlead to these genetic abnormalities?
The factor most associated with lung cancer is cigarette smoking - this association is definitely correct becauseeven 85-90% of all lung cancer cases are associated with long-term smoking .
The longer a person smokes and the more cigarettes a day a person smokes, the more their risk of cancer increases.
Lung cancer develops not only in smokers -it happens that the disease appears in a person who has never used a cigarette in his life . Contrary to appearances, this is not a rare situation, because 10 to 15% of all lung tumor cases are among non-smokers.
The diagnosis of cancer in this case is usually at least surprising, but the truth is that the factors of lung cancer include not only smoking, but also:
- exposure to cigarette smoke (i.e. passive smoking)
- exposure to various toxic substances, such as radon, asbestos or other pollutants in the air
- ionizing radiation
- respiratory conditions (such as chronic obstructive pulmonary disease or pulmonary fibrosis)
- genetic burden (increased risk of lung cancer is experienced by people whose family history has previously been diagnosed with this cancer)
Gender is also related to the risk of lung cancer - men have such a risk up to 3 times higher than women.
According to the National Cancer Registry, women in Poland die more often from lung cancer than from breast cancer, although the latter is diagnosed more than twice as often.
Lung cancer: symptoms
Lung cancer can certainly be considered a rather cunning disease - it is actually due to several reasons.
Well, first of all, for a long time, this disease can only give symptoms that suggest a completely different entity - e.g. some respiratory system infection - which is an extremely unfavorable situation, because it may delay the proper diagnosis of the patient.
The symptoms that may appear in the course of lung cancer include:
- cough (it has a different nature, but always persistent cough, not responding to treatment, but also cough of unknown cause, should be an indication to exclude the existence of a lung cancer in the patient; in the case of cigarette smokers - in whom cough is not uncommon - it should be of concern above allchange of character to everyone)
- hoarseness
- shortness of breath
- chest pain
- hemoptysis (symptom always requires consulting a doctor)
In the course of lung cancer, especially advanced lung cancer, general symptoms may also appear, which include, first of all, unintentional weight loss and significant weakness, deterioration of exercise tolerance and loss of appetite.
Lung cancer manifests itself very atypically - we are talking here about the so-called paraneoplastic syndromes, which may result from the secretion of various hormones and cytokines by the lung tumor, or the fact that the change leads to an autoimmune reaction in the body.
Examples of problems from the group of paraneoplastic syndromes that may result from lung cancer include:
- hypercalcemia
- Lambert-Eaton myasthenic syndrome
- syndrome of inappropiate antidiuretic hormone hypersecretion (SIADH for short)
- ectopic production of corticotropin (ACTH - this hormone is normally secreted by the pituitary gland)
Occasionally, a lung tumor can lead to Horner's syndrome, with symptoms such as drooping eyelid, constriction of the pupil and the collapse of the eyeball into the eye socket.
This problem is sometimes encountered in people who develop the so-called Pancoast tumor, i.e. a lesion located in the apical parts of the lungs (Horner's syndrome develops in those patients whose lung cancer damages the nerve fibers of the sympathetic nervous system).
Lung cancer: types
There are several different types of lung cancer in the group. The basic division is distinguished by:
- non-small-cell lung carcinoma (NSCLC)
- small-cell lung carcinoma (SCLC)
Non-small cell lung neoplasmsare the most common - they are responsible for up to 85% of all lung cancer cases. This group lists changes such as:
- adenocarcinoma: the lesion, typically located in the peripheral parts of the lung, is less related to smoking than other types of lung cancer; Another characteristic feature of lung adenocarcinoma is that it is quite common in women
- squamous-cell carcinoma : tumor uniquely associated with exposure to cigarette smoke, usually developing in the central partsrespiratory system, e.g. in large bronchi
- large-cell carcinoma: a fairly rare type of lung cancer with very different locations
Much rarer than NSCLC tumors issmall-cell lung carcinoma . Like squamous cell carcinoma, it is mainly caused by smoking.
The primary lesion usually appears around the lung cavities,the neoplasm spreads and metastasizes rather quickly- small cell lung cancer is considered to be one of the lung tumors with the most aggressive mileage.
Apart from them, other types of lung cancer are mentioned - although less frequently - such as :
- sarcoma
- tumors of mesenchymal origin
- carcinoid
Lung cancer: diagnosis
The occurrence of symptoms that may be related to lung cancer - especially in a person who, e.g. because of smoking cigarettes, is more likely to develop this disease - always requires diagnostics, thanks to which the disease can be confirmed or ruled out.
Initial imaging examinations are performed: usually a chest X-ray is ordered initially.
A much more detailed examination - especially ordered when X-rays reveal any abnormalities - is computed tomography of the chest.
The above-mentioned tests allow to state the existence of changes in the patient corresponding to a lung tumor, but they do not specify exactly what kind of change appeared in him. To find out, other tests may be ordered - it may be sputum cytology, but also bronchofiberoscopy (during which it is possible to collect material for histopathological examinations).
Pathomorphological examinations in the diagnosis of lung cancer
Due to the fact that lung cancer is often diagnosed relatively late after its onset,in many patients - unfortunately - at the time of diagnosis, cancer has already metastasized.
Malignant changes in the lungs can spread to many different organs of the body, including the lymph nodes and the brain, liver and bones.
In order to find out whether the lung cancer has led to metastases in the patient, imaging tests other than those mentioned above, such as PET or magnetic resonance imaging, may be ordered.
Lung cancer: treatment
There are three main methods used to treat lung cancer:
- surgery
- chemotherapy
- radiation therapy
The first thing that decides which of them will be implemented to the patient is the type of lung tumor he or she has - this is why it is so important to carry out a thorough diagnosis.
In the case of non-small cell carcinomas, surgical treatment is the basis for the management, while in patients with small cell cancer, chemotherapy is the most important.
It needs to be emphasized here that the above information on lung cancer treatment is actually a simplification.
In fact, the treatment plan is developed very individually and only after careful analysis of the advancement of the disease in the patient.
For example, in a patient with non-small cell lung cancer, surgery is not always performed - it may not be possible, e.g. when the lesion infiltrates important, adjacent structures (e.g. large blood vessels) or when the patient is diagnosed with there are many distant metastases of cancer and then the most beneficial therapeutic method may be, for example, radiotherapy.
In addition to those mentioned, lung cancer treatment is increasingly carried out with the use of other methods.
We are talking here, for example, about molecularly targeted treatment - it can be used, inter alia, in in patients with non-small cell lung cancer who are diagnosed with a mutation in the EGFR gene (in this situation, patients may be administered, for example, erlotinib or afatinib). More and more often, attempts are made to use immunotherapy (i.e. the use of appropriate monoclonal antibodies in patients).
Lung cancer: prognosis
In the case of lung cancer, the prognosis is hard to be considered favorable - it can only be improved by the early diagnosis of the disease and the earliest possible initiation of its treatment, which is why it is so emphasized that you should visit your doctor whenever they appear the patient has symptoms that suggest lung cancer.
The survival rate of lung cancer patients depends primarily on the type of lung cancer they have had.
Patients with NSCLC usually have a better prognosis - but it is hard to consider as optimistic, as only 1 in 10 of all patients survive 5 years after diagnosis.
Patients suffering from small cell lung cancer have even worse prognosis - in them, even with the implementation of appropriate treatment, 3-year survival is recorded in 20% of patients.
Lung cancer: prevention
Cancer treatmentlungs is very difficult and, unfortunately, despite the efforts of doctors, it is not always possible to cure the patient. For this reason, prophylaxis seems to be the most important, but how to prevent lung cancer?
Well, first of all, by limiting exposure to risk factors of its occurrence.
Some of them are definitely difficult to avoid - we are talking about the pollution of the air we breathe - but others we can avoid as much as possible.
Avoiding tobacco smoke , both in the form of active and passive smoking, is of the greatest importance in preventing lung cancer.
Long-term smokers often deny the possibility of quitting the addiction, explaining that since they have been smoking cigarettes for many years, quitting smoking will not affect their risk of lung cancer at all.
It is definitely not true - the continuation of the addiction increases the risk of lung cancer, and if a person, even after many years, stops smoking, then the possibility of this cancer at least stops growing.
A milestone in the treatment of patients with advanced lung cancer. New drug much more effective than chemotherapy
Source: biznes.newseria.p
