Lung cancer is a disease involving the uncontrolled growth of malignant neoplastic cells in the tissue of the lung. Lung cancer can be caused by many environmental carcinogens, but cigarette smoking is the cause of most lung cancer cases.

According to the World He alth Organizationlung canceris the most common cause of cancer deaths in both men and women.1

Lung cancer: prevalence and morbidity

Each year, more than 1,300,000 new cases are reported worldwideof lung cancerand bronchitis, from which approximately 1,100,000 people die each year.1It is estimated that in 2004 there were approximately 381,500 new cases of lung cancer and approximately 342,000 deaths from lung cancer in Europe, which is approximately 936 deaths from lung cancer each day. Of all deaths caused by cancer, 18.7% is caused by lung cancer. Lung cancer is considered to be the cancer that causes the highest number of deaths from cancer in Europe.
The table below shows estimates of the incidence and mortality of lung cancer for both genders in specific regions.1

Region

Estimated number of cases

Deaths

World

1 352 132

1 178 918

North America

225 641

178 349

Central, South America and the Caribbean

60 870

57 366

Europe

374 764

341 595

Africa

19 527

18 731

Asia, Australia and the Far East

671 327

582 868

Types of lung cancer

There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). It is important to distinguish between NSCLC and SCLC,because the two types of cancer are treated differently.
Non-small cell lung cancer is the most common form of lung cancer, accounting for around 75-80% of the total number of cancer cases.3There are three types:

  • adenocarcinoma (adenocarcinoma) - which accounts for 40 percent all lung cancers, more common in women
  • squamous cell carcinoma - accounts for 25 percent all cases of lung cancer, more common in men and the elderly
  • large cell carcinoma - only 10 percent cases of lung cancer, compared to other types of lung cancer, it grows faster and spreads faster in the lungs.4,5

Lung cancer: the patient's chances of being cured

Overall, only 20% lung cancer patients will live one year after diagnosis. This percentage is reduced to 6%. 5 years after diagnosis. The survival rate depends on the stage of the cancer at diagnosis and on the choice of treatment method. If the cancer is diagnosed at an early stage, up to 80 percent of the cancer is diagnosed. patients will survive for at least 5 years after the diagnosis is made, of which some patients will be permanently cured.

Lung cancer: too late diagnosis

Unfortunately, few patients are diagnosed with early stage non-small cell lung cancer. Almost 70 percent. cases of non-small cell lung cancer are diagnosed at an advanced stage, when the cancer has already spread to other parts of the body.
At this stage, 15-35 percent patients will live after a year, of which only 2 percent. will live 5 years. Patients with advanced non-small cell lung cancer have a survival time of only 4 months.5.6

Lung cancer risk factors

  • smoking - the most important of these - causes nine out of ten lung cancer cases. The degree of risk depends primarily on the duration of smoking, and not on the number of cigarettes smoked. For example, if you have smoked 20 cigarettes a day for 40 years, your risk of lung cancer is approximately 8 times greater than if you have smoked 40 cigarettes a day for 20 years. Passive smoking increases the risk of developing lung cancer by 25%. in smokers' spouses, while those exposed to tobacco smoke at work increase the risk by about 17%.5
  • exposure to asbestos and radon gases
  • scars from a previous lung disease (e.g. tuberculosis)
  • a family history of lung cancer
  • previous anti-cancer treatment

Air pollution also has an impact, although it is difficult to predict how many cases can be associated with it.

Lung cancer diagnosis

There are no typicalsymptoms of lung cancer . The most common:

  • cough that increases or remains after treatment for respiratory infection
  • chest pain
  • coughing up blood sputum, blood
  • wheezing, shortness of breath, hoarseness
  • recurrent and persistent, more than 3-4 weeks despite treatment, bronchitis or pneumonia
  • swelling of the face or neck
  • lack of appetite, weight loss
  • fatigue, apathy

Of the listed symptoms, one or more symptoms may appear simultaneously during the course of the disease. As the disease worsens, the number of symptoms usually increases.

Lung cancer treatment

It can be complicated as the disease is easily spread through the lymphatic (lymphatic) system. This spread of cancer cells to other parts of the body is called metastasis, and for most people, this means that treatment will not fight the cancer. Currently, there are three standard treatments for lung cancer patients:

  • surgical (operative) treatment
  • irradiation (radiotherapy)
  • chemotherapy.

Depending on the type of cancer, stage, general he alth, and age of the patient, one or more of these methods may be used. Both surgical treatment and radiation therapy can cure lung cancer patients if the tumor is localized (has not spread to any of the surrounding tissues). If the patient is treated at this stage, the percentage of patients cured exceeds 70%, provided that the patient is in good he alth. However, the diagnosis of the disease at this stage of advancement is made only in about 25-30%. cases.3

Chemotherapy regimens

In advanced non-small cell lung cancer, chemotherapy is the first-line treatment. It can be used with or without radiotherapy, depending on the patient's situation. Chemotherapy usually consists of two drugs. Commonly used chemotherapy regimens include four platinum-based drug combinations, i.e. cisplatin / paclitaxel, gemcitabine / cisplatin, cisplatin / docetaxel, and carboplatin / paclitaxel.7If the patient fails to achieve first-line treatment, or if the cancer comes back, second-line treatment should be started. Commonly used treatment for the secondThe line includes drugs such as docetaxel, pemetrexed and narelbin.
In addition to drugs used in traditional chemotherapy, several new drugs are now available for the treatment of patients with non-small cell lung cancer, including erlotinib. These drugs, also known as targeted therapies, allow for comparable efficacy to chemotherapy, but without side effects, and have additional benefits resulting from the convenience of use.

Bibliography:

1. Ferlay J, Bray F, Pisani P and Parkin DM. GLOBOCAN 2002: Cancer Incidence, Mortality and Prevalence Worldwide. IARC CancerBase No. 5, Version 2.0, Lyon: IARC Press, 2004.
2. Boyle P and Ferlay J, Cancer incidence and mortality in Europe, 2004. Annal Oncol (2005): 16; 481-488
3. lungcancercoalition.org
4. Rozengurt E. Autocrine loops, signal transduction, and cell cycle abnormalities in the molecular biology
of lung cancer. Curr Opin Oncol (1999) 11 (2): 116-22
5. cancerhelp.org.uk
6. macmillan.org.uk
7. cancer.gov

Press service of the Polish Lung Cancer Group

Category:

Oncology