Lung Cancer - Signs, Symptoms, Stages And Treatment Of Lung Cancer, Disease Prognosis

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-15 09:49

Signs, symptoms, stages and treatment of lung cancer

Content:

• How long do people live with lung cancer?
• Lung cancer symptoms
• First signs
• Lung cancer causes
• Classification
• Lung cancer stages

• Lung cancer types

  • Peripheral
  • Small cell
  • Non-small cell
  • Squamous
  • Central
• Lung cancer metastases
• Disease prognosis
• Diagnostics
• Lung cancer treatment
• Folk remedies

In the structure of oncological diseases, this is one of the most common pathologies. Lung cancer is based on malignant degeneration of the epithelium of the lung tissue and impaired air exchange. Malignant cells are also called poorly differentiated (on the topic: poorly differentiated lung cancer). The disease is characterized by high mortality. The main risk group is male smokers aged 50-80 years. A feature of modern pathogenesis is a decrease in the age of primary diagnosis and an increase in the likelihood of lung cancer in women. (on the topic: benign lung cancer)

Lung cancer statistics

Lung cancer incidence statistics are controversial and scattered. However, the influence of certain substances on the development of the disease has been unequivocally established. The World Health Organization (WHO) reports that the main cause of lung cancer is tobacco smoking, which causes up to 80% of all reported cases of this type of cancer. In Russia, about 60 thousand citizens fall ill every year.

The main group of patients - long-term smokers men aged 50 to 80 years, this category is 60-70% of all cases of lung cancer, and mortality - 70-90%.

According to some researchers, the structure of the incidence of various forms of this pathology, depending on age, is as follows:

• up to 45 - 10% of all cases;
• from 46 to 60 years old - 52% of cases;
• from 61 to 75 years - 38% of cases.

Until recently, lung cancer was considered a predominantly male disease. Currently, there is an increase in the incidence of diseases in women and a decrease in the age of initial detection of the disease. Researchers associate this phenomenon with an increase in the number of women smokers (up to 10%) and people working in hazardous industries.

The number of sick women from 2003 to 2014 increased by about 5-10%.

Currently, the gender ratio of lung cancer incidence is:

• in the group under 45 years old - four men to one woman;
• from 46 to 60 years old - eight to one;
• from 61 to 75 years old - five to one.

Thus, in the groups under 45 and after 60 years, there is a significant increase in patients of the weaker sex.

How long do people live with lung cancer?

The disease is characterized by high mortality. This feature is associated with the importance of the respiratory function for the body.

Life can continue with the destruction of the brain, liver, kidneys, or any other organs until breathing or heart stops. In accordance with the canons of modern pathophysiology, biological death is the arrest of breathing or heartbeat.

At a certain stage of carcinogenesis, the patient has a rapid extinction of vital functions with a decrease in the respiratory activity of the lungs. It is impossible to compensate the lung function with artificial devices, the process of air exchange (atmospheric air - lungs - blood) is unique.

There are statistics on the probability of five-year survival for people at different stages of lung cancer. It is understood that patients who receive treatment in the early stages of cancer are more likely to save lives. However, without having complete information about the features of pathogenesis, it is not ethical to give an individual prognosis.

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Meanwhile, the survival rate of patients is statistically significantly higher with different localizations of the focus on the periphery or in the center of the lung, where the main airways are concentrated, there are many large vessels and there are nerve nodes.

• High chances of long-term survival with peripheral lung disease. There are known cases of life expectancy over ten years from the moment of diagnosis. The peculiarity of carcinogenesis of the peripheral form of cancer is the slow course and long-term absence of pain response. Patients even in the fourth stage have relatively good physiological conditions and do not feel pain. Only in the critical period does fatigue increase, weight decreases, pain syndrome develops after metastasis to vital organs.
• Low chances for central cancer. Life expectancy from the moment of diagnosis does not exceed 3-4 years. Active carcinogenesis lasts an average of 9-12 months. The tumor is characterized by aggressiveness, especially in the last stages, when any modern treatment is ineffective, differs in the development of pain syndrome with damage to the central bronchi and metastasis to neighboring organs.

It is clear that the above is conditional information. Cancer is always an unpredictable disease, accompanied by an explosive cell growth, or the reverse process and inhibition of carcinogenesis (on the topic: lung cancer in children).

In addition, the aggressiveness of cancer depends on the microscopic (histological) structure of the cells, for example, small cell or non-small cell (in the shape of tumor cells).

Doctors are less likely to prolong the life of patients with small cell cancer, including after radical surgery and relapses of carcinogenesis.

Lung cancer symptoms

Lung cancer, especially its peripheral forms, are difficult to diagnose in the early stages of carcinogenesis.

The causes of diagnostic errors are due to:

• similar density of normal cells and malignant formations, disguise of affected cells as healthy ones - all this complicates the diagnosis, including by imaging methods;
• the location of the focus under the bone tissue of the chest;
• the absence of regional lymph nodes located close to the skin surface and most rapidly responding to pathogenesis;
• weak pain sensitivity of the peripheral areas of the lungs that do not have pain receptors;
• a high level of compensatory protection, respectively, a long absence of dangerous clinical symptoms that confuse diagnosticians with similarities with diseases amenable to drug, rather than surgical treatment.

Diagnostic stages of determining the symptoms of lung cancer and its types include the accumulation or synthesis of clinical, morphological, histological information about the disease and their subsequent analysis.

Thus, the diagnosis of any disease, including this one, includes two areas of research (synthesis and analysis) and three stages of diagnosis (primary signs, general symptoms, differential symptoms):

• Primary signs of the disease. Feelings of the patient in the form of hemoptysis, coughing, fatigue, progressive emaciation, foul smell when breathing and other signs with which a person who feels sick turns to the doctor for consultation and determine the causes of discomfort.
• General symptoms. Determination of the localization of pathogenesis (in the central, peripheral, apical part of the lung). Installed:
• physical methods (examination, palpation, percussion or tapping in order to determine the zones of altered sound, auscultation or listening to changes in respiratory sounds);
• visualization methods, including ionizing - X-ray, CT and modifications, radioisotope, PET, PET-CT; non-ionizing - ultrasound, MRI and modifications;
• laboratory methods (general clinical, specific, including tumor markers).
• Differential symptoms. Needed by oncologists to clarify changes at the cellular and microphysiological level, for example, to determine non-small cell and small cell cancers or their varieties. They are determined by cytological and histological methods in various modifications, sometimes supplemented by instrumental imaging methods, the most informative here are PET and PET-CT methods.

In modern oncology, screening examinations are the most promising method for early diagnosis. This is a large-scale clinical examination of a conditionally healthy population. Screening for some forms of cancer effectively replaces diagnosis with the classic three-step method. Unfortunately, screening studies to determine lung cancer are not carried out in our country due to the low efficiency of instrumental detection of the disease.

For widespread introduction of screening, it is necessary:

• availability of effective highly sensitive diagnostic devices;
• highly qualified medical personnel;
• oncological alertness of the population.

If the first two conditions have recently been more or less successfully fulfilled by the state, then our article calls for an increase in oncological alertness and a sense of responsibility for one's own health.

We do not at all strive to make everyone who reads an oncologist. Our task is to optimize the cooperation between the patient and the doctor. After all, every ninth out of ten lung cancer patients gets to the doctor of the district polyclinic.

Lung cancer cough

Cough is a protective reaction of the respiratory system to irritation of specific receptors. It occurs with short-term or long-term endogenous (internal) or exogenous (external, extraneous) effects on receptors.

During the initial appointment, try to be very accurate in describing the cough reflex, if any. Although cough is not a pathognomonic symptom of lung cancer, it sometimes indicates the nature of the pathogenesis. The combination of research methods - cough, percussion and radiography can provide the doctor with valuable material for analysis during the period of initial diagnosis.

Pathological (long-term) cough sounds are characterized as:

• strong / weak;
• frequent / rare;
• loud / hoarse (hoarse);
• long / short;
• rolling / jerky;
• painful / painless;
• dry / wet.

The following cough sounds are not characteristic of lung damage: strong, loud, short. They are most likely to characterize lesions of the larynx and trachea, or oncology in these areas. Cough with irritation of receptors localized on the vocal cords is manifested by a hoarse or hoarse sound.

Typical cough sounds when the receptors in the lung tissue are irritated:

• Weak, lingering, deaf, deep - characterizes a decrease in the elasticity of the lung or pathological processes scattered in the tissues.
• Painful, turning into a gentle form - coughing, indicates the involvement of the pleura around the lung in the pathogenesis, or the localization of pathogenesis in the large bronchi of the central zone, sensitive to pain. The pain increases with movement of the chest. If auscultation (listening) of the lung reveals a combination of painful cough and splash noise, this means fluid accumulation between the lung and the pleura.

Moist cough:

• with good (liquid) expectoration of the contents - an acute course of pathogenesis in the lungs.
• with viscous discharge - a chronic course of pathogenesis in the lungs.
• A dry cough can precede the development of a wet cough, or a wet cough turns into a dry cough. The phenomenon of dry cough is characteristic of chronic irritation of receptors without the formation of exudate in the lung. It may well also be with a growing neoplasm without inflammatory and necrotic processes around the focus.

Dangerously abrupt cessation of cough is one of the possible signs of suppression of the reflex due to the development of intoxication.

We remind you that you should not make independent conclusions. The information is given so that the patient can most fully describe his own feelings to the doctor in the presence of a cough reflex. The final diagnosis is based on a set of studies.

Blood for lung cancer

Patients are always afraid of the discharge of blood from the respiratory tract. This phenomenon is called hemoptysis. This is not necessarily a sign of lung cancer. Blood secreted from the lungs is not a specific symptom of lung cancer.

Discharge of blood from the nose is a manifestation of a violation of the integrity of one of the blood vessels in the respiratory tract. Oral bleeding is confusing for laypersons.

Isolation of blood from:

• digestive organs - the blood is dark (the color of coffee grounds) due to the effects of digestive enzymes or gastric juice;
• respiratory organs - blood is predominantly scarlet, sometimes dark red, always frothy due to air impurities.

The causes of pulmonary hemoptysis are diverse and accompany diseases with pathogenesis in the human respiratory system. Among them:

• late stages of tuberculosis;
• internal bleeding with chest wounds;
• abscesses in the lungs or airways;
• heart attacks;
• pneumonia.

There may be other reasons as well. Bleeding in lung cancer usually means damage to one of the vessels in the mediastinum or the central part of the lung. Hemoptysis is a dangerous symptom, especially with massive internal blood loss.

Signs of massive bleeding:

• profuse scarlet discharge, slow bleeding of dark red color;
• progressive deterioration in well-being;
• pallor of the mucous membranes;
• threadlike pulse.

The first signs of lung cancer

They can be very different from common symptoms such as coughing, shortness of breath, hemoptysis, and other symptoms common to lung cancer.

Attention! The following symptoms should not be considered dangerous without medical confirmation. They are far from always associated with a deadly pathology.

A person who can be diagnosed with lung cancer, upon initial admission, receives a referral to doctors of the following specialties:

• a neurologist, if the patient has cluster (paroxysmal) headaches and pains that resemble attacks of osteochondrosis;
• to an ophthalmologist or neurologist, in case of impaired mobility and size of the pupil of the eye or changes in the pigmentation of the iris of the eye;
• a therapist, if you suspect a cold with a dry cough, possibly slight hyperthermia (increased body temperature);
• to a therapist or phthisiatrician, with a wet cough, wheezing in the lungs, hemoptysis, a sharp decrease in body weight, general weakness;
• cardiologist, with shortness of breath, pain in the heart after a little physical exertion, general weakness.

A person noticing the above symptoms should report them to the doctor or supplement the information he collects with the following information:

• attitudes towards smoking with pulmonary symptoms;
• the presence of oncological diseases in blood relatives;
• a gradual increase in one of the above symptoms (it is a valuable addition, as it indicates the slow development of the disease, characteristic of oncology);
• an acute intensification of symptoms against the background of chronic previous malaise, general weakness, decreased appetite and body weight is also a variant of carcinogenesis.

Lung cancer causes

The lungs are the only internal human organ that is in direct contact with the external environment. Inhaled air reaches the alveoli unchanged. Microparticles present in the air are retained on the walls of the mucous membranes. Constant contact with the external environment predetermines the main feature of the lung epithelium - an increased rate of renewal of generations of cells of the mucous membranes of the bronchi.

The biological filter functions are carried out by mucous membranes through:

• microvilli lining the airways;
• mucus-producing epithelium;
• cough reflex receptors.

Epithelial cells come into contact with aerosols of inhaled air, consisting of liquid and / or solid particles, including:

• natural - dust, pollen of plants;
• anthropogenic - tobacco smoke, car exhaust gases, dust from factories, mines, mines, thermal power plants.

In order for the reader to understand what we are talking about, an aerosol is a stable suspension in a gas (air):

• ultra-small liquid particles - fog;
• ultra-small solid particles - smoke;
• small solid particles - dust.

The composition of fog, smoke and dust can include aggressive inorganic and organic substances, including plant pollen, microscopic fungi, bacteria, viruses that negatively affect the microvilli of the epithelium.

Poorly protected epithelial cells are under the influence of external pathogenic factors every second, which greatly increases the likelihood of pathological mutations and the development of neoplasms in the lungs.

Potential Factors of Lung Cancer:

1. The high rate of apoptosis of the epithelium - the more new cells are formed, the higher the probability of cancer mutations (a natural factor);
2. The relative vulnerability of delicate tissue from the effects of harmful aerosols of inhaled air (provoking factor).

It has been noticed that the likelihood of developing lung cancer is directly related to the aging of the body, with genetic prerequisites and chronic lung diseases.

Lung cancer risk factors

People who are under the influence of physical, chemical and biological factors for a long time, as well as having a hereditary predisposition, are mainly affected.

• Tobacco smoke. Approximately 80% of lung cancer patients are active smokers, but the harmful effects of tobacco smoke and secondhand smoke have been noticed (see Table: Facts and Effects of Smoking During Pregnancy).
• Radon (weakly radioactive element). The alpha radiation of radon is included in the natural background radiation of the earth. The radiation power is low, however, sufficient to stimulate respiratory tract cell mutations. Radon in the form of gas accumulates in the basements of houses, penetrates into living quarters through the ventilation system, through the cracks between the basement and the first floor.
• Genetic predisposition. The presence of repeated cases of lung cancer in blood relatives.
• Age. Physiological aging significantly increases the risks of developing pathological mutations in epithelial cells.

• Professional risks. High probability of workplace exposure to volatile, dusty carcinogens:

  • asbestos - used in construction, in the production of building materials, mechanical rubber goods, is a part of drilling fluids;
  • cadmium - in the composition of solders it is used by jewelers, when soldering electronic boards, anti-corrosion treatment, in the production of batteries and solar batteries;
  • chromium is used in metallurgy as a component of alloy steels;
  • arsenic - used in metallurgy, pyrotechnics, microelectronics, paint production, leather industry;
  • pairs of synthetic dyes based on nitro-enamel - used in construction, painting;
  • exhaust fumes - workers of auto repair shops suffer;
  • ionizing (gamma, beta, X-ray) radiation - received by workers of X-ray rooms and nuclear power plants.
• Endogenous factors, including chronic pulmonary diseases (tuberculosis, bronchopneumonia);
• Unclear factors. In a number of patients it is impossible to establish the causes of the disease with modern methods.

Lung cancer classification

Without preliminary preparation, it is very difficult to understand the types and differences of forms of lung cancer. In practical medicine, complex terms are used to refer to them. There are many types and forms of cancer. We have simplified the task as much as possible and made the differences clear. All terms used to denote forms of cancer fit into our simplified, adapted classification.

Classification according to the location of the primary focus. A cancerous tumor can be localized in different parts of the lung:

• Central cancer - located in the center of the lung, where large bronchi, vessels and nerve nodes are located;
• Peripheral cancer - located on the sides of the lung, where small bronchioles are localized, small blood vessels - capillaries, few pain receptors;
• Apical cancer (mediastinal lung cancer) - located at the apex of the lung, it is a type of peripheral cancer. It is characterized by distracting symptoms due to the involvement of the blood vessels in the clavicle and stellate ganglion. Pancosta manifests itself with neurological symptoms: on the face (asymmetry), in the pupils (different shapes, drooping, narrowing, others), in the head (severe cluster headache). This confuses diagnosticians with the multiplicity of manifestations and the lack of X-ray imaging of tumor foci.
• Atypical localization. Involvement in carcinogenesis of the anterior and / or upper half of the mediastinum - the organs of the center of the chest, lying between the right and left lungs.

When describing the location of the cancer, the radiologist usually makes an addition, indicating the shape of the tumor, for example:

• knotty;
• branched;
• nodular-branched or others.

Thus, according to the localization of the tumor in the body, cancer can be: central, apical, peripheral, as well as right-sided, left-sided or bilateral. In the form of tumor growth - nodular, branched or mixed.

The above classification does not take into account the microscopic structure of tumor cells. For differentiation, histological analysis is used, which is necessary to clarify the features of the microscopic structure of the neoplasm.

It is well known that microscopic features of the structure of oncocells determine the pathogenesis of the disease, including:

• tumor growth rate;
• predominant localization of the primary focus;
• aggressiveness - a tendency to metastasis.

Knowledge is used by clinicians to determine treatment strategies. In our case, this is necessary for a general understanding of carcinogenesis.

Classification based on histological differences in cells:

• Non-small cell carcinoma. This is a group of oncological diseases, consisting of several closely related forms. The total share of non-small cell forms in the structure of lung cancer is about 80-85%. The association is based on the morphological similarity of the cells, but each form has some peculiarities. Non-small cell carcinoma combines the following forms:
• squamous;
• large cell;
• adenocarcinoma;
• rare forms.
• Small cell carcinoma. More homogeneous group. Includes about 10-15% of clinical cases of lung cancer. Differs in particular aggressiveness. The volume doubling rate of this form of tumor is about 30 days versus more than 100 days in non-small cell forms.

We have given a generalized classification of lung cancer. There are more subtle types of cancer, but they are used in scientific discussions to describe carcinogenesis. Read more about common forms below.

Lung cancer stages

In oncology, for the convenience of description, stages of the disease are distinguished. The staging of carcinogenesis is a conditional concept, but it is very convenient, and allows you to standardize and simplify the description of the disease in professional communication.

In accordance with the international classification, the state of carcinogenesis is usually denoted by the first letters of Latin words:

• Tumor (tumor), denotes a tumor, for the purpose of abbreviation, the first letter of the word - T is used, supplemented with numerical designations from one to four to characterize the size of the tumor.
• Node (node), denotes regional lymph nodes, for the purpose of reduction, the first letter of the word - N is used, which is supplemented with numbers from one to three to indicate the degree of involvement of the nodes.
• Metastasis (metastasis), means the presence of outgrowths of a malignant tumor to distant organs, for the purpose of reduction, the first letter is used - M, which is supplemented with numbers zero or one and characterizes the degree of growth.
• Uses additional designation of aggressiveness of cancer cells by writing the letter G. Indicate G ₁ highly differentiated (non-aggressive cells). Further, in order of increasing aggressiveness to the human body - G ₂, G ₃, G ₄.

Similarly, they indicate the absence of visible changes in the body and precancerous conditions with the addition of symbols:

• Not enough information to describe the state of the tumor - letter (x)
• The tumor is not detected - letter (0)
• Non-invasive cancer is a combination of the letters (is) or (carcinoma in situ).

Using similar designations, we present a description of the stages of lung cancer.

Stage 1 lung cancer

T ₁ - the size of the neoplasm does not exceed three centimeters in diameter (on an x-ray). N ₀ - the lymph nodes are not affected. Metastases - M _{0 are} absent.

Unlike breast cancer - BC (see here), the first stage of lung cancer (LC) is difficult to diagnose.

For example, lymph nodes with:

• BC - freely palpable by hands, starting from the earliest stages of carcinogenesis;
• RL - visible only on radiographs or using other complex imaging methods, since the lymph nodes (peribronchial or lung root) are located deep in the chest.

Stage 2 lung cancer

T ₂ - the size of the neoplasm is from 3 to 6 centimeters in diameter. This group also includes tumors of any other size sufficient to block the bronchus, which is revealed on the roentgenogram in the form of focal atelectasis (collapse) or pneumonia (compaction) of the lung tissue at the periphery of the bronchus. The tumor and pathological foci of small size can be seen on the radiograph in the central region, much more difficult - on the periphery and apex of the lung.

Involvement of regional lymph nodes in the second stage in carcinogenesis - N ₁. This means unilateral damage to the lymph nodes by cancer cells. M ₀ or M ₁ - means that metastases with the same probability can be absent and found in neighboring organs.

Stage 3 lung cancer

T ₃ - the size of the neoplasm is more than 6 centimeters in diameter. The tumor can also be of any other size, but it extends to the chest wall and the area of separation of the main bronchi, the diaphragm, or it is a tumor that causes atelectasis or induration of the entire lung. N ₂ - involvement in carcinogenesis of distant lymph nodes on the affected side or in the area of the bifurcation of the main bronchi. M ₁ - there are signs of metastasis in organs distant from the lungs.

Stage 4 lung cancer

T ₄ - the size of the neoplasm does not matter. The tumor spreads beyond the chest, primarily affects the neighboring organs (heart, digestive tract, thoracic vertebrae), is characterized by the accumulation of exudate in the pleural cavity. N ₃ - total lesion of the lymph nodes of the diseased side, multiple lesions on the opposite side. M ₁ - multiple distant metastases.

Learn More: Stage 4 Lung Cancer

Lung cancer types

Lung cancer is distinguished by the site of localization (peripheral or central), as well as by the cytological, histological structure of cancer cells (small-cell, non-small-cell).

Peripheral lung cancer

The peculiarity of this type of cancer is that the tumor develops as a result of mutations on the surface of small bronchi - subsegmental (3-5 orders) and small (6-16 orders).

To make it clear: the bronchial tree of the lung consists of bronchi in order of decreasing diameter from 1 main bronchus to 16th order bronchi. Small, 16th order, pass into even smaller bronchioles and into the final structures - alveoli.

The clinical significance of the defeat of the small and smallest bronchi:

• prolonged absence of symptoms (no pain receptors, better compensation for damage in small formations of the lung);
• the first symptoms (cough, hemoptysis, pain of uncertain localization) are associated with trauma to the delicate bronchi and small capillaries.

The most characteristic growth of peripheral tumors is nodular. In this form, it is usually found on fluorography (X-ray) images taken for acute or chronic lung diseases.

Typical forms of peripheral cancer are visualized on the images as:

• rounded (solitary) node;
• a rounded hollow node with thin walls;
• infiltration with a blurred outline;
• single knot less than 10 mm;
• multiple small knots.

The growth rhythm (doubling the value) is 110-140 days. Variations from the norm were established within a minimum of 40 days, a maximum of 800 days. To some extent, a long doubling period indicates the good quality of the neoplasm.

A peripheral tumor is characterized by radiant contours. This phenomenon is explained by a special form of growth of nodes in the lung.

In some cases, approximate differentiation of tumors by the shape of contours and rays is possible:

• small, frequent rays along the contour - squamous cell formation;
• thick, long rays, calcareous small-dotted blotches - Glandular cancer;
• clear contours - aggressive small-cell formations.

Other indirect signs of peripheral cancer, found in the images as a negative light area:

• depressions of "Rigler" are visible in the area of connection or separation of the tumor and bronchus of the 3-5th order;
• around the tumor of the lung tissue, a site of a small vessel blocked by the tumor;

Complications of peripheral cancer:

• pneumonia behind the blockage of the bronchus and the exclusion of this site from the respiratory function. Extensive foci lead to a decrease in the respiratory activity of the lung;
• the formation of a cavity in the node, which may later be the focus of the spread of purulent inflammation;
• accumulation of fluid in the cavity between the lung and pleura;
• the rapid growth of the peripheral node and the transition of the process to the mediastinum;

Difficult to diagnose forms of peripheral cancer include apical lung cancer, which is characterized by neurological symptoms due to the spread of damage to important nerve nodes located in this area.

Learn More: Peripheral Lung Cancer

Small cell lung cancer

Received this name because of the shape of the cells, it is also called neuroendocrine lung cancer. Refers to the most aggressive forms of lung cancer. It occurs mainly in male smokers over the age of 40. The detection rate of this disease is no more than 25% of all histological types of cancer.

Biological characteristics of small cell carcinoma:

• small size (only twice as large as a lymphocyte - blood cells);
• malignancy;
• rapid growth, active doubling of volume within 30 days, for comparison in other forms of cancer - more than 100 days;
• sensitivity of cancer cell receptors to chemotherapy and radiation therapy.

There are several types of small cell cancer:

• oatmeal;
• intermediate;
• combined.

Small cell neoplasms are capable of producing some hormones (ACTH, antidiuretic, somatotropic).

The clinical symptoms of small cell cancer do not fundamentally differ from other forms of lung cancer, with the exception that the pathogenesis develops rapidly, and the manifestations visible to the researcher are scarce.

Learn More: Small Cell Lung Cancer

Non-small cell lung cancer

This group of oncological diseases differs from small cell forms in histological features. Clinically manifested:

• increased fatigue;
• pulmonary syndrome (shortness of breath, cough, hemoptysis);
• progressive weight loss.

Includes about 80% of all patients with malignant diseases.

There are three main histological forms of non-small cell carcinoma:

• squamous;
• large cell;
• adenocarcinoma.

The disease is characterized by a subclinical course of pathogenesis up to stage 2-3. For example, about 30% of patients recognize their diagnosis at 3 stages, about 40% - at 4 stages.

The disease is characterized by a rapid course of the latter stages. Within five years, only 15-17% of patients remain alive.

Squamous cell lung cancer

It is a smaller histological type of non-small cell carcinoma. Differs in calm cell growth. Mutations begin either in the central part or in the periphery of the lung.

Squamous cell carcinoma is the result of the degeneration of the ciliated epithelium under the influence of nicotine and other substances contained in tobacco smoke, into the shape of cells resembling the integumentary squamous epithelium.

A growing tumor grows with capillaries of blood vessels to ensure its own life.

The clinical symptoms are similar to those of other forms of lung cancer. They become noticeable for diagnosis after the involvement of a significant part of the lung tissue in the pathogenesis and metastasis to regional lymph nodes.

The main diagnostic method is histological examination of a sample of cancer cells.

Learn More: Squamous Cell Lung Cancer

Central lung cancer

Refers to cancers identified by their location in the lungs. The peculiarity of tumor localization in large bronchi is 1-3 orders.

It is characterized by the early onset of symptoms with:

• involvement of large bronchi and mediastinal organs in carcinogenesis;
• irritation of pain receptors;
• blockage of large bronchi and loss of a significant volume of the respiratory surface.

This type of oncology is relatively simple (except for the very early stages) to be visualized by conventional diagnostic methods, confirmed by laboratory and clinical symptoms.

The most common early symptoms are:

• a dry, debilitating cough that does not respond to treatment;
• the addition of blood to the cough as a result of a violation of the integrity of the blood vessel, and then the appearance of mucous, purulent sputum;
• blockage and compression of a large bronchus is accompanied by shortness of breath at rest.

Lung cancer metastases

Almost all human cancers are capable of metastasis - the movement of cancer cells throughout the body and the formation of foci of distant secondary carcinogenesis.

General patterns of metastases in lung cancer:

• spread throughout the body with the flow of biological fluids (lymph, blood) and in contact with neighboring organs;
• metastatic cells are almost always identical to the cells of the primary focus,
• mechanical movement of cancer cells to other organs does not mean the development of secondary carcinogenesis, inhibition of this process is observed.

The spread of a tumor in lung cancer occurs in three ways - lymphogenous, hematogenous and contact.

Lymphogenous movement of cells is characterized by the most likely places of fixation of malignant cells in the lymph nodes of the lung:

• pulmonary;
• bronchopulmonary;
• tracheobronchial and tracheal;
• pre-pericardial;
• lateral pericardial;
• mediastinal.

Hematogenous cell movement is characterized by the most probable places of fixation of malignant cells in the mediastinal organs:

• the heart and its vessels;
• trachea and main bronchi of the lung;
• esophagus;
• thymus;
• nerve nodes (diaphragmatic, vagus, stellate).

Along the venous pathway, metastases further advance to the following organs, in decreasing order of importance:

• liver;
• kidneys;
• bones of the skeleton;
• adrenal glands.

The contact pathway explains the spread of carcinogenesis to neighboring formations that do not have connections with the lungs of blood and lymphatic vessels, in particular, to the pulmonary pleura.

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Disease prognosis

Above, we talked about a significant increase in the favorable outcome in the detection of cancer at an early stage of oncogenesis. The problem is that this form of cancer is difficult to diagnose in its early stages.

The use of traditional diagnostic algorithms makes it possible to detect lung cancer in 60-80% of cases at stages 3-4 of the disease, when surgical treatment is ineffective and metastases spread far beyond the respiratory system.

It is possible to significantly improve the prognosis of the disease using modern diagnostic technologies.

Pay attention to the consistency of the cost of diagnosing the disease with the quality of subsequent treatment.

The cost of high-tech cancer detection methods:

• justified in the early stages of the disease, when the doctor has a wide range of treatment options;
• are not justified or doubtful, when carcinogenesis has developed to a clinically detectable stage of the disease, in this case it is possible to limit oneself to conventional diagnostic studies.

The most promising methods for early detection of tumor cells in the lung:

• Multilayer spiral computed tomography (MSCT). The technique allows you to examine the breast in 8-10 seconds, or to examine the entire person to determine the foci of primary and secondary tumors. Other methods do not have this capability. At the same time, tumors with a diameter of up to 1-3 mm are detected with high clarity. It is possible to build two and three-dimensional images and determine the exact location of the tumor.
• Positron emission tomography combined with computed tomography (PET-CT), the method is significantly superior to CT or MRI methods in determining the sensitivity and specific characteristics of tumor cells.

If the sensitivity and specificity of CT or MRI is on average 60%, then the same indicators for PET-CT are from 90% and higher, and the minimum size of the detected tumor is 5-7 mm.

Diagnosis of lung cancer

The diagnosis has a multi-stage complex professional algorithm that is understandable only to specialists. In this section, we summarize the information described above that is important to the patient.

A set of symptoms for the diagnosis of lung cancer:

• pulmonary;
• extrapulmonary;
• hormonal.

We have already mentioned the first two directions and mentioned in passing that some tumors secrete hormones and hormone-like substances that change the clinical symptoms of the disease.

For the primary diagnosis, the presence of at least one symptom in each syndrome is important.

Pulmonary syndrome

Includes long-term, non-treatable:

• moist cough, possibly with blood;
• chest pain;
• dyspnea at rest, worse after exercise;
• wheezing;
• hoarseness.

Extrapulmonary syndrome

It is characteristic of lung cancer only in combination with pulmonary syndrome:

• fever;
• weight loss;
• general weakness;
• epileptiform seizures, headache, changes in the size, color of eye structures;
• pain in the bones of the hypochondrium;

Hormonal Disorder Syndrome

It manifests itself in certain cancers. It is important for the primary diagnosis of lung cancer in combination with one or more symptoms of pulmonary and extrapulmonary syndrome.

Violations are revealed by the results of laboratory tests, namely:

• high levels of calcium in the blood;
• low blood sodium levels;
• Itsenko-Cushing's syndrome;
• sudden, long-term non-healing skin rashes;
• thickening of the joints of the phalanges of the fingers.

The order and expediency of instrumental and laboratory studies, the choice of methods for obtaining material for diagnostic histological studies will be left to oncologists.

Learn more: Lung Cancer Tests

Lung cancer treatment

The standard treatments for lung cancer are:

• surgical removal of the tumor;
• chemotherapy - intravenous administration of chemicals that suppress the growth of tumor cells.
• radiation therapy - exposure of altered cells to hard types of radiation.

Use the above as a single method or in combination. Some forms, such as small cell carcinoma, do not respond to surgical methods, but are sensitive to chemotherapy.

Chemotherapy for lung cancer

The tactics of mass chemotherapy are determined by the form of the disease and the stage of carcinogenesis.

Common cytostatics are pharmacological drugs that have the ability to suppress the growth of cancer cells: Cisplatin, Etoposide, Cyclophosphamide, Doxorubicin, Vincristine, Nimustin, Paclitaxel, Carboplatin, Irinotecan, Gemcitabine. These drugs are used before surgery to reduce the size of the tumor. In some cases, the method has a good healing effect. Side effects after using cytostatics are reversible.

Relatively recently introduced into practical use:

• hormonal treatments;
• immunological (cytokinetic) methods of fighting lung cancer.

Their limited use is associated with the complexity of hormonal correction of certain forms of cancer. Immunotherapy and targeted therapy do not effectively fight cancer in a body with destroyed immunity.

Learn More: Chemotherapy for Lung Cancer

Promising treatments for lung cancer

Radiation therapy

• Controlled visual radiation exposure to a cancer cell, or technology (IGRT). It consists in irradiating the damaged cell, its instant correction after sufficient exposure and transferring the load to the adjacent area of the damaged tissue.
• Contact radiation exposure, or brachytherapy technology. It consists in the delivery of special substances to the tumor tissues that enhance the targeting effect on damaged cells.
• Smart knife technology. The principle lies in the ideally accurate action of the cyber knife on the accumulation of damaged cells.

Find out more: Radiation therapy for lung cancer

Modern chemotherapy

Marking of cancer cells (PDT-technology) with substances that increase sensitivity to external laser exposure and eliminate damage to healthy tissue.

The main disadvantage of new technologies is that they affect the developed pathogenesis, but do not prevent pathological mutations.

See also: Prevention of lung cancer

Treatment of lung cancer with folk remedies

It is advisable to talk about the prevention of lung cancer with folk remedies, including quitting smoking and eliminating the effects of dust carcinogens, inhalation. But the priority in cancer treatment still remains with official medicine.

Meanwhile, not even a medical specialist will pay attention to the flourishing of morbidity despite the efforts of doctors. Pharmacies are bursting with an abundance of medicines, and technologies for diagnosing and treating cancer are amazing.

It is not easy to explain this phenomenon, it is multifactorial, and is associated with environmental pollution, unhealthy diet, household and occupational stress.

The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon

Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"