Lung cancer - the first symptoms and signs in men and women at an early stage. Signs and Symptoms of Early Lung Cancer Lung Cancer and Symptoms

- a malignant tumor originating from the tissues of the bronchi or pulmonary parenchyma. Symptoms of lung cancer can be low-grade fever, cough with phlegm or blood streaks, shortness of breath, chest pain, weight loss. Possible development of pleurisy, pericarditis, superior vena cava syndrome, pulmonary hemorrhage. Accurate diagnosis requires X-ray and CT of the lungs, bronchoscopy, examination of sputum and pleural exudate, biopsy of the tumor or lymph nodes. The radical methods of treatment of lung cancer include resection interventions in the amount dictated by the prevalence of the tumor, in combination with chemotherapy and radiation therapy.

General information

Lung cancer is a malignant neoplasm of epithelial origin that develops from the mucous membranes of the bronchial tree, bronchial glands (bronchogenic cancer) or alveolar tissue (lung or pneumogenic cancer). Lung cancer is the leader in the structure of mortality from malignant tumors. Mortality in lung cancer is 85% of the total number of cases, despite the success of modern medicine.

The development of lung cancer is not the same in tumors of different histological structures. Differentiated squamous cell carcinoma is characterized by a slow course, undifferentiated cancer develops rapidly and gives extensive metastases. Small cell lung cancer has the most malignant course: it develops covertly and quickly, metastasizes early, and has a poor prognosis. More often, the tumor occurs in the right lung - in 52%, in the left lung - in 48% of cases.

Causes

The factors of occurrence and mechanisms of development of lung cancer do not differ from the etiology and pathogenesis of other malignant lung tumors. In the development of lung cancer, the main role is played by exogenous factors:

• smoking
• air pollution with carcinogenic substances
• exposure to radiation (especially radon).

Pathogenesis

Cancer is mainly localized in the upper lobe of the lung (60%), less often in the lower or middle (30% and 10%, respectively). This is explained by a more powerful air exchange in the upper lobes, as well as by the peculiarities of the anatomical structure of the bronchial tree, in which the main bronchus of the right lung directly continues the trachea, and the left one in the bifurcation zone forms an acute angle with the trachea. Therefore, carcinogenic substances, foreign bodies, smoke particles, rushing into well-aerated zones and lingering in them for a long time, cause the growth of tumors.

Metastasis of lung cancer is possible in three ways: lymphogenous, hematogenous and implantation. The most common is lymphogenous metastasis of lung cancer to bronchopulmonary, pulmonary, paratracheal, tracheobronchial, bifurcation, and peri-esophageal lymph nodes. The first with lymphogenous metastasis are the pulmonary lymph nodes in the zone of division of the lobar bronchus into segmental branches. Then bronchopulmonary lymph nodes along the lobar bronchus are involved in the metastatic process.

Germination or compression of the vagus nerve by a tumor causes paralysis of the vocal muscles and is manifested by hoarseness. Damage to the phrenic nerve leads to paralysis of the diaphragm. Germination of a cancerous tumor into the pericardium causes pain in the heart, pericarditis. The interest of the superior vena cava leads to impaired venous and lymphatic outflow from the upper half of the body. The so-called superior vena cava syndrome is manifested by puffiness and swelling of the face, hyperemia with a cyanotic tinge, swelling of the veins in the arms, neck, chest, shortness of breath, in severe cases - headache, visual disturbances and impaired consciousness.

Peripheral lung cancer

Peripheral lung cancer in the early stages of its development is asymptomatic, since pain receptors in the lung tissue are absent. As the tumor node increases, the bronchi, pleura, and neighboring organs are involved in the process. Local symptoms of peripheral lung cancer include cough with sputum and blood streaks, compression syndrome of the superior vena cava, and hoarseness. The growth of the tumor into the pleura is accompanied by cancerous pleurisy and compression of the lung by pleural effusion.

The development of lung cancer is accompanied by an increase in general symptoms: intoxication, shortness of breath, weakness, weight loss, increased body temperature. In advanced forms of lung cancer, complications from the organs affected by metastases, the disintegration of the primary tumor, the phenomena of tracheostomy, gastrostomy, enterostomy, nephrostomy, etc. join). For cancer pneumonia, anti-inflammatory treatment is performed, for cancer pleurisy - pleurocentesis, for pulmonary hemorrhage - hemostatic therapy.

Forecast

The worst prognosis is statistically observed in untreated lung cancer: almost 90% of patients die within 1-2 years after diagnosis. With non-combined surgical treatment for lung cancer, the five-year survival rate is about 30%. Treatment of lung cancer at stage I gives a five-year survival rate of 80%, at stage II - 45%, at stage III - 20%.

Self-radiation or chemotherapy gives a 10% five-year survival rate for patients with lung cancer; with combined treatment (surgery + chemotherapy + radiation therapy), the survival rate for the same period is 40%. Prognostically unfavorable metastasis of lung cancer in the lymph nodes and distant organs.

Prophylaxis

Lung cancer prevention issues are relevant due to the high mortality rates of the population from this disease. The most important elements of lung cancer prevention are active health education, prevention of the development of inflammatory and destructive lung diseases, detection and treatment of benign lung tumors, smoking cessation, elimination of occupational hazards and daily exposure to carcinogenic factors. Undergoing fluorography at least once every 2 years allows you to detect lung cancer in the early stages and prevent the development of complications associated with advanced forms of the tumor process.

Lung cancer is the most common localization of the oncological process; it is characterized by a rather latent course and early appearance of metastases. The incidence of lung cancer depends on the area of ​​residence, the degree of industrialization, climatic and working conditions, gender, age, genetic predisposition and other factors.

What is lung cancer?

Lung cancer is a malignant neoplasm that develops from the glands and mucous membranes of the lung tissue and bronchi. In the modern world, lung cancer occupies the top line among all oncological diseases. According to statistics, this oncology affects men eight times more often than women, and it was noted that the older the age, the much higher the incidence rate.

The development of lung cancer is not the same in tumors of different histological structures. Differentiated squamous cell carcinoma is characterized by a slow course, undifferentiated cancer develops rapidly and gives extensive metastases.

Small cell lung cancer has the most malignant course:

• develops stealthily and quickly,
• metastasizes early,
• has a poor prognosis.

More often, the tumor occurs in the right lung - in 52%, in the left lung - in 48% of cases.

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.

Kinds

Depending on the location of the primary tumor, there are:

• Central cancer. It is located in the main and lobar bronchi.
• Aeripheral. This tumor develops from the small bronchi and bronchioles.

Allocate:

1. Small cell carcinoma (less common) is a very aggressive neoplasm, as it can very quickly spread throughout the body by metastasizing to other organs. As a rule, small cell carcinoma occurs in smokers, and at the time of diagnosis, 60% of patients have widespread metastasis.
2. Non-small cell (80–85% of cases) - has a negative prognosis, combines several forms of morphologically similar types of cancer with a similar cell structure.

Anatomical classification:

• central - affects the main, lobar and segmental bronchi;
• peripheral - damage to the epithelium of the smaller bronchi, bronchioles and alveloli;
• massive (mixed).

The progression of the neoplasm goes through three stages:

• Biological - the period between the appearance of a neoplasm and the manifestation of the first symptoms.
• Asymptomatic - the external signs of the pathological process do not appear at all, they become noticeable only on the roentgenogram.
• Clinical - the period when noticeable symptoms of cancer appear, which becomes an incentive to rush to the doctor.

Causes of occurrence

The main causes of lung cancer are:

• smoking, including passive smoking (about 90% of all cases);
• contact with carcinogenic substances;
• inhalation of radon and asbestos fibers;
• hereditary predisposition;
• age category over 50;
• the influence of harmful production factors;
• radiation exposure;
• the presence of chronic diseases of the respiratory system and endocrine pathologies;
• cicatricial changes in the lungs;
• viral infections;
• air pollution.

The disease develops secretly for a long time. The tumor begins to form in the glands, mucous membranes, but the proliferation of metastases throughout the body occurs very quickly. Risk factors for malignant neoplasm are:

• air pollution;
• smoking;
• viral infections;
• hereditary reasons;
• harmful production conditions.

Note: Cancer cells that attack the lungs divide very quickly, spreading the tumor throughout the body and destroying other organs. Therefore, an important point is the timely diagnosis of the disease. The earlier lung cancer is detected and treatment is started, the higher the chance of prolonging the patient's life.

The earliest signs of lung cancer

The first symptoms of lung cancer are often not directly related to the respiratory system. Patients go to various specialists of a different profile for a long time, they are examined for a long time and, accordingly, receive the wrong treatment.

Signs and symptoms of early lung cancer:

• subfebrile temperature, which is not confused by drugs and extremely exhausting the patient (during this period, the body is subjected to internal intoxication);
• weakness and fatigue in the first half of the day;
• itching with the development of dermatitis, and, possibly, the appearance of growths on the skin (caused by the allergic action of malignant cells);
• muscle weakness and increased swelling;
• disorders of the central nervous system, in particular, dizziness (up to fainting), impaired coordination of movements or loss of sensitivity.

When these signs appear, be sure to contact a pulmonologist for a diagnosis and clarification of the diagnosis.

Stages

When faced with lung cancer, many do not know how to stage the disease. In oncology, when assessing the nature and degree of lung cancer, 4 stages of the development of the disease are classified.

However, the duration of any stage is highly individual for each patient. It depends on the size of the neoplasm and the presence of metastases, as well as on the rate of the disease.

Allocate:

• Stage 1 - the tumor is less than 3 cm. It is located within the boundaries of a segment of the lung or one bronchus. There are no metastases. Symptoms are hard to see or none at all.
• 2 - tumor up to 6 cm, located within the boundaries of the segment of the lung or bronchus. Single metastases in individual lymph nodes. Symptoms are more pronounced, hemoptysis, pain, weakness, loss of appetite appear.
• 3 - the tumor exceeds 6 cm, penetrates into other parts of the lung or neighboring bronchi. Numerous metastases. To the symptoms is added blood in mucopurulent sputum, shortness of breath.

How does the last 4 stage of lung cancer manifest?

In this stage of lung cancer, the tumor metastasizes to other organs. Survival over five years is 1% for small cell carcinoma and 2 to 15% for non-small cell carcinoma

The patient develops the following symptoms:

• Constant pain when breathing, which is difficult to live with.
• Chest pain
• Decreased body weight and appetite
• Blood coagulates slowly, fractures (metastases in the bones) often occur.
• The appearance of attacks of severe coughing, often with sputum, sometimes with blood and pus.
• The appearance of severe pain in the chest, which directly speaks of damage to nearby tissues, since there are no pain receptors in the lungs themselves.
• Symptoms of cancer also include heavy breathing and shortness of breath, if the cervical lymph nodes are affected, difficulty in speaking is felt.

For small cell lung cancer, which develops rapidly and affects the body in a short time, only 2 stages of development are characteristic:

• limited stage, when cancer cells are localized in one lung and tissues located in the immediate vicinity.
• an extensive or extensive stage, when the tumor metastasizes to an area outside the lung and to distant organs.

Lung cancer symptoms

The clinical manifestations of lung cancer depend on the primary location of the neoplasm. At the initial stage, most often the disease is asymptomatic. In later stages, general and specific signs of cancer may appear.

The early, early symptoms of lung cancer are nonspecific and usually do not cause anxiety, these include:

• unmotivated fatigue
• decreased appetite
• there may be a slight loss of body weight
• cough
• specific symptoms cough with "rusty" sputum, shortness of breath, hemoptysis join at later stages
• pain syndrome indicates the inclusion of nearby organs and tissues in the process

Specific symptoms of lung cancer:

• The cough is unreasonable, paroxysmal, debilitating, but not dependent on physical activity, sometimes with greenish sputum, which may indicate a central location of the tumor.
• Dyspnea. Lack of air and shortness of breath first appear in case of tension, and with the development of a tumor, they disturb the patient even in a supine position.
• Painful sensations in the chest. When the tumor process affects the pleura (the lining of the lung), where the nerve fibers and endings are located, the patient develops excruciating chest pains. They are sharp and aching, constantly disturbing or dependent on breathing and physical exertion, but most often they are located on the side of the affected lung.
• Hemoptysis. Usually, a meeting between a doctor and a patient occurs after blood begins to come out of the mouth and nose with phlegm. This symptom suggests that the tumor has begun to affect the vessels.

Lung cancer stages	Symptoms
1	dry cough; weakness; loss of appetite; malaise; temperature increase; headache.
2	The disease manifests itself: hemoptysis; wheezing when breathing; weight loss; high temperature; increased cough; chest pain; weakness.
3	Signs of cancer appear: increased wet cough; blood, pus in sputum; difficulty breathing; dyspnea; trouble swallowing; hemoptysis; drastic weight loss; epilepsy, speech impairment, with a small cell form; intense pain.
4	The symptoms are getting worse, this is the last stage of the cancer.

Signs of lung cancer in men

• A debilitating, frequent cough is one of the first signs of lung cancer. Subsequently, sputum appears, its color may turn greenish-yellow. With physical labor or hypothermia, coughing attacks intensify.
• Whistling, shortness of breath appears when breathing;
• Pain appears in the chest area. It can be considered a sign of oncology in the presence of the first two symptoms.
• When coughing, in addition to phlegm, discharge in the form of blood clots may appear.
• Attacks of apathy, increased loss of strength, increased fatigue;
• With a normal diet, the patient loses weight dramatically;
• In the absence of inflammatory processes, colds, the body temperature is increased;
• The voice becomes hoarse, this is due to damage to the larynx nerve;
• From the side of the neoplasm, pain in the shoulder may appear;
• Swallowing problems. This is due to the tumor affecting the walls of the esophagus and respiratory tract;
• Weakness of the muscles. Patients, as a rule, do not pay attention to this symptom;
• Dizziness;
• Abnormal heart rhythm.

Lung cancer in women

An important symptom of lung cancer in women is chest discomfort. They manifest themselves in different intensities depending on the form of the disease. Discomfort becomes especially strong if intercostal nerves are involved in the pathological process. It practically does not lend itself to stopping and does not leave the patient.

Unpleasant sensations are of the following types:

• stitching;
• cutting;
• encircling.

Along with the common symptoms, there are signs of lung cancer in women:

• changes in voice timbre (hoarseness);
• enlarged lymph nodes;
• swallowing dysfunctions;
• pain in the bones;
• frequent fractures;
• jaundice - with liver metastasis.

The presence of one or more signs characteristic of a single category of respiratory diseases should be the reason for immediate referral to a specialist.

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 cancer 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 increase in symptoms against the background of chronic previous malaise, general weakness, decreased appetite and body weight is also a variant of carcinogenesis.

Diagnostics

How is lung cancer defined? Up to 60% of oncological lesions of the lungs are detected during prophylactic fluorography, at different stages of development.

• At stage 1, only 5-15% of patients with lung cancer are registered
• 2 - 20-35%
• At 3 stages -50-75%
• 4 - more than 10%

Diagnosis for suspected lung cancer includes:

• general clinical blood and urine tests;
• biochemical blood test;
• cytological examinations of sputum, bronchial lavage, pleural exudate;
• assessment of physical data;
• X-ray of the lungs in 2 projections, linear tomography, CT of the lungs;
• bronchoscopy (fibrobronchoscopy);
• pleural puncture (if there is an effusion);
• diagnostic thoracotomy;
• pre-scalded lymph node biopsy.

Early diagnosis offers hope for a cure. The most reliable method in this case is an x-ray of the lungs. Clarify the diagnosis using endoscopic bronchography. It can help determine the size and location of the tumor. In addition, a cytological study is required - a biopsy.

Lung cancer treatment

The first thing I want to say is that treatment is carried out only by a doctor! No self-medication! This is a very important point. After all, the sooner you seek help from a specialist, the more chances you have for a favorable outcome of the disease.

The choice of a particular treatment strategy depends on many factors:

• Stage of the disease;
• Histological structure of carcinoma;
• The presence of concomitant pathologies;
• A combination of all the above fatkors.

There are several complementary treatments for lung cancer:

• Surgical intervention;
• Radiation therapy;
• Chemotherapy.

Surgery

Surgical intervention is the most effective method, which is indicated only in stages 1 and 2. There are such types:

• Radical - the primary tumor focus and regional lymph nodes are to be removed;
• Palliative - aimed at maintaining the patient's condition.

Chemotherapy

When small cell cancer is detected, chemotherapy is the leading method of treatment, since this form of tumor is most sensitive to conservative methods of treatment. The effectiveness of chemotherapy is quite high and allows you to achieve a good effect for several years.

Chemotherapy is of the following types:

• therapeutic - to reduce metastases;
• adjuvant - used prophylactically to prevent relapse;
• inadequate - just before surgery to shrink tumors. It also helps to identify the level of cell sensitivity to drug treatment, and to establish its effectiveness.

Radiation therapy

Another method of treatment is radiation therapy: it is used for non-removable stage 3-4 lung tumors, it allows to achieve good results in small cell cancer, especially in combination with chemotherapy. The standard dosage for radiation therapy is 60-70 Gy.

The use of radiation therapy for lung cancer is considered as a separate method if the patient has refused chemotherapy and resection is not possible.

Forecast

Perhaps no experienced doctor will undertake to make accurate predictions for lung cancer. This disease can behave unpredictably, which is largely due to the variety of histological variants of the structure of tumors.

However, the patient can still be cured. Usually, leads to a successful outcome use of a combination of surgery and radiation therapy.

How many people live with lung cancer?

• In the absence of treatment almost 90% of patients after the detection of the disease do not live for more than 2 - 5 years;
• in surgical treatment 30% of patients have a chance to live more than 5 years;
• with a combination of surgical, radiation and chemotherapy the chance to live more than 5 years appears in another 40% of patients.

Do not forget about prevention, this includes:

• a healthy lifestyle: proper nutrition and exercise
• quitting bad habits, especially smoking

Prophylaxis

Lung cancer prevention includes the following guidelines:

• Quitting bad habits, primarily smoking;
• Compliance with a healthy lifestyle: proper nutrition rich in vitamins and daily physical activity, walks in the fresh air.
• Treat bronchial diseases in time so that there is no transition to a chronic form.
• Ventilation of the premises, daily wet cleaning of the apartment;
• It is necessary to reduce contact with harmful chemicals and heavy metals to a minimum. During work, be sure to use protective equipment: respirators, masks.

If you have the symptoms described in this article, be sure to see your doctor for an accurate diagnosis.

21.10.2018

People are poorly attuned to cancer treatment. This is due to the fact that oncology is detected at later stages, when remission is possible in part.

Stage 1 lung cancer is curable and life expectancy is high. In order to detect a pathology in time, you should know what symptoms are inherent in it, how the diagnosis is carried out, what treatment methods give a positive result.

Lung cancer is a malignant tumor that occurs from affected tissues. In medicine, they are called carcinomas. There is no ideal treatment that guarantees complete remission.

Mortality from pathology is one of the highest among oncological diseases.

Lung cancer causes

The oncological process that develops in the lungs is the result of lifestyle, diet, habits and a number of other factors:

• The main cause of cancer development is smoking. The smoke of cigarettes is dangerous for the lungs and contains many carcinogenic substances. They negatively affect the body, create pathological changes.
• The current ecological situation affects human health. Emissions from industrial enterprises, and sometimes high levels of radiation, do not carry anything positive.
• If one of the relatives was ill with lung cancer, the reasons may be hidden at the genetic level, be a hereditary manifestation.
• Other lung diseases lead to lung cancer.
• Activities related to the specialization of the patient and his place of work.

Symptoms of lung cancer

Initial symptoms do not appear. The disease manifests itself in signs that, depending on the location of the neoplasm, will differ. This can be similar to overlooked colds. It is easier for the patient to wait out the symptoms, to try to eliminate them with folk remedies, which is wrong.

Oncologists distinguish between central and peripheral types of tumors. Severe central tumor symptoms, including:

• Mild shortness of breath, similar to a lack of oxygen. She is accompanied by a cough, a symptom occurs without exertion.
• A persistent dry cough, which over time acquires a phlegm with a purulent content. Over time, blood clots and streaks are found in the mucus. Lung cancer can be confused with tuberculosis.
• Pain in the sternum. It arises from the side of the tumor, similar to respiratory problems, which is why patients do not go to the doctor.
• Constant change in body temperature. Its rise may resemble pneumonia or the onset of bronchitis. Signs of apathy, fatigue and lethargy will be characteristic.

Even one of the symptoms is bound to alert a person. Symptoms of the first stage of cancer are mild, prolonged general fatigue and constant weakness give rise to a visit to honey. institutions.

Stage 1 lung cancer types

Lung cancer is widespread, and its stage 1 has a classification:

Degree 1a. The tumor in size does not exceed 3 centimeters, and the five-year survival rate, according to statistics, does not exceed 75%. With small cell carcinoma - 40%.

Degree 1c. The size of the tumor is from 3 to 5 centimeters, while the lymph nodes are not damaged, and the survival rate for 5 years occurs in no more than 60% of cases. The small cell form predicts no more than 25% of cases according to statistics.

To draw accurate conclusions about the state of the patient's body, it is necessary to carry out diagnostics. Learn the details of stage 1 lung cancer so you know how to live and be able to prevent relapse.

Diagnostics of lung oncology

Timely diagnostics is the key to preventing the development of cancer. The most popular diagnostic tool is breast fluorography. It is not for nothing that it needs to be passed annually, it helps to identify lung pathologies as best as possible.

• Based on the patient's complaints, and if there is a suspicion that stage 1 lung cancer is present, the doctor will send the patient for an x-ray. It should be done in frontal and lateral projection. This will help prevent confusion and clarify symptoms.
• Next, you need to do a bronchoscopy. This helps to see the tumor visually, provides a small area of ​​the neoplasm for biopsy.
• Another mandatory measure is sputum analysis. To do this, examine the mucus secreted when coughing up. With the help of certain substances, the presence of a tumor can be suspected.
• An additional method will be computed tomography. It is used for problem situations.

The combination of these diagnostic methods makes it possible to identify pathology, and, if necessary, prescribe studies that provide extensive data. This happens with ambiguous symptoms, the cause of which can be determined with several specific examinations.

Stage 1 lung cancer treatment

Judging by the diagnosis, the doctor chooses with what methods to carry out the treatment:

• Surgical intervention in which the cancerous growth is removed completely. Application is typical for non-small cell cancer. If the cancer is small-cell, then at an early stage, methods that do not affect the body can be used:

• Radiation therapy. Cancer cells are irradiated with gamma radiation, as a result, they stop spreading and die off.
• Chemotherapy. It implies the use of anti-cancer systemic drugs that have a detrimental effect on cancer cells.

Both of the latter methods are used at later stages in order to reduce tumor formation in size before surgery and improve the prognosis after.

If treatment is started in a timely manner, then the survival rate will fluctuate within 55-58%, but when therapy is carried out in patients who did not reveal symptoms in themselves, the prognosis will be favorable. Delaying the visit to the doctor for a long period due to unclear symptoms in cases of oncology in the lungs aggravate the situation. Most patients are difficult to treat.

Cancer prognosis

The early cancerous process of tumor development is easily treated if a diagnosis was made on the basis of the symptoms. The prognosis of the disease depends on the general condition of the patient, his age and the reaction of the tumor neoplasm to the treatment process.

Treatment helps not only prevent metastases, but also destroy the tumor completely. The survival rate at stage 1 is high, but if treatment is not carried out, then within two years 90% of patients die.

Predictions will be reassuring in the development of small cell cancer, which is explained by the reaction of cancer cells to treatment with radiation and chemotherapy.

Do not forget that it is in the early stages that it is easier to cure cancer, and in the later stages it is practically incurable. Therefore, it is worthwhile to undergo medical examinations on time.

Lung cancer is a malignant neoplasm consisting of epithelial cells of the respiratory organ. Cells under the influence of a number of factors become atypical and cease to obey the internal control processes responsible for the appearance of new tissues. The damaged epithelial layer grows rapidly. In the presence of malignancy, the tumor progresses rapidly. She shows aggressiveness in relation to the organism in which it was formed.

Code according to ICD-10 (international classification of diseases of the 10th revision) - assigned C34. A serious illness, if left untreated, the patient will die.

Cancer formed from the epithelial tissue of the lung is considered the most deadly among oncological pathologies and the most commonly diagnosed. A similar problem is common in industrialized countries. The social and cultural factor plays a major role. Often diagnosed in smokers.

For the Russian Federation, the problem of the frequency of diagnosing this type of oncology is extremely urgent. Respiratory cancer occupies a leading position in the statistics of diagnosing malignant processes.

The fight against lung cancer is an important task for society, and it is necessary to take serious measures to reduce the death rate of the population.

The lungs in the human body are a paired organ responsible for the function of respiration. The location is the human chest. Below the lungs are limited by the diaphragm. The narrow part of the organ is at the top, rising a few centimeters above the collarbone. The lungs expand downward.

The lungs are usually divided into lobes. In this case, the left lung includes 2 lobes, and the right one has 3 lobes. The shares are composed of corresponding segments. Any segment is a specific area of ​​the lung parenchyma. The center of the segment is marked by the presence of a segmental bronchus and is fed by arterial blood, diverted from the central pulmonary artery.

The smallest component of the lungs is the alveoli. They consist of connective tissue and are balls of the thinnest epithelium of alluvial tissue and elastic fibers. Directly in the alveoli, the main gas exchange takes place between blood and air. In adults, the normal number of alveoli is 700 million.

The breathing function is made possible by the difference between the pressure inside the lungs and in the surrounding atmosphere.

The difference between a malignant oncological process and a benign one

A benign oncological process is the appearance of a non-aggressive neoplasm. Differs in a lower rate of development and is not dangerous for life. In addition, there is no process of spreading metastases throughout the body.

Of course, even benign neoplasms must be removed from the body due to the risk of their degeneration into a malignant form. Such structures sometimes develop over the years without causing significant negative manifestations of discomfort to a person, without causing symptoms. There is a chance of recovery without treatment.

Malignant tumors pose a serious threat to life, called cancer. On the cut, the damaged tissue looked like a claw of this representative of the Arthropod type - this is how Hippocrates saw the manifestation of the disease. The main danger lies in the development of secondary foci of pathology. Another name for the foci is metastases. The mentioned cellular structures are separated due to the disintegration of the main focus of the pathological process and spread through the lymph nodes (causing carcinomatous lymphangitis, inflammation of the lymph nodes) and blood vessels. The lymphogenous pathway for the spread of metastases is considered the main one. These systems are distributed throughout the body, secondary foci can spread not only to the organs of the chest, but also to distant parts of the body.

The list includes:

• organs of the gastrointestinal tract;
• organs of the small pelvis;
• human skeleton;
• brain;
• trachea;
• esophagus;
• human heart.

The appearance of pain in any of the listed organs may be a symptom of the formation of a secondary focus of the pathological process.

The most difficult and life-threatening situation for the patient is observed if the primary tumor in the lungs is detected after the identification of secondary foci of oncology.

A malignant tumor is determined by the rate of development. In the shortest possible time, the formation increases in diameter to a significant size, inhibiting the functions of respiration, absorption of food, and other functions, depending on the place of primary localization of the tumor process.

The growth rate and invasion of the affected tissue depends on the type and shape of the tumor. Distinguish between large and small cell tumors. The small-cell form is characterized by increased aggressiveness, develops rapidly and is often inoperable. The rate of development of the primary tumor itself and the appearance of metastases is much faster in comparison with the large-cell tumor structure.

With cancer, at the beginning of the process of invasion (penetration) of the tumor into the lung, a cough and intense painful sensations occur, which can lead to the appearance of painful shock. Such pains are relieved by drugs based on narcotic substances. Recognized as medicines of strict accountability, it is impossible to purchase them without a prescription from an oncologist.

It is malignant tumor formations that are called cancer. For many, such a diagnosis becomes a verdict. The great danger lies in the fact that cancer shows symptoms already at an advanced stage, when the disease enters the third stage of development. The statistics of mortality from lung cancer show the paramount importance of early diagnosis of pathology. It is required to regularly undergo a medical examination and consult with specialists regarding the state of their own health.

If the disease is detected at asymptomatic stages - the first and second stages - the cancer is curable, the prognosis of survival is much higher than in the third and fourth stages of the disease. A favorable prognosis consists of the 5-year survival rate of a person after treatment of the pathology. Cancer without metastases is much better treated.

Regular examinations should be carried out not only by people included in the risk group (those who are susceptible to harmful factors that contribute to the emergence of atypical forms of epithelial cells), but also people who are not susceptible to such factors. The isolated applied medical science of oncology has not identified the trigger reasons for the oncological process. We were able to establish only risk factors that have a negative effect on the body, contributing to the mutagenic process in the cells that make up the lung organ.

The malignant process has a clearly pronounced staging of its course. In total, 4 stages of pathology are distinguished. Each stage is characterized by a certain value according to the TNM classification:

• the value "T" refers to the primary tumor;
• the value "N" contains information about the state of regional lymph nodes;
• the value "M" indicates the spread of metastases in the patient's body.

Depending on the data of the diagnostic study of the patient, the disease is assigned a stage and its values ​​according to the international standard. The classification is subdivided into subgroups depending on the neglect of the pathological process. This information is extremely important for choosing a cancer treatment method.

Stage III and IV cancers are virtually untreated. Doctors are making efforts to alleviate the patient's condition.

Causes of Lung Cancer

Trigger reasons for the appearance of lung cancer have not yet been identified. Risk factors include the listed types of negative effects on the body:

• Exposure to carcinogens (eg inhalation of tobacco smoke).
• Technogenic and natural radiation impact. For example, frequent X-ray examinations, undergoing radiation therapy in the treatment of an oncological process of a different localization, prolonged exposure to direct sunlight (the reason is typical for people living in tropical and subtropical climates), performing a labor function (for example, at a nuclear power plant or nuclear submarine).
• Viral infections (for example, human papillomavirus). Viruses are capable of causing mutations in cellular structures, which provokes the appearance of oncological pathologies.
• Household dust exposure. If a person is exposed to dust inhaled with air for a long time, the risk of developing a pathological process in the lungs significantly increases.

The lungs are the only internal organ that directly interacts with the surrounding space. There is a need for constant monitoring of the health of the paired organ. The lungs are a vital organ; when dysfunction occurs, a person's death occurs.

Tobacco smoking is considered the leading cause of lung cancer. Poisons and carcinogens contained in tobacco provoke intoxication of other organs. But primarily the lungs suffer from smoke, and this is where the main process of poisoning takes place. Based on statistics, we summarize: the risk of developing lung cancer in a smoker is 20 times higher than in a non-smoker. A slightly lower risk of developing an oncological process in the lung tissues in people who are constantly exposed to secondhand smoke (inhaling smoke in direct contact with a smoking person).

Nicotine contained in a cigarette provokes the emergence of chemical and psychological dependence on smoking. There is a suppression of the human immune system, which provides a high chance of the appearance of any pathology in the body. According to statistics, 90% of cases of the appearance of a malignant oncological process, which ended in the death of the patient, are caused precisely by smoking tobacco products. These statistics are typical for the industrially developed countries of the world.

Besides nicotine, cigarettes contain radon gas, a colorless chemical. A cigarette contains its radioactive isotope.

In men suffering from nicotine addiction, the risk of developing cancer reaches 17 percent, in women - 14 percent. In non-smokers, the risk is 1 percent.

Exposure to asbestos is also cited as a cause. A similar problem is inherent in professional repairmen and builders who are regularly exposed to particles of the specified material.

The most dangerous is the simultaneous exposure to tobacco products and asbestos, as they can enhance the negative aspect of each other. With the constant inhalation of asbestos particles, a pathology called asbestosis develops. The disease provokes the development of many chronic pulmonary pathologies.

Additional risk factors are considered to be the age of a person in an older age group. With aging, the body's resistance to pathogenic factors decreases.

Genetic predisposition - it was noticed statistically that the risk of developing pathology is higher in persons whose relatives in one or two generations have had the described type of cancer.

The danger of cell mutation is increased in the presence of chronic diseases of the respiratory system, tuberculosis and pneumonia (an inflammatory process in the lungs) are dangerous.

Arsenic, cadmium, chromium also affect the development of mutations. It is possible to get negative exposure to chemicals when performing work duties at industrial facilities.

Other reasons for the appearance were also recorded. In some cases, it is not possible to find out what caused the onset of cancer.

People affected by cancer-causing factors are at risk. To reduce the risk of getting sick, it is required to carry out regular examinations and prevention of pathologies.

Prevention includes giving up bad habits, regular exercise, walking in the fresh air.

Classification of lung cancer by histology

Histological sign is the main classification of oncological organ pathology. Histology examines the original cell and concludes about the malignancy of the process, the rate of spread, the stage of pathology. The following types of oncological pathology are distinguished according to histological characteristics:

1. Squamous cell or epidermoid cancer. The specified type of pathology is widespread and is subdivided into a highly differentiated, moderately differentiated, poorly differentiated type. The aggressiveness of the tumor towards the patient depends on the degree of differentiation. With an advanced stage of poorly differentiated cancer, the chances of recovery are close to zero.
2. Squamous cell carcinoma. This segment deals with such types of lung cancer as oat cell and pleomorphic.
3. Large cell carcinoma. There are giant cell and clear cell types of cancer.
4. Adenocarcinoma. The carcinoma shows a degree of differentiation similar to that of squamous cell carcinoma. But the list is supplemented by a bronchoalveolar tumor.
5. A mixed type of cancer is the presence of several types of cancer cells at once.

Small cell carcinoma exhibits the most pronounced aggression towards the patient and is the most difficult to respond to treatment procedures. The frequency of its diagnosis is 16 percent of the other species. With the appearance of small cell cancer, the rate of development of pathology is rapid, already at the second stage a system of metastases occurs in the regional lymph nodes. The prognosis for the survival of patients with this type of cancer is poor. Most often (in 80 percent of cases), large cell carcinoma is diagnosed.

For an accurate diagnosis, the patient needs to undergo a series of diagnostic procedures.

Symptoms of the disease

At the initial stages during the initial formation of a tumor, the disease is asymptomatic. The initial stage of the disease passes even without a cough. Stealth is one of the main dangers of cancer. It is often detected in the last stages.

There are no specific symptoms related to the tumor. Often, the symptomatology manifests itself in such a way that it is correlated with other pathologies of the human respiratory system. The clinical picture of symptoms depends on the location of the tumor, and the intensity of the symptoms depends on the size of the tumor.

At the time of the spread of the negative effect of oncology on the bronchi of a person, frequent symptoms of lung cancer begin:

• complaints of cough;
• dyspnea;
• coughing up phlegm with pus;
• coughing up blood;
• obstruction of the bronchi;
• temperature increase;
• coughing up mucus.

The spread of cancer to large bronchi has received a special name - central cancer.

When the tumor enters the pleural cavity, the patient begins to experience alarming symptoms:

• cough without phlegm (dry cough);
• intense pain in the affected organ (the main symptom indicating the appearance of metastasis in the organ).

This process is called peripheral cancer. Peripheral lung cancer often develops against the background of vascular sclerosis in the upper lobe of the right or left lung. A diffuse type of changes appears. Precancerous processes - squamous cell metaplasia, dysplasia of the epithelium of small bronchi and bronchioles, adenomatosis with cell atypia and atypical hyperplasia of the epithelium in oval and slit-like structures.

At the same time, there is a violation of the heart rhythm, inflammatory processes in the pericardial region, heart failure, edema appear. With the spread of the influence on the esophagus, there is a violation of the free passage of food into the stomach.

The listed signs are characteristic of damage to organs located near the primary source of the tumor disease. Medical statistics indicate that at the initial appointment with a doctor, the patient already has symptoms of manifestations of secondary foci at a distance from the primary source.

It is impossible to talk about a specific clinical picture, it depends on the geography of the spread of cancer with metastases in the body of a human cancer patient. If metastases enter the liver, a yellow tint may appear on the skin and whites of the eyes, pain on the right side of the peritoneum.

If metastases enter the organs of the urinary system, manifestations of inflammatory processes in the kidneys, bladder, problems with urination are possible.

With damage to the central nervous system, symptoms are likely to manifest: impaired consciousness, loss of consciousness, loss of coordination, change in the functionality of the sense organs.

The intensity of the manifestation of symptoms directly depends on the extent of the spread of the pathological process.

There are a number of signs characteristic of any tumor process. These symptoms include:

• chronic manifestations of fatigue;
• fast fatiguability;
• a sharp decrease in body weight indicators;
• manifestation of anemia.

The symptoms listed above are the first signs in the early stages of the disease. If a suspicion of a pathology is established in connection with the presence of the listed symptoms, it is required to be tested for cancer as soon as possible!

Diagnostics

Cancer does not have specific symptoms, it is differentiated with other chronic pathologies of the respiratory system, and a comprehensive examination of the body is required to obtain an accurate diagnostic conclusion. Diagnostics is carried out in a comprehensive manner. Treatment of any pathology begins with the examination.

At the beginning of the study, a biomaterial of blood, urine and feces is taken. The blood is tested in three studies:

• complete blood count (CBC);
• a blood test for tumor markers;
• blood chemistry.

According to the data obtained during the research, the doctor concludes what the patient's state of health is. After that, they proceed to the study of the tumor, the search for secondary foci (metastases). Various types of research are used.

Fluorography

Fluorography is a specific type of X-ray examination used to diagnose the patient's chest and organs located in it. Doctors recommend a chest x-ray examination every 12 months. Employees of budgetary organizations undergo research without fail. Such a duty also applies to people performing a labor function and undergoing annual specialized medical examinations in order to obtain admission to work.

When conducting a study on fluorography, it is impossible to establish the nature of the neoplasm and to assert that the pathology is benign or malignant. This study allows you to thoroughly establish only the location of the tumor and the approximate size.

For fidelity, not only direct chest images are used, but also lateral ones (used to understand a specific localization - peripheral or central lung cancer). The picture shows the contours, the cavity of the tumor. X-rays show a neoplasm in the form of darkening. But x-rays cannot detect a tumor that is less than 2 centimeters in diameter.

Another name for the procedure is fluoroscopy. The method is based on the use of radiation in safe doses for health, providing an image of internal organs on a fluorescent screen (X-ray picture).

The informativeness of fluorography is not the highest, but it serves as a starting point for further research, making it possible to diagnose the primary tumor and identify its localization on the tissue of the right or left lung.

Magnetic resonance imaging

Magnetic resonance imaging, or MRI for short, is one of the most advanced research methods. When performing a study in a tomograph, an image of the tumor is performed in several projections at once. It is based on the layer-by-layer construction of the picture.

The information content of the method is much higher than fluorography.

Further studies on the tomograph will allow to determine the clear structure of the tumor. For this, computed tomography is used. The minimum slice size for computed tomography is 1 millimeter.

The most informative study performed on a tomograph is positron emission tomography (abbreviated as PET). This method uses the introduction of a radioactive substance that illuminates atypical cells and damaged tissues. This study allows you to establish the metabolism between the tissues of the organ, its functionality.

During the procedure, a 3D picture of the tumor is drawn up, while the patient will receive a dose of radiation equivalent to two X-ray examinations.

Bronchoscopy

For a detailed examination of the respiratory organs, bronchoscopy is used. This method uses an endoscope. A thin tube of the device is inserted into the bronchi through the patient's oral cavity.

Thanks to fiber optics, it becomes possible to visually inspect damaged tissue. At the same time, biomaterial is taken for biopsy (this is a microsurgical method of obtaining tumor cells for research on the subject of tumor malignancy, structure, and structural features). The molecular composition of the tumor is determined.

This method is rightfully considered the most informative, since it allows you to examine the tumor in detail and see the features of the neoplasm of a sick person.

Despite the minimally invasive basis, the method can entail a mild side effect: the patient can expectorate dark sputum for a number of days after the completion of the procedure.

Sputum biomaterial study

Research involves examining the secretions from the respiratory system under a microscope. Includes a cytological examination for the presence of atypical cells. Cancer will be indicated by the presence of squamous cell structures in the biomaterial.

Puncture of fluid in the pleural area

The withdrawal of fluid from the pleura means the presence of cancer when abnormal cells are found in the collected material.

The above research methods are necessary to select the correct treatment for the identified pathology. It is required to clearly understand the features that characterize the neoplasm:

• the size of the tumor;
• tumor structure;
• location of localization;
• the presence of metastases;
• the shape of the tumor;
• histological structure.

Treatment

In modern medicine, three main methods of treatment are used primarily to defeat the disease:

1. Surgical (surgical) intervention in order to remove tissue damaged by the tumor.
2. The use of radiation therapy.
3. The use of chemotherapy.

The combined complex application of the above methods allows you to achieve results in treatment. However, for a number of reasons, it is possible to use only one or two options.

Surgical intervention

Surgery to remove a tumor is the main method of treatment. When small cell cancer is detected, it is often impossible to operate. With large cell cancer, surgery is performed regularly and allows you to cure the cancer completely at the initial stages of development.

When undergoing diagnostics and preparing for an operation, a decision is made to amputate a lobe of an organ (lobectomy), two lobes of an organ (bilobectomy), or complete removal of the lung (pulmonectomy). It is possible to carry out combined surgical operations, other types of surgical intervention (depending on the indicators obtained during diagnostic measures).

The volume of the procedure depends on the neglect of the tumor process, the stage of the tumor. The most effective treatment is achieved when lung surgery takes place in the first and second stages of the disease.

To make a decision on total lung amputation, the spread of cancer on the tissues of the main bronchus, the spread of the tumor to several lobes of the tumor, damage to the vessels in the lung, and carcinomatosis are required.

The spread of metastases on the lung tissue at the third and fourth stages of pathology can also become the basis for total amputation of the pulmonary organ.

An important positive aspect in the implementation of surgical intervention is the ability to immediately conduct a histological examination of the amputated tissue.

Until recently, surgery was the only treatment for cancer. In today's medicine, additional methods are used: chemotherapy and radiation therapy.

It is important to correctly and scrupulously follow the clinical recommendations of doctors in the postoperative period. In many ways, it depends on the patient how the rehabilitation after the operation will go.

After removal of the lung, a long recovery period is required.

Radiation therapy

Oncologists do not recognize this method of treatment as an independent one. Despite the frequent use of the method, it is considered effective only with the participation of chemotherapy or surgery.

The essence of the technique: radiation exposure negatively affects the cell's ability to divide. Radiation accumulates in the cell and destroys the cell's DNA structure.

Radiation therapy is given if the patient has inoperable cancer. The impossibility of carrying out surgical intervention is dictated by the patient's state of health. If the patient's heart can stop due to the use of general anesthesia, invasive intervention is not performed when indicated.

Radiation therapy can be prescribed if the patient refuses to undergo surgery. Or with the spread of cancer metastases to organs that cannot be amputated - the back and the brain, the heart.

Two methods are used in therapy:

1. Non-contact, or remote method - is used to irradiate not only neoplasms, but also regional lymph nodes. It is carried out using a gamma-ray accelerator.
2. Contact method, or brachytherapy - is irradiation with the help of special equipment, which acts on the tumor in a targeted manner. To apply the contact method, it is required that the size of the tumor in cross-section does not exceed 2 centimeters.

The use of radiation therapy has side effects. Reason: when using radiation, damage occurs not only to oncological formations, but also to healthy tissues.

No contraindications are required for the use of radiation therapy. The main ones are:

• the appearance of hemoptysis;
• acute infectious pathologies;
• invasion of the tumor into the tissue of the esophagus;
• heart failure;
• liver failure;
• renal failure;
• anemia;
• stroke;
• heart attack;
• exacerbation of a mental disorder.

For the use of radiation therapy, it is required to eliminate the identified contraindications. Otherwise, the therapy will cause complications.

Chemotherapy

Chemotherapy involves the introduction of a medicinal product based on cytostatic effects. Can be used without surgery. The drug used for therapy is a toxin that accumulates in atypical tumor cells and stops cell division and development. The accumulation of toxin occurs during the course of exposure to the drug. The introduction into the body takes place through a vein.

The drug and the duration of the course are chosen by the oncologist. There is also a choice of dosage, method and rate of administration of the drug into the body.

When treating lung cancer, chemotherapy does not work. Probably the use of chemotherapy. This means the simultaneous use of a number of drugs in a single therapy.

The interval between the courses taken is at least 3-4 weeks. Chemotherapy causes side effects that negatively affect the patient's health. It is important to understand the difference in the level of harm caused by the disease and from the course of treatment.

A person undergoing chemotherapy has similar consequences: hair falls out, signs of body poisoning appear - diarrhea, nausea, vomiting. Temperature rise likely.

The use of drugs is performed if there are indications:

1. With inoperable tumors of the small cell type.
2. In the presence of metastasis, to reduce the rate of spread of the pathological process.
3. When carrying out palliative treatment to maintain the patient's health and prolong life.

The use of chemotherapy is difficult for most patients. Taking into account the fact that drugs poison the body with toxins, the appointment of chemotherapy must be a balanced and thoughtful decision.

Survival prognosis

The survival prognosis is made depending on the circumstances considered by the oncologist. These factors include:

• the age of the patient;
• health status;
• characteristics of the tumor process;
• the patient's lifestyle.

Life expectancy is determined by the stage at which the oncology was identified and appropriate treatment started. If the disease is recognized at the first and second stages, with the right treatment, it will be possible to live for more than ten years. Patients in whom cancer was detected at the third and fourth stages live on average 2 years, depending on the type of cancer pathology.

Relapse after lung cancer is common. To avoid the reappearance of oncology after remission, it is required to follow the clinical recommendations of the attending oncologist. Lead a healthy lifestyle, follow the instructions for taking medications, recommendations for medical examinations, recommendations for the regularity of visits and examinations.