The cancer is the uncontrolled growth of abnormal cells in one or both lungs. Mutated cells do not perform their functions. In addition, the pathological growth of the tumor damages the pulmonary structure. As a result, the lungs lose their ability to provide the body with oxygen.
Causes
All cells human body contain genetic material called DNA. Each time a mature cell divides into two new cells, its DNA is precisely duplicated. The new cells are identical in all respects to the original.
Lung cancer begins with the occurrence of mutation processes in cellular DNA, which can be caused by aging of the body or factors environment(such as tobacco smoke, inhalation of asbestos and radon vapors).
Researchers have discovered that a cell can be in a precancerous state before it becomes cancerous. At this stage, in addition to a small number of mutations, the unhindered functioning of lung cells is observed. After several cycles of tissue division, the tissue becomes pathological.
In later stages of the disease, some mutated cells may travel through the lymphatics and blood vessels from the original tumor to other areas of the body, causing new lesions. This process is called metastasis.
Classification
Depending on the location of the malignant process, tumors are:
- Right lung cancer.
- Left lung cancer.
Stages of development of lung oncology:
I. The size of the neoplasm is 3 cm. It is located in one lung segment. There are no metastases.
II. Tumor size – 6 cm. Localization within a segment of one lung. Single metastases are observed.
III. The tumor is more than 6 cm in diameter and the process spreads into two segments. May grow to the central bronchus. Extensive metastases are detected.
IV. The pathology extends beyond the organ and is characterized by extensive distant metastases.
Clinical picture depending on the location of the malignant process
- Central right lung cancer characterized by the following symptoms:
- Attacks of frequent dry cough, sometimes with blood;
- There is a history of regular treatment for pneumonia;
- The occurrence of shortness of breath for no apparent reason;
- Body temperature a long period maintained at 37º C;
- Painful sensations in the chest area on the right side.
- Peripheral cancer of the right lung on early stages is practically asymptomatic. This form of the disease is diagnosed accidentally (during x-ray examination organs of the chest) or purposefully (in the later stages of the disease, when its general symptoms appear).
General symptoms
- A sharp decrease in body weight.
- Hyperthermia that is not associated with colds or inflammatory diseases body.
- General weakness that increases as the tumor develops.
- Long-term painful sensations on the right side of the body.
Diagnostics
The main way to diagnose each type of lung cancer is an x-ray examination, which determines the location of the tumor, its size and extent. In some cases, magnetic resonance imaging is performed to clarify the boundaries of the area affected by the oncological process. depends on the country of treatment, as well as on the complexity of the techniques used. Finally, oncologists perform a biopsy, which is necessary to determine the cellular composition of the tumor.
Right lung cancer - treatment
There are three main methods of treating oncological lesions of the pulmonary system: surgery, exposure to ionizing radiation and chemotherapy. The treatment option depends on the location of the process and its cellular composition.
- Surgical removal of a malignant neoplasm is carried out in the early stages and can be partial or complete. For example, if a diagnosis of “Cancer of the upper lobe of the right lung” is established, the oncologist decides on partial resection of the upper lobe of the lung. During the operation, lymph nodes are also removed along with the affected lung tissue to prevent the development of relapse of the disease.
- The second most effective method of treating lung cancer is ionizing radiation, which can be used either independently or in combination with surgery. The complex method of exposure is recommended for use when mutated cells are located in hard-to-reach areas (cancer of the lower lobe of the right lung).
- Chemotherapy is mainly used for patients unable to tolerate surgery, or in later stages with extensive foci of tumor metastasis.
Complications of surgical treatment
- The occurrence of extensive bleeding during surgery.
- Development of recurrent lung cancer.
- Formation of pulmonary failure.
- Lymphostasis in the vessels of the chest.
Prevention of lung cancer
- Passing a regular annual medical examination, including fluorography;
- Timely and complete treatment inflammatory processes chest cavity;
- Rejection of bad habits;
- Maintaining a healthy lifestyle;
- Proper nutrition.
Lung cancer is the most common tumor worldwide. More than 1 million people die from this disease every year. Lung oncology is characterized by a latent course and rapid spread of metastases. In men, this pathology is diagnosed much more often than in women, approximately seven to eight times. People of different age groups get sick.
The first signs of lung cancer
Let's look at how lung cancer manifests itself. At the beginning of tumor formation, symptoms are subtle or may be completely absent, which is why most people lose a lot of time and the cancer moves to another stage.
Which people are at risk?
- Age. People over forty need to be checked annually.
- Male gender. Lung cancer most often affects men. Moreover, the difference is very noticeable - 5-8 times depending on the age category of those being compared.
- Nationality. African Americans get sick much more often than other nations.
- Genetic predisposition. Presence of cancer in blood relatives.
- Smoking. Decisive factors in this matter, not only the total smoking experience, but also the intensity in the number of cigarettes smoked per day. The reason for this may be the deposition of nicotine in the lungs.
- Passive smoking. Frequently being near smoking people or in smoky rooms exceeds the disease risk factor by 20%.
- Chronic lung diseases. Diseases such as tuberculosis, chronic obstructive pulmonary disease, bronchiectasis, lung destruction, polycystic pulmonary disease.
- HIV infection. Cancer is diagnosed twice as often in people living with HIV.
- Radiation therapy. People who have undergone radiation exposure are at risk, since the rays affect the cell, changing the functions of the organelles, as a result of which they cannot work fully.
Types
- Small cell cancer- the most terrible and aggressively developing tumor and giving metastases even to the small size of the tumor itself. It is rare, usually in smokers.
- Squamous cell carcinoma– the most common type of tumor, develops from flat epithelial cells.
- Adenocarcinoma– rare, formed from the mucous membrane.
- Large cell– affects women more often than men. A peculiarity is the onset of the development of cancer in the subsegmental bronchi and early education metastases in the lymph nodes of the mediastinum, additionally peripheral damage to the adrenal glands, pleura, bones, and brain occurs.
Stages of cancer
There are only four stages of cancer, each of these stages is characterized by certain symptoms and manifestations. For each stage, individual treatment is selected by an oncologist. It is possible to completely get rid of this pathology only in the early stages.
- First stage 1A. The neoplasm should not exceed 3 cm in diameter. This stage occurs without coughing. It is very difficult to detect.
- First stage 1B. The size of the tumor can reach up to 5 centimeters in diameter, but malignancy does not release tumor markers into the blood, which means it can still be completely removed.
If this disease is detected at this stage, then the prognosis of the disease in 70 cases out of 100 will be favorable. Unfortunately, as mentioned above, recognition at the initial stage is very difficult and almost impossible, since the tumor is very small and there are no obvious symptoms.
It's always worth paying attention to alarming symptoms in both adults and children: the degree of cough and the consistency and smell of sputum; it can be putrid and greenish in color.
There can be a huge danger small cell carcinoma, spreading metastases throughout the body almost instantly. If you suspect such a cancerous lesion, you should immediately resort to treatment: chemotherapy or surgery.
The SECOND stage of cancer begins when a tumor forms more than five centimeters in diameter. Among the main symptoms are an increased cough with sputum interspersed with blood, elevated temperature, rapid breathing, as well as possible “lack of air.” At this stage, sudden weight loss often occurs.
- Stage 2A. Malignant formation in diameter it has grown to 5 centimeters. The lymph nodes have almost been reached, but are not yet affected.
- Stage 2B. Malignant tumor reaches 7 cm, but the neoplasm, as in stage 2A, has not yet spread to the lymph nodes. There may be indigestion. Metastases to the chest cavity are possible.
Survival rate in the second stage: 30 patients out of 100. Correctly chosen treatment can increase life expectancy: up to approximately 4-6 years. For small cell cancer, the prognosis at this stage is even worse: 18 patients out of 100.
THIRD stage of cancer. At this stage, treatment practically does not help.
- Stage 3A. The tumor is more than 7 centimeters. It has already reached closely adjacent tissue and the lymph nodes near the lung are affected. Metastases appear, their area of appearance expands noticeably and covers the chest, trachea, blood vessels, even near the heart and can penetrate the thoracic fascia.
- Stage 3B. A malignant tumor is more than 7 cm in diameter, it can already affect even lung walls. Rarely, metastases can reach the heart, tracheal vessels, which cause the development of pericarditis.
Symptoms in the third stage are pronounced. Severe cough with blood severe pain in the chest area, chest pain. At this stage, doctors prescribe cough suppressants. The main treatment is to suppress the growth of cancer cells with chemotherapy, but unfortunately, the treatment is ineffective, the tumor grows and destroys the body. Cancer of the left or right, with these lesions of parts of the lungs, resection of all or part of the lung is performed.
Lungs' cancer - serious illness, developing mostly from the tissues of the bronchi, as well as the bronchial glands and affecting the human lungs.
Mostly men who smoke are susceptible to it (according to various statistical research- 80-90%), while the lion's share of cases are people from 45 to 80 years old, but lung cancer can also occur in young people.
Table of contents:Note: Cancer cells that attack the lungs divide very quickly, spreading the tumor throughout the body and destroying other organs. That's why important point is timely diagnosis diseases. The earlier lung cancer is detected and its treatment is started, the higher the chance of extending the patient’s life.
In sixty percent of cases, pathology develops in the upper part of the lungs. Most likely, this is due to the fact that it is in this department that tobacco smoke and air containing carcinogenic substances linger the longest.
Cancer originating from the bronchus is called central, and cancer from lung tissue is called peripheral. In 80% of cases, the disease forms in the central zone and hilum of the lung.
Central (hilar) cancer is divided into:
- endobronchial;
- peribronchial.
At an early stage, the tumor looks like a polyp or plaque. Then it can grow in different ways. There is also a mediastinal type, which is characterized by a small tumor and rapid growth.
Depending on the histological changes, our country has adopted a classification that distinguishes:
- non-small cell lung cancer;
- small cell forms.
Non-small cell lung cancer
This is one of the most common forms of malignant pulmonary tumor; it is characterized by the following subtypes:
- Squamous cell carcinoma- degenerated cells of the epithelial tissue lining the bronchi. It spreads slowly, is easy to diagnose, and has a good prognosis for treatment.
- Adenocarcinoma– a type of cancer whose cells are formed from the glandular tissue of the small bronchi. The tumor metastasizes into the tissue of the contralateral lung, forming new foci in the immediate vicinity of the primary node. More often characteristic of women, it is practically unaffected by smoking, and grows to enormous sizes. It looks like a grayish-white nodule, in the center there is sclerotic tissue, lobules are visible in the tumor. Sometimes the neoplasm is covered with mucus, there are noticeable foci of wet necrosis, and bleeding from the vessels. Adenocarcinoma manifests itself with bronchial symptoms – atelectasis and bronchopneumonia.
- Large cell carcinoma- abnormally huge anaplastic cells, the growth of which is usually noticeable in the central part of the bronchial tree. The tumor is aggressive and does not have a typical clinical picture. At a later stage, a cough occurs with sputum streaked with blood. The patients are exhausted. Histological sections show necrosis and hemorrhages.
- Mixed forms– tumors in which cells of several types of cancer are present. Symptoms of the disease and prognosis depend on the combination of types of neoplasms and the degree of predominance of certain cells
This is one of the most aggressive types of cancer. Outwardly it resembles a soft light yellow infiltrate interspersed with foci of necrosis; the cells resemble oat grains. It is characterized by rapid growth and the formation of regional and distant metastases. 99% of patients with this form are smokers.
As is known, the histological picture of one tumor site may differ from another. Accurate diagnosis of a tumor allows you to make a prognosis for the development of the disease and select the most effective treatment regimen.
Stages of lung cancer
Modern medicine distinguishes several stages of the disease
|
Lung cancer stage |
Tumor size |
Pathological process in the lymph nodes |
Metastasis |
|
Stage 0 |
The neoplasm is localized and does not spread to surrounding tissues |
absent |
absent |
|
Stage I A |
Tumor-like neoplasm up to 3 cm, does not affect the main bronchus |
absent |
absent |
|
Stage I B |
The neoplasm is from 3 to 5 cm, localized, does not spread to other areas, is located 2 cm or more below the trachea |
absent |
absent |
|
Stage II A |
The tumor size is up to 3 cm, it does not affect the main bronchus |
Affects single peribronchial regional lymph nodes. |
absent |
|
Stage II B |
The neoplasm is 3 to 5 cm in size, not spread to other parts of the lungs, localized 2 cm or more below the trachea |
There is noticeable damage to single regional peribronchial nodes of the lymphatic system. |
absent |
|
absent |
absent |
||
|
Stage III A |
The size of the neoplasm is up to 5 cm, damage to other parts of the lungs does not occur |
Bifurcation or other types of lymph nodes located in the mediastinum on the affected side are affected |
absent |
|
A tumor of any size that grows into other organs of the chest. Does not affect the heart, large vessels and trachea. |
There is damage to the bifurcation/peribronchial/regional and other mediastinal lymph nodes on the affected side |
absent |
|
|
Stage III B |
Tumor-like neoplasm of any size, spreading to the mediastinum, large vessels, trachea, heart and other organs |
Any nodes of the lymphatic system are affected |
absent |
|
Lung cancer can be of any size and spread to different organs. |
The inflammatory process involves the lymph nodes of the mediastinum not only on the affected side, but also from the opposite side and lymph nodes localized in the upper shoulder girdle |
absent |
|
|
Stage IV |
Tumor size doesn't matter |
Any lymph nodes affected |
Single or multiple metastases are observed in any organs and systems |
Causes and factors of lung cancer
The main cause of oncology of any organ is DNA damage to cells that occurs due to exposure to various factors.
If we talk about lung cancer, the causes of its occurrence may be:
- work in hazardous production;
- inhalation of harmful substances.
Most often, this disease is observed in workers in the following professions:
- steelworkers;
- miners;
- woodworkers;
- metallurgists;
- in the production of ceramics, phosphates and asbestos cement.
The main causes of lung cancer formation:
- Inhalation of carcinogens found in cigarette smoke. The likelihood of developing the disease increases significantly when smoking more than 40 cigarettes per day.
- Poor environmental conditions. This is especially true in areas where processing and mining enterprises are located.
- Exposure to radiation.
- Contact with substances that provoke the occurrence of the disease.
- , frequent
Signs and symptoms of pulmonary cancer
Most often, at the initial stage, the disease practically does not manifest itself outwardly, and a person turns to specialists when it is no longer possible to help him with anything.
Main symptoms of lung cancer:
- chest pain;
- shortness of breath;
- cough that does not go away for a long time;
- weight loss;
- blood in sputum.
However, these manifestations do not always indicate the presence of oncology. They can mean a host of other diseases. Therefore, cancer diagnosis in most cases is delayed.
In addition to the above symptoms, lung cancer clearly manifests:
- lack of interest in life;
- lethargy;
- very low activity;
- elevated temperature for a long period of time.
It is important to understand that this disease is easily disguised as bronchitis or pneumonia, so it is important to differentiate it from other diseases.
Early diagnosis offers hope for cure. The most reliable way in in this case is an x-ray of the lungs. The diagnosis is clarified using endoscopic bronchography. It can be used to determine the size and location of the tumor. In addition, a cytological examination (biopsy) is required.
If the diagnosis is confirmed, treatment should be started immediately, strictly following the doctor’s instructions. Don't count on alternative medicine and folk remedies.
Considering the fact that the onset of the disease occurs without symptoms, it makes sense to do fluorography annually. This is especially recommended for people at risk. If there is suspicion, the diagnosis is considered confirmed until the contrary is proven.
The diagnosis is confirmed using:
- transthoracic puncture;
- biopsies;
- blood test for tumor marker levels.
Trofimova Yaroslava, medical observer
A diagnosis of cancer sounds like a terrible death sentence for many, but is it so? The term “cancer” has been known since the time of Hippocrates, who called diseases of the breast and other organs “cancer” (translated from Greek as “crab”, “cancer”). This name is due to the fact that the neoplasms, like claws, grew deep into the tissue, which in appearance resembled a crab.
Cancer, a group of diseases that affect all human systems, organs and tissues, is characterized by rapid growth atypical cells, which form for a long time from one normal cell under the influence of various factors, penetrate and spread into surrounding organs.
Some statistics! Around the world in 2012 there were approximately 14 million cases of cancer and about 8 million deaths from this disease. Lung cancer accounted for 13% in the morbidity structure, becoming the most common cause deaths from cancer and accounting for about 20% of all deaths from neoplasms. WHO estimates that in 30 years the prevalence of lung cancer will double. Russia and Ukraine are in second place in Europe in terms of mortality from lung cancer.
Such a high mortality rate from lung cancer is due to the fact that most often the diagnosis is made in the later stages of the disease due to poor visualization of the respiratory organs, so it is very important to detect the disease in time, which will increase the chances of recovery.
Interesting fact! Men get lung cancer 10 times more often than women, and the incidence increases with age. Therefore, with an aging population (and today in many European countries The number of older people is higher than that of young people), and the incidence of cancer is also increasing.
The problem of lung cancer is closely intertwined with the spread of tobacco smoking among all groups of the population, the state of the environment, and the spread of viral and other infectious diseases. Therefore, the prevention of cancer is the destiny of not only each individual, but also the public as a whole.
Anatomy of the lungs
Topographic anatomy of the lungs
The lungs are a paired respiratory organ that supplies the blood with oxygen and removes carbon dioxide. The lungs occupy 80% of the chest cavity. Lung structure 
Lung skeleton poses bronchial tree, consisting of: trachea; left and right main bronchi; lobar bronchi; segmental bronchi. The lung tissue itself consists of slices, which are formed from acini, directly carrying out the breathing process.
The lungs are covered with pleura, which is a separate organ that protects the lung from friction during breathing. The pleura consists of two layers (parietal and visceral), between which the pleural sac is formed (normally it is not visible). A small amount of secretion is normally released through the pores of the pleura, which is a kind of “lubricant” that reduces friction between the parietal and visceral pleura.
With lesions of the pleura, exudate (liquid) can be determined:
- serous, serous-purulent, purulent fluid - pleurisy,
- blood (hemorrhagic exudate) – hemithorax,
- air (pneumothorax).
The root of the lung is formed by:
- main bronchus;
- pulmonary arteries and veins;
- bronchial arteries and veins;
- lymphatic vessels and nodes.
The mediastinum is a group of anatomical structures located between the pleural cavities. In order to describe the process, its localization, prevalence, determination of volumes surgical operations it is necessary to divide the mediastinum into upper and lower floors.
The superior mediastinum includes:
- thymus gland (thymus);
- vessels: part of the superior vena cava, aortic arch, brachiocephalic veins;
- trachea;
- esophagus;
- thoracic lymphatic vessel;
- nerve trunks: vagus, phrenic, nerve plexuses of organs and blood vessels.
- heart, aorta and other vessels;
- The lymph nodes;
- pericardium;
- trachea;
- esophagus;
- nerve trunks.
X-ray anatomy of the lungs
Radiography is the layering of all projections of organs on X-ray film in a two-dimensional image. On radiographs, dense tissues are depicted in white, and air spaces in black. How denser than fabric, organs or fluid, the whiter they appear on x-rays. A plain X-ray of the chest organs reveals:
- bone frame in the form of three thoracic vertebrae, sternum, clavicles, ribs and shoulder blades;
- muscular frame (sternocleidomastoid and pectoral muscles);
- right and left pulmonary fields;
- domes of the diaphragm and pleuro-phrenic sinuses;
- heart and other mediastinal organs;
- right and left root of the lung;
- mammary glands and nipples;
- skin folds, moles, papillomas, keloids (scars).
Pulmonary drawing has a branched shape, “depletes” (becomes less branched) from the center to the periphery. The right pulmonary field is wider and shorter than the left due to the cardiac shadow located in the middle (larger on the left).
Any darkening in the lung fields (on x-rays - white formations, due to increased density lung tissue) are pathological and require further investigation differential diagnosis. Also, when diagnosing diseases of the lungs and other organs of the chest cavity, it is important to pay attention to changes in the roots of the lungs, expansion of the mediastinum, the location of the chest organs, the presence of fluid or air in the pleural cavity, deformation of the bone structures of the chest, and more.
Depending on size, shape, structure pathological shadows, found in the lung fields, are divided into:
- Hypopneumatoses(decreased airiness of lung tissue):
- Linear – stringy and branched (fibrosis, connective tissue), strip-like (pleural lesions);
- Spotted - focal (up to 1 cm in size), foci (more than 1 cm in size)
- Hyperpneumatoses(increasing lung transparency):
- Cavities surrounded anatomical structures- bullae, emphysema;
- Cavities surrounded by a ring-shaped shadow are caverns;
- Cavities not limited to surrounding tissues.
- Mixed.
- low-intensity shadows (lighter, “fresh”),
- medium intensity shadows;
- intense shadows (fibrous tissue);
- calcifications (look like bone tissue).
Radiation anatomy of lung cancer
Radiation diagnostics has lung cancer great value in primary diagnosis. X-rays of the lungs can reveal shadows of various sizes, shapes and intensities. The main sign of a cancerous tumor is the bumpiness of the surface and the radiance of the contour.Depending on the x-ray picture, the following are distinguished: types of lung cancer:
- central cancer (photo A);
- peripheral cancer (nodular, pneumonia-like, pleural, cavitary forms) (photo B);
- mediastinal cancer (photo B);
- apical cancer (photo G).
B
IN
G
Pathological anatomy for lung cancer
Oncological formations of the lungs develop from the tissues of the bronchi or alveoli. Most often, cancer appears in the segmental bronchi, after which it affects the large bronchi. In the early stages cancer formation small, perhaps not detectable on radiographs, then gradually grows and can occupy the entire lung and involve lymph nodes and other organs in the process (usually mediastinal organs, pleura), and also metastasize to other organs and systems of the body.Ways of spread of metastases:
- Lymphogenic – along the lymphatic system - regional lymph nodes, mediastinal lymph nodes and other organs and tissues.
- Hematogenous – through the blood along the vessels - brain, bones, liver, thyroid and other organs.
Types of lung cancer depending on the type of cancer cells
- Small cell lung cancer– occurs in 20% of cases, has an aggressive course. It is characterized by rapid progression and metastasis, early dissemination (spread) of metastases to the mediastinal lymph nodes.
- Non-small cell lung cancer:
- Adenocarcinoma – observed in 50% of cases, spreads from the glandular tissue of the bronchi, often to initial stages occurs without symptoms. Characterized by copious sputum production.
- Squamous cell carcinoma occurs in 20-30% of cases, is formed from flat cells in the epithelium of small and large bronchi, in the root of the lungs, grows and metastasizes slowly.
- Undifferentiated cancer characterized by high atypicality of cancer cells.
- Other types of cancer:
- bronchial carcinoids are formed from hormone-producing cells (asymptomatic, difficult to diagnose, slow growing).
- tumors from surrounding tissues (vessels, smooth muscles, immune cells, etc.).
- metastases from tumors localized in other organs.
What does a cancerous lung look like?
The photo of peripheral cancer of the left lung shows a large cancerous tumor under the pleura without clear boundaries. The tumor tissue is dense, gray-white, with hemorrhages and necrosis around. The pleura is also involved in the process. Smoker's lung
Photo of a lung affected by central bronchial cancer. The formation is dense, connected to the main bronchus, gray-white in color, the boundaries of the tumor are unclear.
Causes of lung cancer
- Smoking, including passive smoking.
- Air pollution.
- Harmful working conditions.
- Radioactive background.
- Genetic predisposition.
- Concomitant chronic infectious diseases.
- Other causes of cancer include poor diet, sedentary lifestyle, alcohol abuse, viral infections etc.
Smoking
T 800-900 C
Harm of smoking
- Chemical effect on cell genotype. The main cause of lung cancer is the entry of harmful substances into the lungs with the air. Cigarette smoke contains about 4,000 chemicals, including carcinogens. As the number of cigarettes smoked per day increases, the risk of lung cancer increases exponentially.
Inhalation cigarette smoke Carcinogens can affect cell genes and cause their damage, thereby contributing to the degeneration of a healthy cell into a cancerous one. - Physical effect on the bronchial mucosa high temperatures and smoke.
The risk of developing cancer when smoking also increases due to the temperature of the cigarette: for example, when it smolders, the temperature reaches 800-900C, which is a powerful catalyst for carcinogens. - Narrowing of the bronchi and blood vessels
Under physical and chemical exposure Nicotine narrows the bronchi and the vascular network of the lungs. Over time, the bronchi lose their ability to stretch during breathing, which leads to a decrease in the volume of inhaled oxygen, in turn, to a decrease in oxygen saturation of the body as a whole and the area affected by cancer lung cells in particular. - An increase in the amount of mucus produced, its thickening
Nicotine is able to increase the secretion of pulmonary secretions - sputum, its thickening, and removal from the bronchi, this leads to a decrease in lung volume. - Atrophy of the villous epithelium of the bronchi
Cigarette smoke also negatively affects the villi of the bronchi and upper respiratory tract, which normally contribute to active removal of phlegm with particles of dust, microbial bodies, tar from cigarette smoke and other harmful substances that have entered the respiratory tract. If there is insufficient bronchial villi, the only way to remove phlegm is to cough, which is why smokers constantly cough. - Decreased oxygen saturation levels
Insufficient oxygen saturation of the cells and tissues of the body, as well as the toxic effect of harmful substances from tobacco, affects general body resistance and immunity, which increases the risk of developing cancer in general. - Passive smoking has the same danger as active. When a smoker exhales, the nicotine smoke becomes more concentrated.
Causes of lung cancer in non-smokers, mechanisms of development
- Genetic factor
IN modern times With the study of the genetics of many diseases, it has been proven that predisposition to cancer is inherited. Moreover, the tendency to develop certain forms and localizations of cancer is also inherited. - Environmental pollution exhaust gases from transport, industrial enterprises and other types of human activity affect the human body in the same way as passive smoking. Also relevant is the problem of soil and water contamination with carcinogens.
- Asbestos dust and other industrial substances (arsenic, nickel, cadmium, chromium, etc.) contained in industrial dust are carcinogens. Asbestos dust contains heavy particles that settle in the bronchi and are difficult to remove from the respiratory system. These particles contribute to the development of lung fibrosis and long-term exposure of the carcinogens they contain to the genetic background of normal cells, which leads to the development of cancer.
- Radon
– natural gas, which is a product of the decay of uranium.
Radon can be detected at work, in water, soil and dust. When radon decays, alpha particles are formed, which, along with dust and aerosols, enter the human lungs, where they also affect the DNA of the cell, causing it to degenerate into an abnormal one. - Infectious diseases The bronchopulmonary system, as well as inadequate therapy for them, can lead to chronic inflammation of the bronchi and lungs, this, in turn, contributes to the formation and spread of fibrosis. The development of fibrous tissue can cause the development of cancer cells. The same mechanism of transformation of cancer cells is possible during the formation of scars in tuberculosis.
Symptoms and signs of lung cancer
Early manifestation of lung cancer
It is most important to identify the disease in the early stages of tumor development, and most often the course at the onset of the disease is asymptomatic or asymptomatic.Symptoms of lung cancer are nonspecific and can appear in many other diseases, but a set of symptoms may be a reason to consult a doctor for further examination for the presence of cancer.
Depending on the extent of the lesion, shape, location and stage, symptoms may vary. There are a number of symptoms that may indicate lung cancer.
| Symptom | How the symptom manifests itself | Causes of the symptom |
| Cough | Dry, frequent, forced, paroxysmal, later - wet with copious secretion of thick sputum (mucous or purulent). | Tumor of the bronchus, compression of the bronchus by a tumor from the outside, copious sputum production, enlargement of the intrathoracic lymph nodes, toxic-allergic effect on the bronchi. |
| Dyspnea | Appears with minor physical activity: The larger the tumor damage, the more dyspnea appears. Possible shortness of breath due to bronchial obstruction, accompanied by noisy wheezing. | Narrowing of the lumen of the bronchus, collapse of a segment or lobe of the lung (atelectasis), secondary pneumonia, the presence of fluid in the pleural cavity (pleurisy), tumor spread lymphatic system, damage to the intrathoracic lymph nodes, compression of the superior vena cava, etc. |
| Hemoptysis | It is rare and is manifested by the appearance of streaks or blood clots in the sputum, copious discharge of foamy or jelly-like sputum is possible, in rare cases, profuse bleeding, which can lead to rapid fatal outcome sick. | Associated with tumor damage blood vessel in the form of melting of its wall and blood entering the bronchus. |
| Chest pain | The pain can be different: from periodic to acute paroxysmal and constant. The pain can radiate to the shoulder, neck, or stomach. The pain may also intensify with deep breathing or coughing. The pain is not relieved by taking non-narcotic painkillers. The intensity of the pain can be used to judge the extent of damage to the lungs and other organs of the chest. | Tumor damage to nerve structures, fluid in the pleural cavity, compression of mediastinal organs, damage great vessels And so on. |
| Increased body temperature | A common symptom of cancer. The symptom may be temporary (as with ARVI) or recurring (sometimes patients do not pay attention to this symptom). | Decay of lung tissue, inflammatory changes in the affected organ. |
| General intoxication symptoms | Decreased appetite, weight loss, fatigue, disorders nervous system and others. | Intoxication due to the breakdown of lung tissue, metastasis. |
Stages and types of lung cancer
Depending on the anatomical location:- Central cancer characterized by a tumor in the epithelium of the main bronchi.
- Peripheral cancer affects smaller bronchi and alveoli.
- Mediastinal cancer characterized by metastasis to the intrathoracic lymph nodes, while the primary tumor is not detected.
- Disseminated cancer lungs is manifested by the presence of multiple small cancer foci.
Depending on prevalence tumor process
| Stage | Dimensions | Lymph node involvement | Metastases |
| Stage 0 | The tumor has not spread to surrounding tissues | No | No |
| Stage I A | No | No | |
| Stage I B | No | No | |
| Stage II A | Tumor up to 3 cm, does not affect the main bronchus | No | |
| Stage II B | The tumor is from 3 to 5 cm in size, has not spread to other parts of the lungs, is located 2 cm or more below the trachea | Damage to single regional peribronchial lymph nodes. | No |
| No | No | ||
| Stage III A | Tumor up to 5 cm, with/without involvement of other parts of the lungs | Damage to the bifurcation or other lymph nodes of the mediastinum on the affected side | No |
| A tumor of any size that spreads to other organs of the chest, except the trachea, heart, and large vessels | Damage to peribronchial, regional or bifurcation and other mediastinal lymph nodes on the affected side | No | |
| Stage III B | Tumor of any size, affecting the mediastinum, heart, great vessels, trachea and other organs | Involvement of any lymph nodes | No |
| Tumor of any size and extent | Damage to the lymph nodes of the mediastinum on the opposite side, lymph nodes of the upper shoulder girdle | No | |
| Stage IV | Tumor of any size | Damage to any lymph nodes | Presence of any metastasis |
Diagnosis of lung cancer
X-ray diagnostic methods
- Fluorography (FG)- mass screening x-ray method for examining the chest organs.
Indications:
- the patient has pulmonary or intoxication complaints;
- detection of pathology on fluorography;
- detection of neoplasms in other organs in order to exclude metastasis to the lungs and mediastinum;
- other individual indications.
- the ability to use certain projections individually;
- the ability to use X-ray examinations with the introduction of contrast agents into the bronchi, vessels and esophagus in order to conduct a differential diagnosis of the identified pathology;
- identification of neoplasms, determination of their approximate size, localization, prevalence;
- low X-ray exposure when performing one projection of radiography, since X-rays penetrate the body only along one surface of the body (with an increase in the number of images, the radiation exposure increases sharply);
- a fairly cheap research method.
- insufficient information content - due to the layering of three-dimensional measurement of the chest on the two-dimensional measurement of the x-ray film.
- X-ray
It is a real-time x-ray research method.
Flaws: high radiation exposure, but with the introduction of digital fluoroscopes this disadvantage is practically leveled due to a significant reduction in the radiation dose.Advantages:
- the ability to evaluate not only the organ itself, but also its mobility, as well as the movement of injected contrast agents;
- the ability to control invasive procedures (angiography, etc.).
- detection of fluid in the pleural cavity;
- conducting contrast research methods and instrumental manipulations;
- screening of the condition of the chest organs in the postoperative period.
- CT scan(CT)
Advantages:
- Efficiency and safety.
- Mapping the structure of the body using radio waves emitted by hydrogen atoms, which are contained in all cells and tissues of the body.
- No radiation exposure - is a tomographic, but not x-ray method of examination,
- High accuracy of detecting tumors, their position, type, shape and stage of cancer.
- unwanted use of x-rays;
- suspicion of the presence of a neoplasm and metastases;
- the presence of fluid in the pleural cavity (pleurisy);
- enlarged intrathoracic lymph nodes;
- control of surgery in the chest cavity.
- Presence of contraindications (use of a pacemaker, electronic and metal implants, presence of metal fragments, artificial joints).
- MRI is not recommended when using insulin pumps, claustrophobia, mental agitation of the patient, or the presence of tattoos using dyes made from metal compounds.
- Expensive research method.
Indications:
- determining the presence of liquid or gases in the pleural cavity, enlarged mediastinal lymph nodes;
- detection of metastases in the abdominal and pelvic organs, kidneys and adrenal glands.
- Bronchoscopy
This is an invasive method of examining the airways using a bronchoscope.
Advantages:
- detection of tumors, inflammatory processes and foreign bodies in the bronchi;
- the possibility of taking a tumor biopsy.
- invasiveness And discomfort during the procedure.
- suspicion of a neoplasm in the bronchus;
- taking tissue biopsy material.
Histological and cytological methods for studying lung cancer
Determination of the cellular composition of the formation, detection of cancer cells by microscopy of tissue sections. The method is highly specific and informative. Biopsy methods:
- thoracentesis – puncture of the pleural cavity;
- fine needle aspiration biopsy– taking material through the chest;
- mediastinoscopy – taking material from the lymph nodes of the mediastinum through a puncture of the chest;
- thoracotomy - surgical diagnostic operations with opening of the chest;
- cytological examination of sputum.
Tumor markers
They are detected by a blood test for specific proteins secreted by cancer cells. Indications:
- an additional method for detecting tumors using other methods;
- monitoring the effectiveness of treatment;
- detection of disease relapses.
- low specificity;
- insufficient sensitivity.
- Carcinoembryonic antigen(REA)
up to 5 µg/l – normal;
5-10 µg/l – may indicate nonspecific diseases;
10-20 µg/l – indicates a risk of cancer;
more than 20 µg/l – indicates a high probability of presence cancer. - Neuron-specific enolase (NSE)
up to 16.9 µg/l – normal;
more than 17.0 μg/l – high probability of small cell lung cancer. - Cyfra 21-1
up to 3.3 µg/l – normal;
more than 3.3 μg/l – high probability of non-small cell lung cancer.
Lung cancer treatment
Treatment of any cancer must be long-term, comprehensive and consistent. The earlier treatment is started, the more effective it becomes.Efficiency treatment determines:
- absence of relapses and metastases for 2-3 years (the risk of relapses after 3 years is sharply reduced);
- five-year survival after completion of treatment.
- chemotherapy;
- radiation therapy;
- surgery;
- ethnoscience.
Chemotherapy
- Chemotherapy (CT) is a common method of treating lung cancer (especially in complex treatment), which consists of taking chemotherapy drugs that affect the growth and activity of cancer cells.
- In modern times, scientists around the world are studying and discovering the latest chemotherapy drugs, which leaves the possibility for this method to take first place in the treatment of cancer.
- CT is carried out in courses. The number of courses depends on the effectiveness of the therapy (on average, 4–6 blocks of chemotherapy are required).
- The tactics and regimens of chemotherapy differ for small cell and non-small cell lung cancer.
- Chemotherapy is more effective for rapidly growing forms of cancer (small cell cancer).
- Chemotherapy can be used for cancer at any stage, even in the most advanced cases.
- CT is used in combination with radiation therapy or surgical treatment.
In combination with radiation therapy or surgical intervention– five-year survival rate for stage I is up to 65%, for stage II - up to 40%, for stage III - up to 25%, for stage IV - up to 2%.
Radiotherapy (radiation therapy)
Radiation therapy is a method of treating cancer that uses ionizing radiation to target cancer cells. The dose, duration, and number of procedures are determined individually.When to use:
- Small cancerous tumors.
- Before or after surgery to target cancer cells.
- Presence of metastases.
- As one of the methods of palliative treatment.
Video of using CyberKnife for lung cancer:
Main possible side effects from radiation therapy:
- Damage to the skin at the site of exposure to the radioactive beam.
- Fatigue.
- Baldness.
- Bleeding from an organ affected by cancer.
- Pneumonia, pleurisy.
- Hyperthermic syndrome (increased body temperature).
Surgical treatment of lung cancer
Surgery to remove the tumor is the most effective treatment for cancer. But, unfortunately, surgical intervention is possible only with timely identified processes (I – II and partly III stages). The effectiveness of surgical treatment is higher for non-small cell lung cancer than for small cell lung cancer. Thus, only 10-30% of lung cancer patients are operable.TO inoperable cases include:
- Advanced forms of lung cancer.
- Cases with relative contraindications to surgical treatment:
- heart failure of ІІ-ІІІ degrees;
- severe heart pathologies;
- severe liver or kidney failure;
- severe general condition;
- patient's age.
Types of operations:
- Partial lung resection.
- Lobectomy - removal of an entire lobe of the lung.
- Pulmonectomy – removal of the entire lung.
- Combined operations – removal of the affected part of the lung and affected parts of surrounding organs.
Efficiency of surgical treatment depends on the stage and type of cancer, on general condition patient, the type of operation chosen, professionalism operating team, equipment and complexity of treatment.
- Three-year absence of relapses – up to 50%.
- Five-year survival rate is up to 30%.
Without treatment, about 80% of lung cancer patients die within two years.
Palliative care – activities aimed at making life easier for patients with advanced forms of lung cancer or with no effect on the therapy.
Palliative care includes:
- Symptomatic treatment that relieves symptoms but does not cure the disease (narcotic and non-narcotic analgesics, antitussives, tranquilizers and others). In addition to medications, palliative operations (radiation and chemotherapy) are used.
- Improving the psycho-emotional state of the patient.
- Prevention of infectious diseases.
- Individual approach to such patients.
Traditional methods
- The effectiveness of treatment with traditional methods has not been studied enough.
- It is advisable to use these methods in combination with traditional medicine methods (after consultation with the attending physician).
- It is possible to use traditional methods as palliative care for the patient.
- As in traditional medicine, treatment regimens with traditional methods depend on the form, location, type, stage and extent of the cancer process.
- Herbal decoctions and tinctures (mostly poisonous plants are used).
- Applications of herbal tinctures, medicinal stones.
- Energy medicine.
- Special diets and exercises.
A decoction of aconite roots. 20 g of plant roots are poured with water (1 liter), then boiled for 2 hours. Drink 30 ml daily before bed.
Musk tincture. Pour 5 g of musk into 200 ml of vodka and leave for 1 month in the dark. Start taking 5 drops after each meal, the dose is gradually increased to 25 drops. After each month of treatment there is a break of 7 days.
Tincture of catharanthus rosea. Pour caranthus leaves and flowers into a half-liter container, fill them with 70 percent alcohol to a volume of 1 liter, leave in a dark place for 2 weeks. Drink 5 drops 3 times before meals. Increase the dose to 20 drops over the course of a month. After a month - break for 7 days, then start again. This treatment lasts 8 months.
Cetraria decoction. Pour 2 teaspoons of crushed cetrarium into 250 ml of chilled water for 12 hours. Then put in a water bath, evaporate to 2/3 of the volume. Take 1-2 tablespoons 3 times a day. Every 3 weeks – a break of 7 days.
Tincture of cherry laurel leaves. Pour 250 g of fresh leaves into 1 liter of vodka and leave in the dark for 2-3 weeks. Take 10 drops 2 times a day 1 hour after meals, gradually increase the dose to 20-25 drops per dose, then to 7 and 10 ml. Drink for a month, then take a break for 2 weeks, repeat this regimen.
Also, in the treatment of lung cancer, various decoctions and tinctures of saffron, sage, sage, wormwood, violet roots, squeaky grass and many other plants are used.
Prevention of lung cancer
The basis for the prevention of lung cancer and any other cancer is: - Healthy lifestyle
- Quitting smoking cigarettes.
- Protection from passive smoking.
- Avoidance or moderate consumption of alcohol.
- Quitting drug use.
- Active lifestyle.
- Healthy eating.
- Fighting excess body weight.
- Refusal to accept any medicines without the need or prescription of a doctor.
- Prevention of infectious diseases, especially those transmitted through blood and sexual contact.
- Adequate antibiotic therapy for infectious diseases of the lungs and bronchi.
- Dosage of exposure to sunlight.
- Pregnancy planning – healthy image life during the period of conceiving and bearing a child will significantly reduce the risk of cancer.
- Society's fight against environmental pollution.
- Personal respiratory protection in hazardous industries.
- Reducing exposure to radiation: improving ventilation in the home, checking radon levels of building materials used in the home, avoiding non-indicated X-ray diagnostic tests.
- Timely and regular medical examination.
