Lung cancer

Overview

belongs among the most common s in general. For men, it is even the second most common type of disease, straight after the prostate . The average age, at which the disease occurs, is 55-60 years.

Risk factors are mainly smoking (cigarette smoke) and dust in the environment in which we live and work, for example, in occupations with an increased incidence of dust or dirt of the working environment (working class occupations, residence near factories or busy roads, etc..).

An unexpected finding on chest x-ray is often just the first proof that something is not right with us. Ailments such as cough, trouble breathing, coughing up of blood or weight loss occur at a later stage and should be strictly monitored and tested to determine their cause.

At lung , we distinguish:

• small cell carcinomas (approximately 25% of cases), which begin to metastasize at an early stage (in 80% of cases at the time of diagnosis detects metastasis also in other organs, such as, liver or lungs)
• non-small cell carcinomas, which grow mainly locally.

The above division shows that at the second option the primary objective is a surgery that is possible in about 20% of diagnosed cases. Following the surgery, respectively, if the surgery is not possible, chemotherapy and / or radiation therapy are deployed. In the next 5 years, however, only about 20-50% of patients survive.

Small cell lung is primarily treated by chemotherapy, which generally results in a reduction of the tumour. However, due to the high likelihood of recurrence of the disease the forecast to cure it is too optimistic, patients do not usually survive more than 4-12 months. It is a truly malignant, aggressive disease, likely to return at any location in the body. The glimmer of hope are studies, so called immune therapies that could improve the prognosis above.

General

, technically called as bronchial , is a malignant disease of the bronchi

Frequency

About 17% of all men s affect lungs. It is interesting that men are affected by this disease about three times more often than women, most frequently aged 55-70 years. For example, in Germany, it is the second most frequent , in the United States – like in Germany – lung is in the second place among s.

Causes

Environmental impacts

There are a number of substances that support the formation of lung . The greatest danger is, however, with no doubt smoking, smokers (i.e. former smokers) account for 90% of all lung s.

According to a study of the English private company Research Funds, engaged in research, 16% of smokers died of lung in the 75 year of life. In contrast, the non-smokers made up only 0.4%. According to this research, the risk of in the smoker is 40 times higher than in non-smokers. As shown in the graph, it is possible to reduce the risk of developing lung , if at 50 you stop smoking. This group of people (i.e. former smokers) represents “only” 6% of affected people.

The main causes of lung :

• smoking
• asbestos dust (occurs, e.g. at brake casing or in isolation used for fire protection)
• arsenic compounds
• chromium (cement, Galvanik)
• nickel (jewelry)
• polycyclic aromatic hydrocarbons (benzene in fuels)
• radioactive substances

etc.

Genetically determined risk factors

For people whose parents suffered from lung , the risk of contracting this disease is 2-3 times higher.

First symptoms

Basically there is no reliable indicator of the first symptoms of lung . Cough, difficulty breathing or chest pain may or may not occur. In addition, these are not typical symptoms of . Men aged over 40 years with recently occurred respiratory problems and recurring inflammation of the airways, lasting more than 3 weeks should be examined by a specialist. Unfortunately, the disease is mostly identified not until late stage based on symptoms such as weight loss, coughing up bloody sputum, difficulty breathing or fever. At this stage, the treatment is already ineffective.

Diagnosis

Diagnosis of lung is in its early stage mostly random, because the disease does not, in its early stage, show externally. Diagnosis is determined by radiographs or computed tomography of the lungs in respect with the clinical symptoms. In case of positive finding, the suspicion of is higher in long-term smokers, respectively, former smokers. In to determine whether it is or not, it is necessary to undergo the following tests:

• Computed tomography of the chest, i.e. examination on the basis of tomographic images. Without any burdening of the patient by X-rays, this technology provide the image inside the body, namely in the extremely high quality. This method is important, both for the location of the tumour, on the basis of which it is possible to estimate even the spreading of the tumour.
• Computed tomography of the head. At neurological problems, such as headaches, frequent loss of balance, forgetfulness, visual disturbances, and symptoms of paralysis eventual metastasis in the brain can be determined.
• Sonography of the abdomen is an abdominal ultrasound examination, which aim is to detect eventual metastasis in the liver
• Gamagraphy of bones – nuclear – medical examination of bones with the help of radioactive substances. It is used to determine the eventual bone metastasis.

is, however, possible to diagnose with certainty only by collecting a sample of the affected lung tissue meant for histological and zytological examination under a microscope. The sample is obtained by inserting a bronchoscope into the bronchi and subsequent sample collecting.

From the histological and prognostic point of view we can bronchial carcinomas divide into two groups:

• Small-cell bronchial carcinomas form 25-30% of all lung s, and because of their rapid growth, rapid expansion and early formation of metastases the prognosis to heal is not too positive. In 80% of patients metastases can be already proved at initial diagnosis. They are often found in the brain, result of which is nausea, headaches or most diverse diss, which may be identical to an attack. Then there are visual diss, balance diss, paralysis, etc.
• Non-small cell carcinomas can be further divided into:
  • squamous cell carcinoma of epil, which are responsible for 40-50% of all s
  • adenocarcinoma – 10-15% of all s. They represent the most common form of in non-smokers
  • large cell bronchial carcinomas are relatively rare, only about 5-10% of all s

From the microscopic-histological point of view, we can divide tumours into:

• G1 – good
• G2 – mild
• G3 – poorly differentiated
• G4 – generalized

G1 areas have fewer poor prognosis. The worst prognosis have lung G4. Small tumours without lymph nodes being affected and without metastasis have, on the other hand, a relatively good prognosis.

Therapy

Therapy of bronchial carcinoma is primarily dependent on its histological type and extensiveness (progress, the stage at which it was diagnosed). Another important factor for the choice of therapy is that whether it is a small cell or non-small cell bronchial carcinoma.

Therapy of non-small cell bronchial carcinoma

As far as possible, non-small cell bronchial carcinoma should be removed surgically. Surgery is possible if distant metastases do not occur. After surgery the patient should be irradiated if there are lymph node metastases, or if the neighbouring structures were infiltrated. Patients, who develop metastasis or tumour is too large and therefore inoperable, they undergo radiation and possibly chemotherapy. The irradiation is performed through a linear accelerator (50 und 60 Gy)

Therapy of non- bronchial carcinomas

Patients with small cell carcinoma generally do not undergo any surgery. small cell carcinomas are particularly sensitive to chemotherapy and also in the same way to irradiation. The advantage of chemotherapy is its impact also on distant metastases, occurring in 80% of diagnosed patients. Irradiation may be preceded by chemotherapy, for example, if breathing is difficult, which puts pressure of metastases on the airways, however, radiation therapy may also be followed by chemotherapy. Special irradiation is used to eliminate metastases in the brain and this also as a precaution, although other results do not suggest metastases in the brain.

Prognosis

You could say that at the the prognosis is not very good. Only 20% of non-small cell lung s affecting lungs can be operated on. 5 years after the operation, only about 30-50% of the operated patients live. Regarding the non operated patients, who underwent radiation therapy, only about 20-30% live after 5 years. With the occurrence of metastasis and small cell carcinomas, the prognosis is even worse. The average time of life is 4-12 months. However, there are also exceptions, therefore, none of the people affected by the disease should not prematurely give up and face this disease.