Lungs' cancer. Causes, symptoms, stages, diagnosis and treatment of the disease

Cancer is one of the most dangerous and intractable diseases that can affect literally any part of the human body.

Disease of vital organs such as the heart, lungs, kidneys, and liver is especially deadly. Lung cancer, whose symptoms and signs are so similar to common respiratory diseases, takes the lives of a large number of people.

Lung cancer is a change in DNA that leads to the appearance of malignant tumors. Its name depends on where the focus of the disease is located: central lung cancer, peripheral lung cancer and mixed cancer.

Causes of lung cancer

Hereditary predisposition. It is worth keeping in mind that the risk is not only for those who have a family history of lung cancer, but also for other forms of cancer.
Chronic respiratory diseases: pneumonia, bronchitis, tuberculosis and others.
Tobacco smoking. There are statistics that say that smokers develop lung cancer much more often than those who do not smoke.
Hard work that involves chemicals.
Old age (people over 50 are more likely to develop tumors).
Sexual characteristics. Lung cancer is more common in men than in women.
Living in a metropolis has its downsides - a high risk of lung cancer. So, they chose to live in the center of events, and yet lung cancer is also not by the way, but a global problem.
Poor nutrition. People who regularly eat vegetables and fruits and also enrich their body with minerals have a much lower risk of lung cancer.

Lung cancer: the first symptoms are something that most patients do not pay attention to, because they are so similar to other diseases, and thoughts about such a terrible disease are obviously not the first thing that comes to mind.

Cancer occurs when

Cough for no reason. This is exactly how it all begins for many oncology patients. At first this does not cause any concern: a dry cough, you never know why, an allergy or a cold. Afterwards the cough becomes wet, the discharge is purulent or bloody. Usually, only at this moment, after trying to postpone or cope with the “painful throat” themselves, do patients organize a trip to the hospital.

When you cough, blood is released. This symptom affects patients in the final stages, when the lungs are completely affected by cancer.

Shortness of breath during physical activity and more. Cancer disrupts the functioning of the lung and this affects a person’s quality of life, in particular, their breathing.

Sudden significant weight loss. People suffering from cancer are usually all very thin, because cancer takes all the strength from the body, slowly sucking the life out of every cell of the human body.

Constant fatigue and desire to sleep. The body experiences stress that it is unable to cope with, and therefore it decides to gain strength in a way known to it - sleep. Thus, fatigue is a signal that something has gone wrong somewhere.

Reluctance to eat. A sharp lack of appetite over a considerable period of time is also a warning bell, which is important to heed in a timely manner.

Chest pain, pain when inhaling, coughing. The most obvious and, alas, one of the last symptoms is pain; people often come to the doctor for examination with this complaint.

Communication with the patient, recording complaints and entering into the card.
Appointment of an x-ray examination. The images allow you to see the lungs, to suspect, but not to detect lung cancer.
Computed tomography examination. Thanks to this procedure, the doctor can see the exact coordinates of the tumors and the presence of metastases.
Spiral computed tomography examination. This method is more preferable for smokers, as it more accurately determines the presence of cancer tumors and metastases.
Carrying out magnetic resonance imaging. This procedure involves finding the exact location of the tumors. The picture is clear, and taking it is absolutely harmless to humans.
Carrying out positron emission tomography. Such an image allows you to diagnose a tumor and its growth process, and is used to determine the stage of the disease.
Carrying out a cytological examination of the patient's sputum. A high-precision microscope examines sputum, in which cancer cells can be detected. Although this is an effective and cheap method, its accuracy is low. The fact is that sputum may not always contain cancer cells. Such a game of hide and seek can cost a person those precious days and weeks that will decide the fate and outcome of treatment.
Examination of the bronchus using bronchoscopy. In this procedure, the doctor can observe the condition of the bronchial tubes when the probe is inserted, and also take tissue samples for further examination.
Examination of lung tissue through puncture biopsy. During the procedure, samples of lung tissue are taken from the patient for examination and precise determination of the location of the cancerous tumor.
Diagnosis of cancer using pleural puncture. Sometimes cancer affects a part of the lung called the pleura and causes fluid to accumulate there. The procedure involves taking a sample of the fluid and examining it.
Help from a surgeon to examine the tumor tissue or remove it.
General blood analysis. It is carried out in order to find out the body's reaction to a cancerous tumor. A change in the blood sample can indicate metastases and where they are located. For example, a large amount of calcium minerals in the blood indicates bone damage.

Lung cancer has differences based on the location of the cancerous tumor.

So, the types of lung cancer are:

Central lung cancer. This cancer is predominant among patients, affecting the main, intermediate and longitudinal bronchi. It is accompanied by an inflammatory process and fever, which greatly worsens the process of diagnosis and treatment itself.
Peripheral lung cancer. This type of cancer “specializes” in affecting the branches of the bronchus.

Central lung cancer: symptoms

Pain in the chest. This symptom is caused by cancer cells affecting nerve endings.
Severe cough with sputum, subsequently with bloody discharge.
Dyspnea.
Patients have a high body temperature.
Purulent discharge.
Deterioration of the condition of the vocal cords (symptom of a “shallow” voice, speech deformation)

In addition to chest pain, a person suffering from cancer may experience tachycardia, chest pain, and may also develop chronic heart failure.

External signs: the face swells, the veins on the arms, legs and chest swell and become blue-green.

In some cases, mental disorders, headache and loss of consciousness are observed.

Peripheral lung cancer: symptoms

The initial stage of this type of cancer occurs without symptoms, which complicates the diagnosis. When the tumor grows slightly, typical symptoms of lung cancer occur.

Features of peripheral lung cancer are the appearance of body intoxication, shortness of breath, weight loss, chronic pneumonia and internal bleeding.

Another dangerous form of cancer, small cell lung cancer, also deserves special attention.

Small cell lung cancer is a systemic disease, which is especially dangerous due to its complications, namely metastases that cover the entire body. He has no special symptoms, only in the later stages can typical symptoms appear: pain when talking, swallowing, pain in the back, chest. In order to cure such cancer, it is necessary to treat all those foci of cancer cells that appeared on other organs during the first, asymptomatic stages.

In order to determine the correct treatment for lung cancer, the cancer is diagnosed and staged:

The first stage of lung cancer has primary symptoms. At this time, the tumor is still very small, and metastases are far away. Usually, people with the first stage of cancer do not yet know about their disease.
The second stage of cancer occurs with noticeable symptoms and deterioration. The size of the tumor is slightly more than 3 centimeters, there are metastases in the bronchi. Usually, only now does the patient learn about the disease and begin treatment. With timely diagnosis, 40% of patients can be cured or live the rest of their days well.
The third stage of lung cancer involves tumor growth, as well as damage to the chest walls and pleura. Metastases of bronchial lymph nodes in the opposite direction. Treatment at this stage is still not hopeless, but often the life of patients lasts no more than 3-5 years.
Stage 4 lung cancer, which is fatal for many. At this stage, the tumor grows and affects all nearby parts of the body, for example, the spine, heart, blood vessels and others. Metastases in all lymph nodes of the upper body. At this stage, patients ask the question: “Lung cancer stage 4: how long do people with this diagnosis live?” At this stage, most of the internal organs are affected, and every day begins with a new portion of pain. Life expectancy is measured not in years, but in months.
The fifth stage of lung cancer is metastases in all parts of the body. The most cruel and hopeless type of cancer is developing - intercellular lung cancer. Patients experience terrible pain; life, or rather, existence, lasts no more than 3 months. Horrible pictures of lung cancer can be seen in autopsy photographs of patients.

Treatment of lung cancer is a complex procedure, the effectiveness of which affects human life.

There are such types of treatment for lung cancer:

ü Chemotherapy is a treatment method that helps in the initial stages, but in others it simply relieves some symptoms (reduction of tumor, metastases, stopping the growth of cancerous lesions).

ü Radiation therapy – reduces the manifestation of symptoms, prolongs the life of patients for some time. The effectiveness is higher than chemotherapy, but still does not cure cancer.

ü Cyberknife is an excellent addition to the therapy complex. In this procedure, X-rays are used to destroy cancerous compounds.

ü Comprehensive treatment - the use of all therapies to improve the condition.

ü Operation. The tumor is removed using a surgical method. This method is effective only in the early stages of cancer, and also does not exclude the appearance of new tumors.

Treatment of lung cancer with folk remedies is used as an addition to the main course or in cases where doctors have done everything possible, but in vain. Examples of traditional medicine are herbal decoctions with an anti-inflammatory effect, as well as tinctures to maintain immunity and reduce pain. The most famous examples of traditional medicine: plantain tincture, potato flowering tincture, celandine decoction, use of licorice syrup, and the like.

Lung cancer is very difficult to treat, and therefore the best remedy is prevention, reducing the risk of becoming one of the victims of malignant tumors and metastases. Also, for early detection and timely treatment, which is mostly effective, it is necessary to undergo fluorography annually, donate blood, and at the first signs of lung cancer go to the doctor. It’s better to be diagnosed with a cold or bronchitis and breathe a sigh of relief than to self-medicate while cancer cells occupy vacant spaces in the lungs. Naturally, if relatives have had cancer, then you need to protect yourself, take care of your immunity, and give up smoking and junk food. People whose profession involves chemicals need to carefully monitor the toilet of the nasal cavity and do not forget to be examined annually.

Lung cancer is the most frequently diagnosed cancer among adults. It occupies a leading place among the causes of mortality in adults from cancer. According to medical statistics, mature and elderly men more often suffer from this oncopathology.

Rapid tumor growth and early metastasis determine the high mortality rate among patients with this oncological pathology.

Detection of lung cancer in the early stages allows for timely treatment and significantly increases the five-year survival rate of patients.

Clinical picture of lung cancer in adults

The initial stages of lung cancer in adults in most cases are asymptomatic, therefore lung cancer pathology is often discovered by chance: during treatment of other pulmonary diseases, during a routine examination. This is explained by the paucity and nonspecificity of symptoms of lung cancer in the initial stages.

Symptoms of lung cancer in men and women often appear in the later stages, when the tumor reaches a significant size, and do not differ by sex, especially if patients smoke. Clinicians conditionally divide the course of a malignant neoplasm in the lungs into:

The first signs of lung cancer in men and women at the preclinical stage depend on the location of the primary tumor: near the roots of the lungs (central cancer) or in parts distant from the large bronchi (peripheral cancer).

Symptoms of central lung cancer

The clinical picture of lung cancer with its central location is more pronounced than with its peripheral location.

If the tumor is localized near the pulmonary roots, the main complaints of patients will be:

painful dry cough;
difficulty breathing up to shortness of breath;
prolonged sputum discharge;
blood streaks in sputum.

Cough is the main and very first sign of a tumor process near the roots of the lung. It occurs reflexively, in response to irritation of the nerve endings of the mucous membrane by a neoplasm that has grown into the lumen of the bronchi.

The meaning of the cough reflex is to expel an irritating factor from the bronchi with a flow of air. Since the tumor is not removed from the lungs with coughing attacks, the cough becomes constant, annoying, and painful. Until the lumen of the bronchial tube is blocked by a neoplasm, sputum is not released during coughing.

When the lumen of the bronchus is partially blocked by the tumor, sputum begins to cough up. At first it is slimy in nature. Then the sputum begins to stagnate in the bronchi below the point of their partial overlap, which leads to the appearance of mucopurulent discharge.

As the diameter of the bronchus decreases, patients experience another symptom of cancer: shortness of breath. First, shortness of breath appears during physical exertion of the patient, later - when walking and at rest.

The appearance of streaks of blood in the sputum in the initial stages of central cancer is caused by injury to the bronchial mucosa by a hysterical cough. Hemoptysis appears at later stages and is associated with the disintegration or ulceration of the tumor. With hemoptysis, the sputum becomes characteristically “raspberry jelly.”

Pain in central lung cancer appears in the affected half of the chest in the later stages and is associated with compression or spread of the tumor to surrounding tissues, complete blocking of the lumen of a large bronchus. The intensity of pain varies from aching to moderate.

Signs of peripheral cancer

With peripheral cancer localization, the tumor is located relatively far from the large bronchi and mediastinum, so its first symptoms appear later than with central cancer. Therefore, in the initial stages of peripheral carcinoma, shortness of breath and pain on the affected side of the chest appear first.

Cough and blood in the sputum with such localization of the tumor occur in the later stages and are associated with the spread of the tumor process to surrounding tissues, including the bronchi.

Late signs of cancer pathology

In later stages, the cancer reaches a large size. The waste products of cancer cells are toxic to the human body, so patients experience cancer intoxication, which manifests itself in the form of general symptoms:

The tumor begins to disintegrate and metastasize: first to regional lymph nodes, later to other organs.

In the armpits and above the collarbone, the lymph nodes enlarge, sometimes to such a size that they become visible to the naked eye. When the tumor metastasizes to the bones, bone pain and spontaneous fractures appear. With metastasis to the liver, pain in the right hypochondrium and jaundice occur.

Diagnosis of lung carcinoma

To diagnose carcinoma in the lungs, the doctor finds out from the patient what symptoms and when they appeared, conducts an examination and physical examination (percussion, auscultation). But identifying lung cancer, the symptoms and signs of which are nonspecific, is clinically difficult.

To diagnose this oncopathology, doctors prescribe additional research methods. How to detect lung cancer using additional diagnostic methods?

The most informative research methods for lung cancer are:

X-ray diagnosis of lung cancer

The X-ray method is the first diagnostic method to determine the presence of lung cancer in a patient. Radiological signs of lung cancer differ depending on the pathological appearance of the tumor.

There are four pathomorphological types of lung cancer, each of which has its own x-ray picture:

After receiving the results of the X-ray examination, it is necessary to interpret them. This is performed by a radiologist who knows how to recognize cancer.

Tomography for lung cancer

Computed tomography and its varieties, as well as magnetic resonance imaging, are highly informative types of studies that can recognize cancer in the early stages, when clinical symptoms of a lung tumor do not yet appear.

Tomography makes it possible to determine the boundaries of cancerous and healthy tissues, establish the size of the tumor and the stage of the disease, identify metastases, and monitor the effectiveness of treatment.

Computed tomography is also used in combination with transthoracic puncture biopsy, when it is necessary to select certain biomaterial for histological examination from the lungs or mediastinum without surgical intervention.

Histological and cytological studies

Histological and cytological studies are used to establish the pathomorphological form of cancer. It is very important for clinicians to know the histological type of the detected tumor, since its ability to metastasize depends on the pathomorphology. After receiving the results of histological examination, the oncologist can understand what the treatment tactics will be, the extent of surgical intervention and the prognosis for the patient’s overall survival.

The histological type of tumor depends on the type of original cells from which it was formed. Oncology scientists have identified more than 20 histological variants of lung cancer.

Practicing oncologists use a more simplified classification of the histological structure of cancer tumors, which distinguishes three pathomorphological types:

Squamous cell carcinoma(from epithelial cells of the bronchial mucosa).
Adenocarcinomas (from glandular cells).
Undifferentiated cancer(from the cellular structures of the basal epithelium).

In the case of squamous cell carcinoma, the histological specimen reveals a discrepancy between the structure of the base (stroma) and the mass (parenchyma) of the tumor. The vessels of such a neoplasm cannot provide a sufficient level of blood supply to the tumor, so foci of necrosis (death) appear in its parenchyma, which quickly decay. The larger the tumor and the more foci of necrosis in it, the greater the likelihood of metastasis.

Adenocarcinoma develops more slowly than other histological types, so it is less likely to metastasize.

Undifferentiated lung cancers tend to germinate into surrounding tissues and rapidly spread into perivasal (perivascular) tissues, so identifying these tumors entails extensive surgical interventions even in the early stages of the disease.

Determination of tumor markers in blood

Determination of tumor markers for lung cancer is prescribed by oncologists not only to confirm the established diagnosis. Based on the level of tumor marker in the blood, the increase or decrease in its concentration over time, and the presence of combinations of markers, you can:

For lung cancer, the following blood markers are examined:

NSE – neuron-specific enolase.
CEA (CEA) – carcinoembryonic antigen.
CYFRA 21-1 is a fragment of cytokeratin 19.
SCC – squamous cell carcinoma antigen.
CA 125 is a cancer antigen.
TPA – tissue polypeptide antigen.

There is no clear, comprehensive list of diagnostic methods that should be prescribed for suspected or established lung cancer. Other research methods are less specific and are therefore prescribed by doctors depending on the clinical course of the cancer, the presence of metastases and complications from other organs and systems of the patient.

Lung cancer occurs more often in older patients, so the doctor should always be more oncologically focused on examining patients (especially men) over the age of 40.

Patients themselves should also be more attentive and careful about any changes in their health and promptly consult a doctor if they discover the first signs of deterioration. Modern medicine has in its arsenal enough ways to combat lung cancer, but their effectiveness depends entirely on the timely detection of cancer pathology.

Content

According to statistics, more than 60 thousand cases of lung cancer are diagnosed every year in Russia. The majority of people at risk are people over 50 years of age. Smoking and air pollution are the main reasons that provoke the development of the disease. The outcome of treatment depends on the timely detection of a malignant tumor.

What is lung cancer

Today, among oncological diseases, lung cancer occupies a leading position. A malignant tumor is formed from the tissue of the lungs and bronchi. Manifestations of the disease depend on the location and form of the tumor.

There are 2 forms of the disease: central and peripheral. In the first case, cancerous tissue develops in areas where blood vessels and nerve endings are concentrated. The disease affects the large bronchi.

Symptoms of a central tumor appear early.

Among them, severe pain and hemoptysis are indicative. The life expectancy of patients is no more than 5 years.

It is difficult to detect peripheral lung cancer at an early stage. The tumor develops slowly. For a long time it has no external manifestations. The tumor affects the epithelium of small bronchi and pulmonary vesicles. The patient experiences pain at the 4th stage of the disease. Patients with this type of cancer live for about 10 years.

Signs of lung cancer do not differ between men and women.

It is extremely rare in children. The risk group includes babies whose mothers smoked during pregnancy and breastfeeding. In adolescents, the disease occurs more often and proceeds in the same way as in adults.

Symptoms of lung cancer at an early stage are not associated with disruption of the respiratory system. The first signs of the disease:

disturbances in the functioning of the central nervous system - dizziness, fainting;
skin problems – itching, dermatitis;
subfebrile temperature – indicators 37.1–38° C;
fatigue and weakness in the first half of the day.

Characteristic symptoms

The appearance of clear signs of a lung tumor is typical for late stages. The clinical picture is individual for each patient. It depends on the size of the tumor, the presence of metastases, and the rate of spread of cancer cells.

Temperature

Fever is a nonspecific symptom of a lung tumor. It accompanies many diseases. Long-term indicators of 37–38° C are the first sign of the disease.

Taking antipyretics does not give stable results.

After 2-3 days the fever starts again. At the next stages, it is joined by apathy, lethargy, and unmotivated fatigue.

Cough

A cough helps detect lung cancer. It is observed at all stages of the disease. Infrequent coughing at the initial stage gradually acquires an annoying paroxysmal character.

You should immediately consult a doctor if your cough persists for a month or more.

The symptom manifests itself in different ways. Characteristics of dry cough:

practically inaudible;
does not provide relief;
There is no expectoration.

Physical activity, uncomfortable posture, and hypothermia cause severe coughing attacks. It is accompanied by pulmonary spasms, vomiting, and fainting. A short cough does not last long, but occurs frequently. It provokes intense contraction of the abdominal muscles.

Stages 1 and 2 of cancer are characterized by a dry cough. Strong wet – appears in stages 3 and 4.

No variations in the manifestation of this symptom are expressed in the peripheral form of the disease, which complicates diagnosis.

Sputum

Coughing up light, mucous sputum is a typical symptom of a lung tumor. Detection of blood in it is a reason for bronchoscopy and chest x-ray. In the later stages of the disease, about 200 ml of sputum is produced per day. In complex forms of cancer, it becomes purulent. The mucus takes on a crimson color and a jelly-like consistency.

Pain

Depending on the form of the disease, pain varies in nature and intensity. In most patients, they appear in the area where the tumor is located. In the last stages of lung cancer, the nerve endings are affected and the pain intensifies. When metastases spread, discomfort spreads throughout the body.

The pain can be girdling, stabbing, cutting.

Hypercortisolism syndrome

A tumor in the lungs causes severe hormonal imbalance in the patient’s body – hypercortisolism syndrome. It is characterized by the following symptoms:

weight gain;
the appearance of pink stripes on the skin;
heavy hair growth.

Weight loss

At stage 3 of lung cancer, the patient’s weight decreases by 50%. The patient's nervous and digestive systems are disrupted. No appetite. Frequent vomiting occurs.

Exhaustion weakens the body and brings death closer.

Hemoptysis

At stage 2 of respiratory oncology, hemoptysis appears. Outwardly, it looks like blood streaks in the sputum or blood clots. The pathological phenomenon is associated with the destruction of the blood vessels of the bronchi and alveoli. The disintegration of the tumor causes pulmonary hemorrhage. The patient chokes on blood and coughs it up with a mouthful.

Diagnostics

The first symptoms of a lung tumor are similar to colds. The doctor’s task is to recognize nonspecific signs of lung cancer and prescribe a thorough examination of the patient. The effectiveness of treatment is guaranteed in the early stages of the disease.

Annual chest fluorography helps prevent this dangerous disease.

The examination is especially important for smokers and people employed in hazardous industries.

For a patient with suspected lung cancer, the following chest examinations are prescribed:

x-ray– is the most common method;
magnetic resonance imaging (MRI);
computed tomography (CT)– rarely used as a primary method;
biopsy– with its help you can determine not only the stage of development of the lesion, but also its type.

Additionally, the doctor prescribes urine and blood tests. The patient's sputum is examined. The results characterize the state of metabolic processes and the functionality of the patient’s internal organs.

Video

Lung cancer is a malignant neoplasm developed from the glands of bronchioles, alveoli and bronchial epithelium. Its occurrence is due to environmental influences, tobacco smoking, frequent diseases of the bronchopulmonary system and heredity.

Smoking is the main enemy of the lungs. A smoker's length of service and the number of cigarettes he smokes per day increase the risk of developing a tumor.

The classification of cancer is presented in several forms, each of which has its own characteristics:
- central, developed from large bronchi;
- peripheral, developed from bronchioles or affecting the lung parenchyma;
- atypical forms, represented by mediastinal, brain, bone, liver varieties, miliary carcinosis, etc.

What health changes indicate lung cancer?

A protracted debilitating cough that cannot be treated is the first alarming symptom. Initially dry, over time it is accompanied by the release of sputum of a mucous or mucopurulent nature.

In addition, the patient complains of increased fatigue caused by general weakness of the body, sudden and causeless loss of weight and voice. Frequent pneumonia is explained by the blocking of large airways by a tumor and infection of an area of the lung.

Drug treatment for lung cancer in the form of anti-inflammatory drugs and expectorants is prescribed to relieve symptoms. Special narcotic substances help relieve severe pain in the final stages.

Signs of lung cancer on an x-ray

The central form of cancer is not recognized by an increase in the root of the lung. Thanks to x-rays, the oncologist is able to see the blurred contours in the root area, from which wavy shadows radiate.

If the root of the lung has decreased in size, but the transparency of the pulmonary pattern is increased, the doctor can conclude that the tumor is developing peribronchially. Bronchial blockage is determined by swelling.

With lung cancer occurring in a peripheral form, the image shows heterogeneous shading with jagged contours and specific uneven rays. They are connected to the root of the lung by a distinct shadow.

Danger of lung cancer

Cancerous lymphangitis causes disruption of the pulmonary circulation. In turn, it causes respiratory failure, the appearance of recurrent thrombosis and thrombophlebitis.

At first, the pathology does not affect the appearance of the patient, and only towards the last stage does the body become depleted. After diagnosis, the patient lives from 1 to 3 years, and he dies from metastasis of cancer cells, various complications and intoxication.

Lung cancer is a disease accompanied by the development of a malignant tumor formation in the lungs. Lung cancer, the symptoms of which may be absent for a long time, most often occurs due to smoking, and its detection, precisely due to absent symptoms, without preventive methods of studying the area in question, often occurs already at serious stages of the process.

general description

Lung cancer in general is a group of types of tumors that develop in the lung. These tumors are formed by the cells lining the lungs or bronchi, they are characterized by their intensive growth and early metastasis, which implies the formation of tumor nodes already at a distance from the lungs (in this case).

Lung cancer in men is almost 10 times more common compared to the incidence of this disease in women, and the increase in incidence is determined in proportion to age. Thus, for the age of 60-70 years, the morbidity figures are 60 times higher than the morbidity figures determined for the 30-40-year-old age.

Remarkably, lung cancer (lung cancer) is one of the most common cancers. As for the transformation that is relevant for the process as a whole, due to which the transformation of ordinary cells into cancer cells occurs, its mechanism is not completely clear at the moment. Meanwhile, a number of studies carried out in this regard have identified a specific group of substances, the action of which has a corresponding effect, against the background of which, in turn, the transformation of normal cells into malignant ones occurs. These substances are defined as carcinogens.

The main cause of cancer development, accordingly, in this case, is the inhalation of carcinogens. As already noted, smoking is the main reason contributing to the development of lung cancer - about 90% of the total number of incidence cases indicates precisely this trend, which, in turn, is based on the inhalation of carcinogens contained directly in tobacco smoke. As for the likelihood of developing cancer, it increases in proportion to the total smoking experience and the number of cigarettes smoked. The greatest danger in this regard is identified for smokers who use unfiltered cigarettes using cheap tobacco.

What is noteworthy is that tobacco smoke is dangerous not only for the smoker himself, but also for the people around him. It is known that lung cancer develops in family members of a smoker up to two times more often than in families of non-smokers.

Air pollution also plays an important role. For example, industrial areas with developed mining and processing infrastructure are characterized by an increase in the incidence of lung cancer up to several times (when compared with results in remote villages, for example).

Other risk factors for lung cancer include the following:

contact with a specific type of substance: arsenic, asbestos, chromium, radon, cadmium, chlormethyl ether, nickel, etc.;
exposure to radiation;
long-term course of lung diseases (advanced cases): bronchitis, tuberculosis, bronchiectasis, pneumonia.

Lung cancer: features of the process

The division of cancer cells occurs, as we noted above, quite quickly, due to which, in turn, the tumor formation increases in size. The lack of appropriate therapy leads to the fact that it gradually begins to grow into the organs adjacent to it, and these are large vessels, the heart, the esophagus and the spine. This process inevitably leads to damage to the affected areas.

With lymph and blood, cancer cells spread throughout the body, which already determines metastasis, in which new nodes of tumor formations are formed. The development of metastases is predominantly concentrated in the other lung, in the area of the lymph nodes, in the liver, in the adrenal glands, kidneys, brain and bones.

In accordance with the histological structure, lung cancer can occur in four types: squamous cell cancer, glandular cancer (or adenocarcinoma), small cell cancer and large cell cancer.

The most important in practical terms and the most general position relating to the histological structure of lung cancer is the following: the lower the differentiation of the tumor formation, the more malignant the tumor is, accordingly, in development. Given this feature, each of the histological types of lung cancer has its own characteristics. Briefly, they can be distinguished as follows:

squamous cell lung cancer develops relatively slowly, in addition, it is less prone to early metastases;
the development of adenocarcinoma also occurs relatively slowly, but here we already highlight its tendency to early onset of hematogenous spread with accompanying symptoms;
undifferentiated type of lung cancer (especially small cell) is predisposed to particularly rapid development; in addition, a characteristic feature of such cancer is that it is predisposed to early and extensive metastasis (hematogenous and lymphogenous).

Tumor growth in lung cancer, main features

The development of lung cancer occurs on the basis of the mucosal epithelium. Almost the same degree of incidence was determined for both the right and left lungs. If cancer affects the lobar, segmental or central bronchi, central lung cancer is determined. The occurrence of a tumor in the bronchi, whose caliber is smaller than segmental ones, determines peripheral cancer.

With a peripheral tumor formed on the basis of the bronchial epithelium of the subsegmental bronchi and smaller bronchi, in most cases the uniformity of its development within the lung parenchyma is determined when a round formation of a characteristic spherical shape is formed in it.

Further growth of this type of tumor often leads to spread to nearby extrapulmonary structures, namely the parietal pleura, diaphragm, chest wall, etc. As a variant of a peripheral lung tumor, a cancer defined as “Pencoast type cancer” is identified. It, in turn, is characterized by the formation of a spherical tumor formation, concentrated in the area of the upper lobe of the lung with its subsequent transition to the nerves of the brachial plexus, to the subclavian vessels and to the trunk of the sympathetic nerve (which occurs in combination with Horner’s symptoms in the form of enophthalmos, miosis and ptosis on the affected side).

As for the features of the development of central cancer, they consist, first of all, in the fact that the process occurs in the bronchi with a larger caliber, respectively, in the lobar and segmental bronchi. Mostly, the course of the process is accompanied by a current disturbance in their patency and with simultaneous hypoventilation, which can almost reach atelectasis (stretching, collapse of the lung tissue, in which its airlessness is noted).

With this development of the process, its features are determined by the type of growth inherent in a particular tumor; it is predominantly endobronchial, peribronchial or perivasal. Endobronchial tumor is characterized by a predominance of disturbances due to blockage of the airways of bronchial patency. A peribronchial tumor, in turn, is characterized by compression of the airways, which is accompanied by a decrease in the lumen almost up to the formation in this case of an absolute barrier to the entry and passage of air. In frequent cases, “centralization” may be observed, which is relevant for peripheral cancer, in which a tumor initially formed in the periphery, according to the degree of its own growth, is characterized by its own spread to the lobar or segmental bronchi, as a result of which germination occurs in them with subsequent obstruction of patency.

When the blastomatous type of changes passes from the lung to the anatomical structures of the mediastinal region (that is, to the pericardium, pleura, vessels and trachea), it is advisable to determine the mediastinal form of lung cancer.

Lung cancer: stages

Stage I– characterized by the small size of the tumor formation, as well as the absence of its spread to the lymph nodes. This stage, in turn, is divided into substages, 1A and 1B:

1A– this substage determines the size of the tumor formation within up to 3 cm of its largest diameter. For this substage, survival over the next 5 years is determined to be 58-73% in the case of non-small cell cancer and 38% in the case of small cell cancer.
1B– the substage determines the size of the tumor formation within 3-5 cm of its largest diameter. In this case, spread to the lymph nodes, as well as to other parts of the body, does not occur. Regarding the 5-year survival rate in this period, the figures are 43-58% if the cancer is non-small cell and 21% if it is small cell.

Stage II. It, in turn, is also divided into substages 2A and 2B.

2A the substage determines the size of the tumor formation within 5-7 cm in greatest diameter; spread to the lymph nodes does not occur. An option is also possible for diameters up to 5 cm, but in the presence of cancer cells concentrated in the lymph nodes close to the affected lung. Regarding 5-year survival, the figures are 36-46% in the case of non-small cell cancer, and about 38% in the case of small cell cancer.
2B the substage determines the size of the tumor formation within limits not exceeding 7 cm in greatest diameter, without concomitant spread to the lymph nodes. It is also possible for a tumor to develop within the considered substage with its size ranging up to 5 cm in maximum diameter, but in the presence of cancer cells in the lymph nodes located close to the affected lung. This substage may also determine the absence of spread to the lymph nodes of the tumor formation, but with its growth into the lining of the lung (pleura) or affecting neighboring areas. Regarding 5-year survival rates, the figures are 25-36% for non-small cell cancer and about 18% for small cell cancer.

Stage III. In this case, there is also a division into substages, 3A and 3B.

3A substage indicates the size of the tumor formation is more than 7 cm in greatest diameter with spread to the nearest lymph nodes or adjacent areas (diaphragm, pleura, etc.). It is also possible that the tumor will spread to the lymph nodes concentrated in the heart area or that it will interfere with the passage of air through the large respiratory tract (main bronchi and trachea). For this stage, 5-year survival is estimated at 19-24% for non-small cell cancer and 13% for small cell cancer.
3B The substage determines the process in which the tumor has spread to the lymph nodes located on the back of the chest. It is also possible to consider an option in which the tumor spreads to the diaphragm, to the middle of the chest (to the lymph nodes of the mediastinum), to the lining of the heart (pericardium). Regarding the 5-year survival rate for this stage, figures are indicated in the range of 7-9% for non-small cell cancer and about 9% for small cell cancer.

IV stage. This stage indicates the spread of the tumor to other organs (in other words, metastases occur), or it leads to the accumulation of fluid, which includes cancer cells when it is concentrated in the environment of the affected lung or a neighboring lung. The same option is possible when localized in close proximity to the heart. Regarding survival in this case, figures within the range of 2-13% for non-small cell cancer and within 1% for small cell cancer can be indicated.

Lung cancer: symptoms

The health state accompanying the disease in question, as well as the severity of symptoms, is quite variable and is mainly determined by the specific stage of the disease in terms of the development of tumor formation in it.

The most typical type of lung cancer is one in which there is no symptomatology for a long time, which in general can cause anxiety and alertness on the part of the patient in the early stages. It is this kind of course that corresponds to the prevailing ideas about the long-term development of a tumor, which can continue for many years.

The development of lung cancer is determined in three main periods: the biological period (the time determined from the onset of the tumor until the first signs of its presence are identified using an x-ray); preclinical period (or asymptomatic, characterized exclusively by radiological changes in the course of cancer); the clinical period (during which, in addition to radiological manifestations, obvious symptoms are also noted).

Based on the stages discussed above, it can be noted that the I and II stages are characterized by correspondence to the biological period and the asymptomatic period in the development of tumor formation. Due to the absence of symptoms as such, patients do not independently seek appropriate medical care. Most often, if such a visit to medical institutions occurs, it is on the basis of clinical manifestations, which, in turn, indicate more serious stages of lung cancer. What is noteworthy is that even at this time, the manifestations of the disease are ambiguous, which is determined by a complex of various internal factors of its course.

The very beginning of the disease, based on certain observations, is characterized by somewhat disguised symptoms, which in particular manifest themselves in the form of a slight decrease in performance and rapid fatigue, as well as a weakening of interest in everything that happens around and apathy.

The further course, again, manifests itself in the form of a mask, manifested in the form of a number of respiratory diseases, such as repeated episodes of “flu”, pneumonia, etc. Often such manifestations correspond to the third period in the development of lung cancer (clinical). Associated symptoms include a periodic increase in temperature, the appearance, disappearance and reappearance of a mild degree of malaise.

What is noteworthy is that taking anti-inflammatory drugs along with antipyretic drugs in combination with one or another “home” treatment methods - all this allows one to eliminate current manifestations only for a certain time. Meanwhile, the reappearance of such an ailment within a period of 1-2 months allows, in some cases, patients to still pay attention to it from a somewhat more serious angle.

Let's look at other symptoms that accompany lung cancer.

Cough. Initially, the cough is dry in nature, but a little later it becomes annoying and constantly disturbing. And although cough is often indicated as the leading symptom of the disease we are interested in, it does not appear as such often. In the case of central lung cancer, a cough indicates that the process involves the walls of the bronchi, which have a large caliber, respectively, this is either the main bronchus or the lobar bronchus.
Hemoptysis. This symptom consists of the appearance of blood streaks in the sputum, and this, in turn, indicates that the walls of the bronchus have been damaged, and also that this damage is accompanied by destructive processes aimed at the mucous membrane of this wall in combination with damage to the passages in its area of blood vessels. It is noteworthy that this sign, which in most cases is considered one of the early symptoms of cancer, is a sign of cancer at much more serious stages of the process, corresponding in particular to stages III-IV of its course. With a more serious manifestation of this symptom (in the form of pulmonary hemorrhage, accompanied not just by streaks of blood, but by the release of a significant amount of scarlet fresh blood), it is necessary to immediately call an ambulance, because we are talking about a dangerous complication of the general condition, and as with lung cancer, and in general for any other conditions that may be accompanied by this symptom.
Chest pain. This symptom is predominantly concentrated on the side on which the lung has undergone a tumor process. In most cases, this symptom is regarded as neuralgia, but neuralgia, as it becomes clear, is only a “mask” of the disease. As for the nature of the manifestations of pain in this case, it does not have clear norms; accordingly, pain manifests itself in a wide variety of variations in its sensation and intensity. Mostly the pain is associated with the fact that the parietal pleura is involved in the process, and somewhat later – the intercostal nerves and ribs (and all this can even lead to their destruction). If we are talking about the latter option, then this is combined with excruciating and constant pain; moreover, it is almost impossible to eliminate them through the use of analgesics in one form or another. In any case, increased pain is observed at the time of deep inhalation/exhalation, as well as when coughing.
Dyspnea. It consists of a feeling of lack of air that appears at rest or during exercise. In this case, shortness of breath appears due to the tumor process blocking the air flow through large bronchi. This, in turn, leads to disruptions in the functioning of a certain area of the lung.

In some cases, disorders occur that are manifested by disturbances in the process of food passing along the esophagus, which, in turn, is evidence of a fairly advanced stage of the disease - in this case, a tumor of the esophagus acts as a “mask” of lung cancer. The manifestations in question occur against the background of compression of the esophagus by metastases of the peri-esophageal or bifurcation groups of lymph nodes.

The appearance of metastases from lung cancer to the brain, skeletal bones, kidneys, liver and other organs in accordance with their gradual growth leads, accordingly, to an increase in the manifestations of symptoms, which, in turn, manifests itself directly in the disruption of the activity of the organ that is involved in this case was damaged. Disorders of this type already indicate stage IV, which is also defined as the terminal stage. What is noteworthy is that it is often the symptoms of this stage that become the reason for seeking help, and it can lead to a variety of specialists, namely a neurologist, orthopedist, ophthalmologist, etc.

Lack of treatment for lung cancer leads to death in its natural course. According to available data, it can be noted that without the treatment required for lung cancer from the moment of correct diagnosis, about 48% of patients die during the first year, about 3.4% survive up to three years, and less than 1% survive up to 5 years.

Diagnosis

Considering the asymptomatic course of the disease, it is recommended that all groups of patients, and especially those who are active smokers, be periodically diagnosed with regard to its presence (in general, this also applies to passive smokers). Every year, adult patients are prescribed fluorography, which involves a preventive X-ray examination of the lung area.

If certain changes are detected during fluorography, the doctor will additionally prescribe studies, based on the results of which a reliable diagnosis can subsequently be established. This type of research includes:

radiography the chest, through which the structure of the lungs is studied, and the relevance of suspicious darkening, possible displacement of organs, the condition of modified lymph nodes and other possible pathologies accompanying lung cancer are determined;
CT , computed tomography, as the most in-depth and informative way to diagnose the disease in question, through which it is possible to examine suspicious areas in the lungs. CT also provides the opportunity to examine other tumor formations that could not be detected by radiographs;
bronchoscopy – a diagnostic method, by which part of the tumor formation is removed for subsequent study (biopsy), involves the insertion of a flexible tube equipped with a video camera into the respiratory tract, due to which an objective examination and removal of the tissue area is carried out;
biopsy performed through the skin (needle biopsy) - this method is applicable when the tumor formation is located deep in the small bronchi, which excludes the possibility of research using the previous diagnostic method.