Lung cancer stage 5 000000000. Stages (degrees) of lung cancer. Unusual signs of lung cancer

One of the first questions a person may ask when diagnosed with stage 1 lung cancer is “How long do I have to live?” Unfortunately, lung cancer gets a bad rap. However, stage 1 is an early stage of invasive lung cancer, and many people survive long periods of time with the disease. Let's look at some of the variables that can affect your prognosis, as well as advances that improve survival.

Determination of stage 1 lung cancer

Stage 1 lung cancer is an early stage of invasive non-small cell lung cancer. (Stage 0 lung cancer is the pre-invasive stage of lung cancer or carcinoma in situ).

Tumors that are classified as stage I are divided into two classes:

• Stage IA cancers are found only in the lungs and are 3 cm in diameter or smaller.
• Stage IB lung cancer is 3 to 5 cm in diameter and may: a) spread to the main bronchus, b) spread to the inner membrane overlying the lung, or c) part of the lung may collapse.

Life expectancy

Because lung cancer has a reputation for being aggressive and has a poor prognosis, questions about survival often arise. Before we go any further, it is important to note that treatment for lung cancer is improving and survival rates are also improving. Besides, every case is different.

Variables that influence survival rates

Some of the variables that can affect lung cancer survival include:

• Your specific type and location of lung cancer: About 85% of lung cancers are considered non-small cell lung cancer. These cancers tend to spread more slowly than small cell lung cancer, although small cell lung cancer tends to respond well to chemotherapy and radiation therapy, at least initially.
• Location of your cancer: Although surgery is often chosen for stage 1 lung cancer, some of these tumors are located in areas that make surgery risky. If surgery is not an option, there are two types of radiation therapy that can be used for curative purposes: stereotactic body radiotherapy (SBRT) and proton therapy. (Survival is slightly better with VATS vs SBRT lobectomy).
• Molecular profile of your tumor: We currently have treatments for people with certain genetic changes in their tumors. Molecular profiling (gene testing) should be performed for all patients with non-small cell lung cancer. The drugs are available for people with EGFR mutations, ALK rearrangements and ROS1 rearrangements, and clinical trials are evaluating treatments for lung cancers with other genetic profiles. (These treatments are not typically used to treat stage 1, but are available if the cancer is expected to recur or spread.)
• Your age: Younger people tend to live longer than older people with lung cancer.
• Your gender: Life expectancy for a woman with lung cancer is higher at every stage of the disease.
• Your overall health at the time of diagnosis: Being generally healthy at the time of diagnosis is associated with a longer life expectancy and a greater ability to resist treatment, which can prolong survival.
• How you respond to treatment: Side effects of treatment vary from person to person and may limit your ability to tolerate treatment.
• Other health conditions you may have: A health condition such as emphysema or heart failure may shorten your life expectancy with stage 1 lung cancer. Those without COPD have a better prognosis.
• Smoking: Quitting smoking before surgery for stage I lung cancer appears to significantly improve survival. Currently, most people who develop lung cancer do not smoke, but for those who do, there are many reasons why people with cancer should quit smoking, including survival.
• Where you are treated: Several studies have shown that people who have lung cancer surgery at a facility that performs most of those surgeries (such as a cancer center) have better outcomes.

In addition to all the differences noted above among people, each cancer is also different. From a molecular perspective, if there were 100 people in a room with stage I lung cancer, they would have 100 different types of cancer at the molecular level. Different molecular characteristics may lead to different tumor behavior.

Statistics

In addition to the variations between different people and different cancers, it is important to keep in mind that statistics are often several years old. Many of the treatments that are now available to treat lung cancer were not available when these numbers were obtained. For example, there are several immunotherapies and targeted drugs that have been approved since early 2015.

Currently, the overall 5-year survival rate is 49% for people with stage IA lung cancer and 45% for people with stage IA non-small cell lung cancer. These rates may be higher for people who have lung cancer detected only through screening, and may be as high as 90%.

Stage I and risk of recurrence

After treatment for stage 1 cancer, there is a possibility that lung cancer will recur. It is estimated that 30 to 50% of stage I cancers may recur, and adjuvant treatments such as chemotherapy are sometimes used to reduce this risk. Repetition can occur in one of three ways:

1. Local recurrence refers to cancers that appear in the lungs, close to the original tumor.
2. Regional recurrence refers to cancers that recur in lymph nodes near the original tumor.
3. Distant recurrence refers to cancers that recur at distant sites in the body, most often in the bones, brain, liver, or adrenal glands. When cancer recurs at a distant site, it is referred to as metastatic or stage 4 cancer.

Unfortunately, most stage I lung cancer recurrences occur at distant sites. But even with repetition, survival improves. In fact, most of the recent advances in lung cancer treatment are for stage 4 disease.

Importance of Clinical Trials

Every person with any stage of lung cancer should consider participating in a clinical trial. For stage 1 disease, there are currently several studies looking at the causes of early cancer that may recur, as well as adjuvant treatments that may reduce this risk.

The prognosis for stage 1 lung cancer is higher for other stages of the disease, but at least a third of these tumors will recur. Treatments are improving, but there are also things you can do yourself to improve your survival rate. Ask a lot of questions. Get a second opinion, ideally from a cancer center that performs a high volume of these surgeries.

It is possible to detect a tumor in the lungs and determine what it may be with a detailed examination. People of different ages are susceptible to this disease. Formations arise due to disruption of the process of cell differentiation, which can be caused by internal and external factors.

Neoplasms in the lungs are a large group of different formations in the lung area, which have a characteristic structure, location and nature of origin.

Neoplasms in the lungs can be benign or malignant.

Benign tumors have different genesis, structure, location and different clinical manifestations. Benign tumors are less common than malignant tumors and make up about 10% of the total. They tend to develop slowly and do not destroy tissue, since they are not characterized by infiltrating growth. Some benign tumors tend to transform into malignant ones.

Depending on the location there are:

1. Central - tumors from the main, segmental, lobar bronchi. They can grow inside the bronchus and surrounding lung tissue.
2. Peripheral - tumors from surrounding tissues and walls of small bronchi. They grow superficially or intrapulmonarily.

Types of benign tumors

There are the following benign lung tumors:

Briefly about malignant tumors

Lung cancer (bronchogenic carcinoma) is a tumor consisting of epithelial tissue. The disease tends to metastasize to other organs. It can be located in the periphery, the main bronchi, or grow into the lumen of the bronchus or organ tissue.

Malignant neoplasms include:

1. Lung cancer has the following types: epidermoid, adenocarcinoma, small cell tumor.
2. Lymphoma is a tumor that affects the lower respiratory tract. It may occur primarily in the lungs or as a result of metastases.
3. Sarcoma is a malignant formation consisting of connective tissue. Symptoms are similar to those of cancer, but develop more quickly.
4. Pleural cancer is a tumor that develops in the epithelial tissue of the pleura. It can occur primarily, and as a result of metastases from other organs.

Risk factors

The causes of malignant and benign tumors are largely similar. Factors that provoke tissue proliferation:

• Smoking active and passive. 90% of men and 70% of women who have been diagnosed with malignant tumors in the lungs are smokers.
• Contact with hazardous chemicals and radioactive substances due to professional activities and environmental pollution in the area of ​​residence. Such substances include radon, asbestos, vinyl chloride, formaldehyde, chromium, arsenic, and radioactive dust.
• Chronic respiratory diseases. The development of benign tumors is associated with the following diseases: chronic bronchitis, chronic obstructive pulmonary disease, pneumonia, tuberculosis. The risk of malignant neoplasms increases if there is a history of chronic tuberculosis and fibrosis.

The peculiarity is that benign formations can be caused not by external factors, but by gene mutations and genetic predisposition. Malignancy and transformation of the tumor into malignant also often occur.

Any lung formations can be caused by viruses. Cell division can be caused by cytomegalovirus, human papillomavirus, multifocal leukoencephalopathy, simian virus SV-40, and human polyomavirus.

Symptoms of a tumor in the lung

Benign lung formations have various signs that depend on the location of the tumor, its size, existing complications, hormonal activity, the direction of tumor growth, and impaired bronchial obstruction.

Complications include:

• abscess pneumonia;
• malignancy;
• bronchiectasis;
• atelectasis;
• bleeding;
• metastases;
• pneumofibrosis;
• compression syndrome.

Bronchial patency has three degrees of impairment:

• 1st degree – partial narrowing of the bronchus.
• 2nd degree – valvular narrowing of the bronchus.
• 3rd degree – occlusion (impaired patency) of the bronchus.

Symptoms of the tumor may not be observed for a long time. The absence of symptoms is most likely with peripheral tumors. Depending on the severity of the symptoms, several stages of the pathology are distinguished.

Stages of formations

Stage 1. It is asymptomatic. At this stage, partial narrowing of the bronchus occurs. Patients may have a cough with a small amount of sputum. Hemoptysis is rare. During examination, the x-ray does not reveal any abnormalities. Tests such as bronchography, bronchoscopy, and computed tomography can show the tumor.

Stage 2. Valve narrowing of the bronchus is observed. At this point, the lumen of the bronchus is practically closed by the formation, but the elasticity of the walls is not impaired. When you inhale, the lumen partially opens, and when you exhale, it closes with the tumor. In the area of ​​the lung that is ventilated by the bronchus, expiratory emphysema develops. As a result of the presence of bloody impurities in the sputum and swelling of the mucous membrane, complete obstruction (impaired patency) of the lung can occur. Inflammatory processes may develop in the lung tissues. The second stage is characterized by a cough with the release of mucous sputum (pus is often present), hemoptysis, shortness of breath, increased fatigue, weakness, chest pain, fever (due to the inflammatory process). The second stage is characterized by alternation of symptoms and their temporary disappearance (with treatment). An X-ray image shows impaired ventilation, the presence of an inflammatory process in a segment, lobe of the lung, or an entire organ.

To be able to make an accurate diagnosis, bronchography, computed tomography, and linear tomography are required.

Stage 3. Complete obstruction of the bronchial tube occurs, suppuration develops, and irreversible changes in lung tissue and their death occur. At this stage, the disease has such manifestations as impaired breathing (shortness of breath, suffocation), general weakness, excessive sweating, chest pain, elevated body temperature, cough with purulent sputum (often with bloody particles). Sometimes pulmonary hemorrhage may occur. During examination, an x-ray may show atelectasis (partial or complete), inflammatory processes with purulent-destructive changes, bronchiectasis, and a space-occupying lesion in the lungs. To clarify the diagnosis, a more detailed study is necessary.

Symptoms

Symptoms of low-quality tumors also vary depending on the size, location of the tumor, the size of the bronchial lumen, the presence of various complications, and metastases. The most common complications include atelectasis and pneumonia.

At the initial stages of development, malignant cavitary formations that arise in the lungs show few signs. The patient may experience the following symptoms:

• general weakness, which intensifies as the disease progresses;
• increased body temperature;
• fast fatiguability;
• general malaise.

Symptoms of the initial stage of neoplasm development are similar to those of pneumonia, acute respiratory viral infections, and bronchitis.

The progression of a malignant formation is accompanied by symptoms such as cough with sputum consisting of mucus and pus, hemoptysis, shortness of breath, and suffocation. When the tumor grows into the vessels, pulmonary hemorrhage occurs.

A peripheral lung mass may not show signs until it invades the pleura or chest wall. After this, the main symptom is pain in the lungs that occurs when inhaling.

In later stages, malignant tumors appear:

• increased constant weakness;
• weight loss;
• cachexia (depletion of the body);
• the occurrence of hemorrhagic pleurisy.

Diagnostics

To detect tumors, the following examination methods are used:

1. Fluorography. A preventive diagnostic method, x-ray diagnostics, which allows you to identify many pathological formations in the lungs. read this article.
2. Plain radiography of the lungs. Allows you to identify spherical formations in the lungs that have a round outline. An x-ray image reveals changes in the parenchyma of the examined lungs on the right, left or both sides.
3. CT scan. Using this diagnostic method, the lung parenchyma, pathological changes in the lungs, and each intrathoracic lymph node are examined. This study is prescribed when differential diagnosis of round formations with metastases, vascular tumors, and peripheral cancer is necessary. Computed tomography allows a more accurate diagnosis to be made than x-ray examination.
4. Bronchoscopy. This method allows you to examine the tumor and perform a biopsy for further cytological examination.
5. Angiopulmonography. It involves performing invasive radiography of blood vessels using a contrast agent to detect vascular tumors of the lung.
6. Magnetic resonance imaging. This diagnostic method is used in severe cases for additional diagnostics.
7. Pleural puncture. Study in the pleural cavity with a peripheral tumor location.
8. Cytological examination of sputum. Helps determine the presence of a primary tumor, as well as the appearance of metastases in the lungs.
9. Thoracoscopy. It is carried out to determine the operability of a malignant tumor.

Fluorography.

Bronchoscopy.

Angiopulmonography.

Magnetic resonance imaging.

Pleural puncture.

Cytological examination of sputum.

Thoracoscopy.

It is believed that benign focal formations of the lungs are no more than 4 cm in size; larger focal changes indicate malignancy.

Treatment

All neoplasms are subject to surgical treatment. Benign tumors must be immediately removed after diagnosis in order to avoid an increase in the area of ​​affected tissue, trauma from surgery, the development of complications, metastases and malignancy. For malignant tumors and benign complications, a lobectomy or bilobectomy may be required to remove a lobe of the lung. With the progression of irreversible processes, a pneumonectomy is performed - removal of the lung and surrounding lymph nodes.

Central cavity formations localized in the lungs are removed by resection of the bronchus without affecting the lung tissue. With such localization, removal can be done endoscopically. To remove tumors with a narrow base, a fenestrated resection of the bronchial wall is performed, and for tumors with a wide base, a circular resection of the bronchus is performed.

For peripheral tumors, surgical treatment methods such as enucleation, marginal or segmental resection are used. For large tumors, lobectomy is used.

Lung formations are removed using thoracoscopy, thoracotomy and videothoracoscopy. During the operation, a biopsy is performed, and the resulting material is sent for histological examination.

For malignant tumors, surgical intervention is not performed in the following cases:

• when it is not possible to completely remove the tumor;
• metastases are located at a distance;
• impaired functioning of the liver, kidneys, heart, lungs;
• The patient's age is more than 75 years.

After removal of the malignant tumor, the patient undergoes chemotherapy or radiation therapy. In many cases, these methods are combined.

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

How long do they live with lung cancer?

The development of oncology without treatment always ends in death. 48% of patients who did not receive treatment for any reason die in the first year after diagnosis, only 1% survive to 5 years, only 3% of untreated patients live 3 years.

In Russia, according to lung cancer statistics, the incidence is relatively stable, with a slight decrease in the rate. Pathology occupies a leading position among the male population, its share is 25% among all malignant neoplasms. Among women, the disease is less common: 4.3%.

Dynamics of lung cancer incidence for 2004-2014 in Russia:

Lung cancer treatment at Hadassah

In Israel, various types of cancer are successfully treated, including lung cancer, which is considered one of the aggressive types of cancer. This type of cancer is more associated with smoking (including passive smoking) than others, although 10 to 20% of all patients are non-smokers.
One of the reasons for the unfavorable prognosis of the disease is the late stage of detection of a malignant tumor. In the early stages, when treatment is most successful, no more than a third of all lung cancer cases are diagnosed. In Israel, modern methods and drugs are used to diagnose and treat lung cancer, which contributes to a more favorable outcome of the disease.

In 2009, the modern Assuta Medical Center was built in the Ramat HaHayal area of ​​Tel Aviv. The hospital immediately won the title of a leading surgical center, not only in Israel, but also in the world. The Assuta Clinic is equipped with the most modern world-class technology, which allows for a highly accurate diagnostic process and excellent results in the treatment of completely different diseases.

For several decades now, the latest methods for diagnosing and treating various types of cancer have been used here. Of course, the earlier a malignant disease is detected, the greater the patient’s chances of a complete recovery. As world practice shows, up to 90% of patients who were diagnosed with cancer at the primary stage were able to overcome the disease.

Symptoms of lung cancer

Symptoms that allow one to suspect lung cancer are divided into general and specific.

General symptoms:

1. weakness
2. weight loss
3. loss of appetite
4. sweating
5. causeless rises in body temperature.

Specific symptoms of lung cancer may include the following:

cough- the occurrence of an unreasonable, annoying, debilitating cough accompanies bronchial cancer (central cancer). The patient, carefully monitoring his health, can independently notice changes in the nature of the cough: it becomes more frequent, annoying, and the nature of the sputum changes. The cough may be paroxysmal, without cause, or associated with inhaling cold air, physical activity, or lying down. This cough occurs when the mucous membrane of the bronchial tree is irritated by a tumor growing into its lumen. With central lung cancer, sputum appears, usually yellowish-greenish in color, due to concomitant inflammatory phenomena in the lung tissue.

One of the most characteristic symptoms of lung cancer is hemoptysis(blood discharge with sputum): the blood can be foamy, mixed with sputum, giving it a pinkish tint and bright scarlet, intense, in the form of streaks (active bleeding) or in the form of dark clots (clotted old blood). Bleeding from the respiratory tract can be quite intense and prolonged, sometimes leading to the death of patients. But, hemoptysis can be a symptom of other pulmonary diseases: pulmonary tuberculosis, bronchiectasis (air cavities in the lung).

dyspnea associated with changes in the lung tissue: inflammation of the lungs accompanying the tumor, collapse of part of the lung due to blockage of the bronchial tube by the tumor (atelectasis), disrupting gas exchange in the lung tissue and worsening the conditions of ventilation of the lungs, reducing the respiratory surface. With tumors growing in large bronchi, atelectasis of the entire lung and its complete shutdown can occur.

pain in the chest - associated with tumor germination of the serous lining of the lungs (pleura), which has many pain endings, concomitant inflammatory changes in the lungs and tumor germination into the bones, large nerve plexuses of the chest.

ManifestationssyndromeItsenko- Cushing(obesity, increased hair growth, pink stripes on the skin). This is due to the fact that some types of cancer cells can synthesize ACTH (adrenocorticotropic hormone). Excessive synthesis of this hormone causes similar symptoms.

Anorexia(loss of body weight), vomiting, problems with the functioning of the nervous system - such signs may bother the patient if the tumor synthesizes antidiuretic hormone.

Violationexchangecalcium(vomiting, lethargy, vision problems, osteoporosis). These symptoms appear if cancer cells synthesize substances similar to the hormones of the parathyroid gland, which regulates calcium metabolism.

Syndromecompressiontophollowveins(subcutaneous veins protrude, the neck and shoulder girdle swell, problems with swallowing appear). This symptom complex develops with the rapid development of the tumor process.

When nerve fibers are damaged, paralysis and paresis of the muscles of the shoulder girdle and phrenic nerves develop, and swallowing processes are disrupted. If lung cancer metastasizes to the brain, any neurological disorders and death of the patient can occur.

At the early stage of the disease there is no pain; persistent intense pain is typical for late, advanced stages of the tumor. The pain may be in one place or radiate to the neck, shoulder, arm, back or abdominal cavity, and may worsen when coughing.

Cough

Cough with lung cancer is one of the most recognizable symptoms of malignant oncology. In almost all types and forms of lung cancer, the course of the disease is significantly aggravated by cough. This means that people who suffer from this disease must not only be able to alleviate their condition, but also know effective treatment both for such processes and for other pulmonary pathologies.

Cough in lung cancer can be characterized as a kind of protective reaction of the body to a specific receptor irritation. This reaction occurs when external or internal mediators act on receptors located in all parts of the respiratory system.

The pathological process, that is, chronic cough, can be characterized as:

rare/frequent;

strong/weak;

short/long;

raucous/loud;

jerky/rolling;

painless/painful;

wet/dry.

For a cancer tumor that is based in the body of the lung, the following types of cough are not typical: strong, short and loud. Patients who make similar sounds when coughing most likely are not carriers of lung cancer; their larynx and trachea are susceptible to infectious diseases, and in rare cases, the tumor is localized in these organs and not in the lungs. If such changes are not recognized in time and treatment is prescribed in accordance with oncological protocols, you can skip the intensive cycle of disease development and allow it to enter the subacute stage, which will certainly end in death.

Characteristic cough intonations when irritating receptors located in the lung tissues:

Lengthy, muffled, weak and deep - indicates a sharp decrease in the elasticity of the lung tissue, as well as the presence of one or more pathological foci in this organ. Treatment should be symptomatic.

Pain in lung cancer, characteristic of constant coughing, tells the specialist that the tumor has affected the pleura around the lungs or is localized in the bronchi, which are sensitive to pain impulses. The pain may intensify with intense movement of the sternum. In the case when auscultation gives the result in the form of a painful cough and bursting noises, this means only one thing, fluid begins to accumulate between the pleura and the lung.

There are two types of wet cough: with regular release of liquid contents and with expectoration of a viscous substance. In the first case, we can talk about it as an acute course of a pathological process in the lungs, in the second - about a chronic form of the disease.

The cough may be dry and make breathing difficult. In some cases, it precedes the occurrence of a wet cough or, conversely, is its consequence. A dry cough itself is a sign of chronic receptor irritation, but fluid does not accumulate in the lungs. It can act as a sign of a progressive tumor, at a stage when inflammation and tissue necrosis are not yet observed around the localized lesion. Treatment is prescribed according to the results of a microbiological study.

If coughing and hemoptysis suddenly stop, you should urgently consult your doctor, as this is a very dangerous situation. Suppression of the cough reflex indicates the development of intoxication of the body with tumor decay products.

Self-diagnosis and treatment at home can only worsen the situation. It is best to most expressively describe the sensations associated with the disease to your oncologist. The final result is drawn up after a whole range of necessary analyzes and studies have been carried out.

Hemoptysis and sputum as nonspecific symptoms of cancer

Most patients are frankly frightened when sputum begins to come out of the lungs with blood clots. Hemoptysis is the name of this process in modern medicine. But hemoptysis is not always a direct sign of a tumor. Blood contained in sputum as exudate is not a typical symptom of lung cancer.

Bleeding when blowing your nose during a coughing attack characterizes damage to the small blood vessels of the respiratory system. Hemoptysis implies the release of blood as part of accumulated mucus, when sputum is expelled in the process, and with pulmonary hemorrhages, the blood is scarlet and has a foamy structure.

Signs of lung cancer

There are 3 phases of lung cancer development:

Biological period - the time from the appearance of a neoplasm to the first signs during an x-ray examination

Asymptomatic period - no symptoms, only radiological signs of cancer

Clinical period - the appearance of symptoms of the disease

With stage 1-2 of the oncological process, this is a biological or asymptomatic period of cancer, when a person does not feel any health problems. A small number of patients seek medical help during this period, so timely early diagnosis of the first stages is extremely difficult.

In stages 2-3 of lung cancer, certain syndromes may appear, that is, “masks” of other ailments.

At first, the oncological process is manifested by a simple decrease in a person’s vitality, he begins to quickly get tired of simple daily everyday activities, loses interest in current events, performance decreases, weakness appears, a person may say “how tired I am of everything,” “I’m tired of everything.”

Then, as the disease progresses, cancer can disguise itself as frequent bronchitis, acute respiratory viral infections, catarrh of the respiratory tract, and pneumonia.

The patient may periodically simply have an increase in body temperature, then recover and rise again to low-grade levels. Taking antipyretics, NSAIDs or traditional methods of treatment relieves the malaise for some time, but the repetition of this condition within several months forces people who monitor their health to consult a doctor.

Main causes of lung cancer:

smoking, including passive smoking (about 90% of all cases);

contact with carcinogenic substances;

inhalation of radon and asbestos fibers;

hereditary predisposition;

influence of harmful production factors;

radioactive exposure;

the presence of chronic respiratory diseases and endocrine pathologies;

cicatricial changes in the lungs;

viral infections;

air pollution.

Hazardous types of production:

steelmaking;

wood processing;

metallurgy;

mining;

asbestos-cement;

ceramic;

phosphate;

fulling;

Cancer cells have the ability to divide rapidly. The tumor can reach a significant size and, in the absence of timely treatment, penetrate into neighboring organs. Later, malignant cells are spread throughout the body by lymphogenous and hematogenous routes - this process is called metastasis.

Cigarette smoking, including secondhand smoke, is the most important cause of lung cancer. The risk depends on age and intensity of smoking, as well as duration of smoking; The risk decreases after smoking cessation, but probably never returns to baseline.

For non-smokers, the most important environmental risk factor is exposure to radon, a product of the destruction of natural radium and uranium. Occupational hazards associated with exposure to radon (miners in uranium mines); asbestos (in construction and demolition workers, plumbers, shipbuilders and auto mechanics); quartz (for miners and sandblasters); arsenic (in workers involved in copper smelting, pesticide production and plant protection products); chromium derivatives (in stainless steel factories and pigment factories); nickel (in battery factories and stainless steel factories); chloromethyl ethers; beryllium and coke oven emissions (from steel industry workers) result in a small number of cases each year.

The risk of malignant neoplasms of the respiratory system is higher when two factors are combined - occupational hazards and cigarette smoking - than when only one of them is present. COPD and pulmonary fibrosis may increase the risk of developing the disease; medications containing beta-carotene may increase the risk of developing the disease in smokers. Polluted air and cigar smoke contain carcinogens, but their role in the development of lung cancer has not been proven.

Classification

There are several clinical and radiological forms of lung cancer:

1. central cancer - bronchial cancer, grows in the lumen of large bronchi (central, lobar, segmental). The tumor grows both in the lumen of the bronchus (manifests earlier) and in the lung tissue surrounding the bronchus. In the initial stages it does not manifest itself in any way, often not visible on fluorography and x-ray photographs, since the shadow of the tumor merges with the heart and blood vessels. The presence of a tumor can be suspected by indirect signs on an x-ray: a decrease in the airiness of an area of ​​the lung or inflammation in the same place repeatedly (recurrent pneumonia). Characterized by cough, shortness of breath, hemoptysis, in advanced cases - chest pain, high body temperature

Central tumor right lung large sizes

2. Peripheral cancer - grows in the thickness of the lung tissue. There are no symptoms, it is detected accidentally during examination or when complications develop. The tumor can reach large sizes without showing itself; such patients often refuse treatment, citing the absence of symptoms.

A type of peripheral cancer - cancer of the apex of the lung (Penkosta), is characterized by germination into the vessels and nerves of the shoulder girdle. Such patients are treated for a long time by a neurologist or therapist with a diagnosis of osteochondrosis, plexitis and are referred to an oncologist with an already advanced tumor. A type of peripheral cancer is also a cavitary form of cancer - a tumor with a cavity in the center. The cavity in the tumor occurs as a result of the disintegration of the central part of the tumor, which lacks nutrition during the growth process. These tumors can reach large sizes up to 10 cm or more, they are easily confused with inflammatory processes - abscesses, tuberculosis with decay, lung cysts, which delays the correct diagnosis and leads to the progression of the disease without special treatment.

Cavitary form cancer lung: tumor V right lung indicated arrow

3. Pneumonia-like cancer, as the name suggests, is similar to pneumonia, patients are treated for a long time by a general practitioner, when there is no effect of antibiotic treatment, cancer is suspected. The tumor is characterized by rapid growth, grows diffusely, not in the form of a node, and occupies one or more lobes of the lung.

Pneumonia-like form cancer lung With defeat both lungs

4. Atypical forms: liver, brain, bone and others. They are associated with the symptoms not of the lung tumor itself, but of its metastases. The hepatic form is characterized by jaundice, changes in blood tests, enlarged liver, heaviness in the right hypochondrium. Brain - often manifests as a stroke clinic - the arm and leg on the side opposite to the lesion stop working, speech impairment, loss of consciousness, there may be convulsions, headaches, double vision. Bone - pain in the spine, pelvic bones or limbs, spontaneous (not associated with trauma) fractures often occur.

5. Metastatic tumors are screenings from the main tumor of another organ (for example, breast, intestines, other lung, ENT organs, prostate gland and others), having the structure of the original tumor and capable of growing, disrupting the function of the organ. In some cases, metastases can reach enormous sizes (more than 10 cm) and lead to the death of patients from poisoning by tumor waste products and disruption of internal organs (liver and respiratory failure, increased intracranial pressure, and so on). Most often, metastases arise from tumors of the intestine, mammary gland, second lung, which is associated with the specifics of the organ’s blood circulation: a very small and highly developed vascular network, tumor cells settle in it from the bloodstream and begin to grow, forming colonies - metastases. A malignant tumor of any organ can metastasize to the lungs. Metastases in the lungs are common and can be very similar to independent tumors.

Sometimes, after a complete examination, the tumor - the original source of metastases - cannot be detected.

Lung cancer is systematized according to the structure of the changed cells, their location, the shape of the tumor and the prevalence of tumors in the patient’s body.

Morphological classification:

Small cell (15-20% of cases) - extremely aggressive cell division and rapid metastasis. Most often caused by smoking, it is detected in the later stages when internal organs are damaged.

Non-small cell (80-85% of cases) - has a negative prognosis, combines several forms of morphologically similar types of cancer with a similar cell structure.

Types of non-small cell cancer:

squamous;

large cell;

adenocarcinoma;

mixed.

These species have fundamental differences in their growth, spread, and treatment processes, so identifying them is a priority.

Anatomical classification:

central - affects the main, lobar and segmental bronchi;

peripheral - damage to the epithelium of smaller bronchi, bronchioles and alveloli;

massive (mixed).

Stages of development:

Stage 0 - small neoplasms, there is no damage to internal organs and lymph nodes;

Stage 1: a tumor in the lung no more than 3 cm in size or a bronchial tumor spreading within one lobe, no metastases in nearby lymph nodes;

Stage 2: tumor in the lung more than 3 cm, grows into the pleura, blocks the bronchus, causing atelectasis of one lobe;

Stage 3: the tumor spreads to neighboring structures, atelectasis of the entire lung, the presence of metastases in nearby lymph nodes - the root of the lung and mediastinum, supraclavicular;

Stage 4: the tumor grows into surrounding organs - the heart, large vessels, or fluid joins the pleural cavity (metastatic pleurisy).

Stage 1 lung cancer

The size of a malignant neoplasm in the first degree of oncological pathology is estimated at 3-5 cm, and symptoms do not always appear. The cancer cells are located in one fixed segment of the lung area, called peripheral cancer. They can also be located in a person within the bronchial region - this is already a centrally located cancer in an early form.

A distinctive characteristic of the presented period should be considered that cancer cells have not yet affected the lymph nodes.

Oncologists suggest taking into account the following classification: dividing stage 1 lung cancer into two stages, which follow each other.

Grade 1A is associated with a maximum tumor size of 3 cm. Survival for 5 years at this stage for non-small cell cancer is from 60 to 75%. If we talk about the small cell variety, then these figures are at least 40%.

When a person encounters degree 1B, he develops the following changes and symptoms:

the tumor reaches a size of no more than 3-5 cm in diameter;

lymph nodes and other leading parts of the body are not damaged;

life expectancy for 5 years in the case of non-small cell cancer is from 45 to 60%, and in the small cell form - no more than 25%.

Stage 2 lung cancer

Stage 2 goes through like a normal stage of a cold, having all its symptoms. Because of this, most patients do not panic, but wait for the symptoms to gradually regress and everything to return to normal.

But these expectations are futile if you have cancer. The symptoms will only progress, and new, more serious ones will appear, for example, pain in the chest.

There are, of course, cases where there is a 2nd degree, but there are no manifestations. Moreover, if the patient takes a regular x-ray of the chest organs, it will be possible to observe the primary tumor, sometimes large in size, metastasizing to nearby lymph nodes.

The second degree is very aggressive, the tumor grows very quickly, extending beyond the lung. Tumor cells entering the bloodstream are transported over long distances. Metastases are detected in the brain and other organs and systems. Most often, patients complain of high fever, cough, very rapid fatigue, lack of desire to eat, and often nausea. Very often such patients have pain in their bones, muscles, and head. Coughing up blood is very rare at this stage.

The disease often has a secretive course, only 3 out of 10 patients seek help at this stage. It is worth noting that in the beginning, the disease is much easier to achieve a cure; you just need to do an x-ray of the lungs every year. Today, medicine has made great progress; methods for early diagnosis of tumors have been developed by identifying tumor markers freely circulating in the human bloodstream.

Stage 3 lung cancer.

Stage 3 lung cancer is characterized by severe symptoms of the disease. Such differences distinguish this stage of oncology from the second, in which a person does not constantly experience painful sensations, they can be observed at certain hours or after intense physical exertion.

Sick people who have stage three cancer suffer from such problems as a strong, debilitating, hacking cough. It is observed against the background of the discharge of sputum, which may contain blood clots. In difficult cases, when a person smokes for a long time or has serious illnesses, for example, pneumonia, pulmonary hemorrhage is observed.

There are several signs that can be visually seen - sinking of the chest on the side affected by cancer, audible wheezing when taking a large breath. Breathing becomes difficult and sometimes painful. The prognosis is negative, surgery is not advisable, therapy can only be prescribed to make you feel better.

In stage three lung cancer, the tumor can vary in size. In most cases, it spreads to nearby anatomical tissues of the chest wall: mediastinal and diaphragmatic. The addition of atelectasis and pneumonia to the malignant process leads to the formation of effusion in the pleural cavity and inflammation of the entire lung tissue. The degree of differentiation of lung cancer depends on the pathomorphological structure. Squamous cell lung cancer has a high degree of differentiation, so identifying it even at the third stage of development can give hope for effective treatment and a favorable prognosis for life.

Stage 4 lung cancer

A patient diagnosed with the last stage of lung cancer experiences numerous complaints:

1. Constant pain when breathing, which is difficult to live with.
2. Decrease in body weight and appetite, in some cases, intestinal activity fails due to metastases, food stops being absorbed. Constipation - this symptom can occur very often, especially if the cancer has metastasized to the intestines. Also, constipation can occur due to lack of appetite and a sedentary lifestyle of the patient. It is difficult to treat such constipation with diet or medication, due to the fact that the patient has no appetite and does not accept medications well.
3. Blood clots slowly, and fractures (bone metastases) often occur.
4. The appearance of severe coughing attacks, often with sputum, sometimes with blood and pus. Hemoptysis - at the beginning of the disease, the patient may cough up sputum with small streaks of blood, but when the process reaches the fourth stage, the sputum contains so much blood that it begins to resemble raspberry jelly. In addition to blood, traces of pus sometimes appear in the sputum. Often, the fourth stage of lung cancer is accompanied by attacks of hacking cough, which in turn can cause ruptures of blood vessels, which will inevitably lead to heavy bleeding.
5. The appearance of severe pain in the chest, which directly indicates damage to nearby tissues, since there are no pain receptors in the lungs themselves.
6. Symptoms of cancer also include heavy breathing and shortness of breath, if the cervical lymph nodes are affected, difficulty speaking is felt.
7. Temperature is a very common occurrence during lung cancer, which is observed in 85% of all patients, and becomes evidence of an advanced phase of the disease. In some patients, the temperature occurs in the form of outbreaks, in others it is subfebrile and does not exceed 37.5 degrees.

The symptom complex is provoked by metastasis to distant organs and can be varied, depending on the area affected by the metastases. For example, if they reach the bone tissue, severe pain may be observed in the limbs, ribs, and spine.

If metastasis has reached the brain, the patient experiences seizures, loss of vision, incoordination, speech and memory disorders. A secondary liver tumor causes symptoms such as jaundice and liver failure. Secondary kidney tumors often provoke girdling pain in the lower back and hematuria.

Peripheral lung cancer

A malignant tumor developing from the alveoli, small bronchi and their branches; localized on the periphery of the lung, away from the root. Symptoms of peripheral lung cancer appear at a late stage, when the tumor invades large bronchi, pleura, and chest wall. They include shortness of breath, cough, hemoptysis, chest pain, and weakness.
Peripheral lung cancer is cancer arising from the bronchi of the 4th-6th order and their smaller branches, not associated with the lumen of the bronchus. In pulmonology, peripheral lung cancer accounts for 12-37% of all lung tumors. The ratio of the detection rate of central and peripheral lung cancer is 2:1. Most often (in 70% of cases) peripheral lung cancer is localized in the upper lobes, less often (23%) in the lower lobes and very rarely (7%) in the middle lobe of the right lung. The danger of peripheral lung cancer lies in its long-term latent, asymptomatic course and frequent detection in an advanced or inoperable stage. According to histological structure, peripheral lung cancer is most often represented by bronchoalveolar adenocarcinoma or squamous cell carcinoma.

In the origin of peripheral lung cancer, the role of endogenous factors is great - lung diseases (pneumonia, chronic bronchitis, smoker's bronchitis, tuberculosis, limited pneumosclerosis), which can be traced in the history of a significant number of patients. The majority of cases are people over 45 years of age. In the pathogenesis of peripheral tumors, dysplasia of the epithelium of small bronchi and alveolar epithelium plays a decisive role. Neoplasms develop from basal, ciliated, goblet epithelial cells of the bronchi, type II alveolocytes and Clara cells.
In addition, there are three clinical forms of peripheral lung cancer: nodular, pneumonia-like and Pancoast cancer (cancer of the apex of the lung)

Nodal form originates from the terminal bronchioles and clinically manifests itself only after germination of large bronchi and adjacent tissues.

Pneumonia-like form peripheral lung cancer develops in the pulmonary parenchyma and is characterized by infiltrating growth; histologically always represents adenocarcinoma; clinically resembles indolent pneumonia.

Localization Features apical lung cancer cause tumor infiltration of the cervical and brachial nerve plexuses, ribs, spine and corresponding clinical symptoms. Sometimes the cavitary form of lung cancer (formation of a pseudocavernous decay cavity in the thickness of the node) and cortico-pleural cancer (comes from the mantle layer, spreads along the pleura along the spine, grows into the tissue of the chest wall) are added to the above three main forms.

The forms of the disease presented deserve special attention. The first of these is corticopleural, in which an oval-shaped formation appears. It begins to grow into the chest, and therefore is located in the subpleural plane. This variety is dangerous due to the fact that it tends to grow into adjacent ribs, as well as into the bodies of the thoracic vertebrae located nearby.

The next form is cavitary, which is a tumor with an empty formation in the central part. Such neoplasms reach dimensions of more than 10 cm, and therefore they are confused with negative algorithms (cysts, tuberculosis, abscess) in the lungs. This form of peripheral lung cancer most often occurs without any symptoms.

Oncologists draw patients' attention to the fact that the cavitary type of the disease is most often identified in the later stages. In this case, the process turns out to be irreversible. Peripheral cancer of the left and right lungs is also distinguished; in order to identify it and determine the prognosis, a diagnostic examination will be required.

Small cell cancer

A malignant tumor that has the most aggressive course and widespread metastasis. This form accounts for about 20-25% of all types of lung cancer. Many scientific experts regard this type of tumor as a systemic disease, in the early stages of which there are almost always metastases in the regional lymph nodes. Men suffer from this type of tumor most often, but the percentage of women affected is growing significantly. Almost all patients have a fairly severe form of cancer, which is associated with rapid tumor growth and widespread metastasis.

Grades of small cell lung cancer

Stage 1 - the tumor size is up to 3 cm in diameter, the tumor has affected one lung. There is no metastasis.

Stage 2 - the size of the tumor in the lung is from 3 to 6 cm, blocks the bronchus and grows into the pleura, causing atelectasis;

Stage 3 - the tumor rapidly spreads to neighboring organs, its size has increased from 6 to 7 cm, and atelectasis of the entire lung occurs. Metastases in neighboring lymph nodes.

Stage 4 small cell lung cancer is characterized by the spread of malignant cells to distant organs of the human body, which in turn causes symptoms such as:

headache;

general malaise;

loss of appetite and sudden weight loss;

back pain

Squamous cell lung cancer

Squamous cell lung cancer is a histological type of bronchopulmonary cancer resulting from squamous cell metaplasia of the bronchial epithelium.

Clinical manifestations depend on the localization of the tumor (central or peripheral lung cancer). The disease can occur with cough, hemoptysis, chest pain, shortness of breath, pneumonia, pleurisy, general weakness, and metastasis.
Squamous cell lung cancer accounts for more than half (about 60%) of all histological forms of lung cancer. It predominantly affects men over 40 years of age. Up to 70% of tumors of this type are localized in the root of the lung; in a third of cases, peripheral lung cancer is detected. The relevance of squamous cell lung cancer for clinical pulmonology lies, first of all, in its high prevalence and potential reversibility of risk factors for the disease.
The diagnosis of squamous cell lung cancer combines several types of neoplasms of malignant etymology. Therefore, the course of different forms of the disease is different, and they also arise in different ways. Depending on which part of the respiratory system the tumor originates, there are two types:

1. Central squamous cell lung cancer. This type is diagnosed in 2/3 of patients. As a rule, the tumor is localized in the main, intermediate or lobar part of the bronchi. It is detected against the background of prolonged pneumonia or an abscess. Due to the unclear picture in this case, the symptoms are blurred.
2. Peripheral lung cancer. The tumor occurs in the segmental part of the bronchi or in their lobes. The picture of the disease can be blurred against the background of concomitant chronic processes. This form appears when metastases begin to appear.
3. Massive. This type combines the first two forms.
4. Depending on the type of tissue, two more types of cancer are distinguished: small cell and squamous cell keratinizing non-small cell lung cancer. The first type is diagnosed extremely rarely, in 15%. But, however, this is the most malignant course, rapid metastasis. Against a background of unclear symptoms. The process develops very rapidly and the prognosis is unfavorable.

Squamous cell lung cancer is very common. It begins with the degeneration of cells located in the respiratory tract. Therefore, the prognosis is made based on the type of cancer, rate of progression and malignancy of the tumor.

Central lung cancer

ByhisstructureAndformscentralcancerlungsMaybehavethe mostvariousforms:

plaque-like;

polyposis;

branched (peribronchial and perivascular);

knotty;

endobronchial diffuse

Location of the tumorByratioTolumenbronchiMaybehighlighttwobasicformscentralcancer:

1. endobronchial - developing inside the bronchus;
2. peribronchial - developing outside the bronchus, in its lumen.

The difference between these forms lies in the different symptoms and course of the disease. Much more often, central cancer of the right lung is diagnosed, accounting for approximately 52% of patients. Most often, this group includes men whose age has reached 40-45 years and who are heavy smokers with experience. Central cancer of the left lung is slightly less common; its diagnosis accounts for 48% of the disease.

It has been revealed that the main cause of bronchial cancer development is irritation of the bronchial mucosa. But despite this, the most important cause of bronchial cancer development is smoking, and passive smokers are at the same risk as active smokers. Harmful substances found in tobacco smoke (nicotine) destroy the bronchial mucosa and negatively affect the endocrine glands. In addition, tobacco smoke also contains a lot of harmful substances, which in turn are harmful to the body.

Metastases

Mestases (metastasis - og Greek. Meta staseo - otherwise I stand) are secondary foci of growth of almost any malignant tumor. Most cancers lead to the appearance of secondary lesions in local and regional lymph nodes, liver, lungs, and spine.

Modern concepts of the development of metastases are based on the fact that metastases in the lung develop almost immediately as soon as the malignant tumor itself appears. Individual cells detached from it first penetrate the lumen of the blood vessel (hematogenous dissemination pathway) or lymphatic vessel (lymphogenous dissemination pathway), and then are transported with the blood or lymph flow, stop at a new location, then leave the vessel and grow, forming new metastases. At first, this process is slow and imperceptible, since cancer cells from the maternal lesion suppress the activity of secondary lesions.

Liver metastases in lung cancer

Often, with lung cancer, general cerebral or focal symptoms predominate. Paroxysmal symptoms are observed very rarely, so they are not considered standard. Anticonvulsants are prescribed as prophylactic agents.

The liver is the most favorable place for the localization of metastases, regardless of where the primary tumor is located. Lung cancer and liver metastases are observed in half of all cases of lung cancer.

Symptoms of liver metastases are similar to those of liver cancer.

To themrelate:

frequent ailments;

causeless nausea and vomiting;

sudden weight loss;

heaviness in the upper abdomen;

attacks of acute abdominal pain;

excessive sweating.

Lung cancer metastases in the spine

Bone metastases, in particular metastases to the spine, are also quite common in lung cancer. Cancer cells spread throughout the body through the bloodstream and enter bone tissue, which leads to its destruction. Such processes of bone destruction cause more harm to the body than cancer cells. When bones break down, frequent fractures can occur.

Metastases in the spine usually cause pain in the area of ​​the corresponding vertebrae and, in addition, neuralgic pain caused by the pressure of these metastases on the nerve roots of the spinal cord. Localized more often in the lumbar spine, metastases cause sciatica pain; in rare cases, even compression of the spinal cord may occur and cause paralysis of the lower extremities. Metastases in the spine often occur at the initial stage of the disease. At later stages, metastases to the ribs are noted, which can cause severe pain simulating intercostal neuralgia. An impetuous change of position or careless squeezing of the chest leads to fractured ribs. Diagnosis of tumor metastases in the spine and ribs is facilitated by x-rays.

WITHmanycirculatoryvesselsarisemetastasesVbones:

shoulder;

femoral;

• cranial;

• spine.

Such metastases often occur asymptomatically, which is a very big danger. The main symptom of bone metastases in lung cancer is hypercalcemia.

HerCandefineBylike thissignsHow:

dry mouth;

excessive urine production;

disturbance of consciousness.

Lung cancer metastases to the brain

Often, patients have cancer of the left lung with metastases that spread to the brain. In order for the treatment to give the best possible results, the entire brain is exposed to irradiation. Stereotactic radiosurgery is used for multifocal lesions, followed by systemic chemotherapy. This metastasis may be asymptomatic or it may be affected by signs of damage to the central nervous system, for example, drowsiness, apathy, headaches, etc.

Metastases in lung cancer appear synchronously or within one year after the onset of the disease. Metastases often affect the parietal lobe of the brain.

There are enough methods for treating lung metastases. Each treatment method is selected individually for each patient, taking into account the course of the disease and the location of the metastases.

Lung cancer metastases to lymph nodes

Metastases in the lymph nodes are secondary foci of growth of malignant tumors that are present in the body. The development of metastases indicates active progression of the disease.

The main reason for the spread of metastases in the body is the growth of a malignant tumor. As production increases, cells begin to move throughout the body, using the lymphatic system.

Lung cancer, laryngeal cancer, bronchial cancer are provocateurs for the appearance of metastases in the lymphatic system.

Symptoms of metastasis to lymph nodes

The first sign of metastases in the lymph nodes is their enlargement, which the patient himself can determine by touch. Pain may not be felt.

At inspection, available definition lymph nodes:

• supraclavicular;

  axillary

Alsoincreaselymph nodesMaybebe presentWith:

• general weakness;

  weight loss.

These symptoms are an alarming signal that requires you to immediately consult a doctor.

Mortality and lung cancer

Despite increases in incidence and prevalence, mortality from lung cancer is declining worldwide, but survival prognoses remain extremely poor.

Lung cancer mortality per 100,000 population:

According to statistics, lung cancer accounts for 31% of the structure of cancer mortality; mortality within 1 year after an accurate diagnosis is 50%. Projections for five-year survival rate, subject to timely diagnosis and rational treatment, reach 40-50%. But in the absence of adequate therapy, 80% of patients die within 2 years, and only 10% can live 5 years or more.

Dynamics of mortality from lung cancer in Russia per 100,000 population for 2004-2014:

Lung cancer survival forecasts

The mortality rate for lung cancer has remained high for many years, so survival projections are relatively low and stable. The life expectancy of patients depends on various factors: age, concomitant pathology, stage of cancer, type of tumor, tumor size, metastases and others.

According to statistics, lung cancer most often develops in the upper lobe (40%), in the lower lobe in 30% and least often in the middle lobe - 10%. In most cases, the tumor forms in the central regions (80%). Cancer of the central part of the lungs rapidly progresses, causing the appearance of unfavorable symptoms in the early stages; the life expectancy of patients with this type of tumor is no more than 4 years. Peripheral forms of lung cancer are less aggressive and exist for a long time without clinical manifestations.

Lung cancer is divided into types according to different characteristics; classification based on the histological structure of the tumor plays an important role:

Non-small cell lung cancer: occurs in 80-85%, survival prognosis depends on the stage of the disease, but is generally favorable;

Small cell lung cancer: registered in 10-15% of cases, a rather aggressive form of the tumor, it is susceptible to chemotherapy and undergoes reverse development in 60-80%. The mortality rate from lung cancer of this type is high: at stages 1-2 of the tumor, no more than 40% of patients can survive for 5 years, 2-year survival rate is 50%, 5-year survival rate is 10-15%.

Projections of five-year survival in different countries in%:

Mortality from lung cancer and its stages

Lung cancer, according to the classification, has 4 stages, which have a strong impact on survival prognosis:

1. The neoplasm is no more than 3 cm, located in one of the segments. If a non-small cell tumor is formed, then the prognosis for five-year survival is 60-70%, with a small cell type - no more than 40%. If the size of the tumor increases to 5 cm, then the prognosis worsens by 20%;
2. The neoplasm is more than 6 cm in size, localized in one of the segments, a single lesion of regional lymph nodes cannot be excluded, the 5-year survival prognosis for non-small cell cancer is 40%, for small cell cancer - 18%;
3. Lung cancer actively grows, affecting surrounding tissues, metastases to the lymph nodes, the five-year survival rate reaches 19%, but with multiple metastases in the lymph nodes no more than 8%;
4. Lung cancer of arbitrary size, gives multiple metastases to all organs and tissues, five-year survival prognosis is no more than 13%.

According to statistics, lung cancer in Russia is most often registered at stages 3-4, although in recent years the proportion of patients in the early stages has increased.

The share of registered patients depending on the stage of lung cancer for 2007-2017 in Russia.

Diagnosis of lung cancer

Modern diagnostics of lung cancer allows doctors to detect a tumor at any of its stages of development. Of course, it is better for the patient if doctors manage to detect lung cancer in the first stages of its development, and ideally: even at the stage of the beginning of the degeneration of healthy cells into cancer cells. Symptoms of oncology of the respiratory system of the body today can be diagnosed using the following methods:

Taking an x-ray. This is a simple, and at the same time the oldest method for determining the presence or absence of cancer in the lungs. It is performed by recording the condition of the lungs on a fluorographic image. If there is a foreign tumor inside the organ, then it will be displayed in the image as a dark spot or slight shading.

It all depends on the volume of the tumor and the density of its tissue. Unfortunately, this method for detecting lung cancer is not able to completely identify the tumor. As dark spots, he can recognize inflammation, or a completely different disease unrelated to oncology. Always after fluorography, and detection of darkening of the lungs in the image, additional diagnostic measures are prescribed.

CT scan. It is a more modern method of studying the lung. The diagnostic accuracy is so high that lung cancer detected using computed tomography may go unnoticed on a fluorographic image. Thanks to this, doctors are able to identify a tumor at the stage of its initial inception, when there are still practically no symptoms, and begin timely drug therapy.

Bronchoscopy. After lung cancer has been identified using an x-ray or computed tomography, the next stage of cancer diagnosis begins. A special flexible tube is inserted into the respiratory tract of the subject, at the end of which a video camera is installed. The image is displayed on a special monitor of medical equipment. The doctors' task is to locate the tumor inside the lungs, visually examine it, and then use special instruments to select part of the tumor tissue. A tumor fragment is sent for biopsy to determine whether it is malignant or benign.

Needle biopsy. This type of diagnosis, like the previous one, involves penetration into the lungs, but not with the help of a bronchoscope, but with a special needle. It is so thin that it is injected through the patient’s skin and penetrates the small bronchi. These are the most distant and microscopic parts of the airways in the lungs. The selected biological material is also transferred for laboratory study.

Blood test for markers. Special drugs with a protein structure are introduced into the patient’s body and circulate throughout the body along with the blood. Their task is to signal the presence or absence of cancer cells in the lungs. If they are present there, then in the resulting analyzes the number of markers will be displayed in excess. Each individual organ studied has its own type of markers.

In addition, in case of unclear diagnostic cases and identification of signs characteristic of lung cancer, diagnostic thoracotomy can be used - material for histological examination is obtained during the surgical procedure. To detect metastases of lung cancer, a biopsy of a lymph node or organ, ultrasound, or radioisotope scanning can be performed.

A method by which the level of accumulation of radioisotopes in tissues is measured and affected areas are identified (radioisotope scanning).

Positron emission tomography, which makes it possible to make a functional assessment of oncological formation.

Ultrasound examination using a modern ultrasound machine

Pulmonary syndrome

There are several pulmonary syndromes: pulmonary compaction syndrome, pleural syndrome, cavity syndrome, broncho-obstructive syndrome, hyperairy lung syndrome, Pickwickian syndrome, sleep apnea syndrome (sleep apnea syndrome), respiratory failure syndrome. It should be borne in mind that within the same major syndrome there are a number of variants, the diagnosis of which is certainly important, since treatment methods will be different.

Main clinical (pulmonary) syndromes:

Pulmonary consolidation syndrome:

1. Infiltrate (pneumonic, tuberculous, eosinophilic).
2. Pulmonary infarction (thromboembolism, thrombosis).
3. Atelectasis (obstructive, compression, middle lobe syndrome).
4. Congestive heart failure (stagnation of fluid in the lower parts of the lungs).
5. Tumor.

Pleural syndrome:

1. Fluid in the pleural cavity (transudate, exudative pleurisy).
2. Air in the pleural cavity (pneumothorax).

Cavity syndrome(disintegrating abscess and tumor, cavity).

Broncho-obstructive syndrome:

1. Obstruction or narrowing of the bronchus.
2. Bronchospasm.

Hyperairy lung syndrome(various types of emphysema).

Pickwickian syndrome And apnea syndrome during sleep (night apnea syndrome).

Respiratory distress syndrome:

1. Acute respiratory failure (including adult distress syndrome).
2. Chronic respiratory failure.

The identification of these syndromes occurs primarily when using the basic methods of examining the patient - examination, palpation, percussion, auscultation.

Pulmonary consolidation syndrome

Pulmonary compaction syndrome is one of the most pronounced manifestations of pulmonary diseases. Its essence lies in a significant reduction or complete disappearance of the airiness of the lung tissue in a more or less widespread area (segment, lobe, several lobes at the same time). Foci of compaction differ in location (lower areas, apexes of the lungs, middle lobe, etc.), which also has differential diagnostic significance; they specifically highlight the subpleural localization of the focus of compaction with the involvement of the visceral and adjacent parietal layers of the pleura, which is accompanied by the addition of signs of pleural syndrome. The development of compaction can occur quite quickly (acute pneumonia, pulmonary infarction) or gradually (tumor, atelectasis).

There are a number of types of pulmonary compaction: infiltrate (pneumonic focus) with the release of tuberculous infiltrate, which is prone to caseous decay; pulmonary infarction due to thromboembolism or local vascular thrombosis; obstructive (segmental or lobar) and compression atelectasis (collapse, collapse of the lung) and hypoventilation; a variant of atelectasis is hypoventilation of the middle lobe due to obstruction of the middle lobe bronchus (bronchopulmonary lymph nodes, fibrous tissue), which, as is known, normally does not ventilate the lobe completely enough - middle lobe syndrome; lung tumor; congestive heart failure.

Subjective manifestations of pulmonary compaction syndrome vary depending on the nature of the compaction and are discussed when describing the corresponding diseases.

A common objective sign of a developing decrease in airiness corresponding to the compaction of a section of lung tissue is the asymmetry of the chest, revealed during examination and palpation.

Regardless of the nature of this syndrome, with large foci of compaction and their superficial location, one can detect bulging and lag in breathing of this part of the chest (and only with large obstructive atelectasis is it possible to retract it), vocal tremors are increased. Percussion determines dullness (or absolute dullness) in the area of ​​compaction, and in the presence of infiltration (pneumonia), in the initial stage and during the period of resorption, when the alveoli are partially free of exudate, and the draining bronchi retain full patency (and therefore contain air), dullness combined with a tympanic shade of percussion sound. The same dull-tympanic shade upon percussion is noted in the initial stage of development of atelectasis, when there is still air in the alveoli and communication with the afferent bronchus is preserved. Subsequently, when the air is completely absorbed, a dull percussion sound appears. A dull percussion sound is also noted above the tumor node.

Auscultation in the infiltrate zone in the initial and final stages of inflammation, when there is little exudate in the alveoli and they straighten when air enters, weakened vesicular breathing and crepitus are heard. At the height of pneumonia, due to the filling of the alveoli with exudate, vesicular breathing disappears and is replaced by bronchial breathing. The same auscultatory picture is observed with pulmonary infarction. With any atelectasis in the initial stage (hypoventilation), when slight ventilation of the alveoli still occurs in the collapse zone, a weakening of vesicular respiration is noted. Then, after resorption of air in the case of compression atelectasis (compression of the lung from the outside by liquid or gas of the pleural cavity, tumor, with a high position of the diaphragm), bronchial breathing is heard: the bronchus, which remains passable for air, conducts bronchial breathing, which spreads to the periphery by a compacted, compressed area of ​​the lung.

With obstructive atelectasis (reduction of the lumen of the afferent bronchus by an endobronchial tumor, foreign body, compression from the outside) in the stage of complete blockage of the bronchus above the airless zone, no breathing will be heard. Breath sounds will also not be heard over the tumor area. Bronchophony with all types of compactions repeats the patterns identified by determining vocal tremors.

During auscultation over subpleurally located infiltrate and tumor, as well as during pulmonary infarction, a pleural friction noise is detected.

Since the bronchi are often involved in the process in various types of compaction, it is possible to detect moist rales of different sizes. Of particular diagnostic importance is listening to fine-bubbly ringing rales, indicating the presence of an infiltration zone around the small bronchi, which enhances the sound vibrations occurring in the bronchi.

In heart failure, a decrease in the airiness of the lung tissue is detected, primarily in the lower parts of the lungs on both sides, which is associated with stagnation of blood in the pulmonary circulation. This is accompanied by a shortening of the percussion sound, sometimes with a tympanic tint, a decrease in the excursion of the lower edge of the lungs, a weakening of vesicular breathing, the appearance of moist fine rales, and sometimes crepitus.

Pleural syndrome

Pleural syndrome is a set of symptoms characteristic of damage to the pleural layers (inflammation, tumor) and (or) accumulation of fluid (exudate, transudate, blood, pus) or gas in the pleural cavity; sometimes inflammation of the pleura (dry pleurisy) precedes the appearance of pleural fluid; in addition, liquid and gas can be detected simultaneously in the pleural cavity.

With dry pleurisy, during breathing there is a lag in the affected half of the chest, since due to severe pain the patient spares this area. Auscultation over the affected half of the chest reveals a rough pleural friction noise, sounding equally loud throughout inhalation and exhalation, blocking vesicular breathing; sometimes the friction of the pleura is clearly noticeable upon palpation.

Accumulation of fluid in the pleural cavity (hydrothorax), which can be exudate, transudate, pus (pyothorax, pleural empyema), blood (hemothorax) or of a mixed nature, is accompanied by smoothing of the intercostal spaces and even bulging of the affected half of the chest, lag in breathing, voice no shaking is performed on this side. With comparative percussion, a sharp dullness or absolute dullness of the percussion sound is determined, above the upper border of which a poorly ventilated, compressed lung gives it a dull-tympanic hue. With topographic percussion, features of the upper border of the dullness are revealed, which, as already mentioned, can have a different direction depending on the nature of the fluid, as well as a significant limitation in the mobility of the lower edge of the compressed lung. Auscultation above the zone of dullness reveals a sharp weakening of vesicular breathing or, more often, its absence, above this zone - weakening of vesicular breathing, and in an oblique direction of the upper line of the zone of dullness (exudative pleurisy) part of a more compressed lung (closer

to the spine) is adjacent to the large bronchi, so a site is formed where bronchial breathing (Garland’s triangle) is heard against the background of a dull tympanic percussion sound. With exudative pleurisy, another small area is sometimes identified adjacent to the spine in the lower part of the dullness zone and already on the healthy side, where, as a result of some displacement of the aorta, dullness of percussion sound and absence of breathing during auscultation are determined (Rauchfuss-Grocco triangle).

The presence of gas in the pleural cavity (pneumothorax) is indicated by characteristic symptoms that make it possible to diagnose this condition even before radiography. Upon examination and palpation of the affected half of the chest, smoothness of the intercostal spaces, a lag in breathing, and a weakening of vocal tremors are revealed. The percussion sound over this zone is tympanic in nature; with large pneumothorax, the lower border of tympanitis falls below the usual border of the lungs beyond the light of the expansion of the pleural sinuses.

With the simultaneous presence of gas and liquid (hydropneumothorax, pyopneumothorax, hemopneumothorax), percussion over the affected half of the chest reveals a combination of dull (lower part) and tympanic (upper part) shades of sound.

Auscultation allows us to detect the absence of vesicular breathing (or its sharp weakening), and with the so-called valvular pneumothorax, when there is communication between the pleural cavity and the respiratory tract, and with each breath a new portion of air enters it, you can listen to bronchial breathing (also only on inspiration) .

Cavity syndrome

Cavity syndrome includes signs the appearance of which is associated with the presence of a cavity, abscesses, cysts, i.e. formations that have a dense, more or less smooth wall, often surrounded by an infiltrative or fibrous shaft. The cavity can be filled entirely with air only (empty cavity) or contain, in addition to air, this or that amount of liquid, remain closed or communicate with the draining bronchus. All this, of course, is reflected in the characteristics of the symptoms, which also depend on the size of the cavity and the depth of its location. With large, superficially located and isolated cavities, regardless of their contents, vocal tremors are weakened. If the cavity communicates with the bronchus and at least partially contains air, the percussion sound will have a tympanic tint; dullness or absolute dullness is noted above the fluid-filled cavity. When auscultating over an isolated air cavity, breathing is not heard; if the air cavity has a connection with the draining bronchus, bronchial breathing will be heard, which is easily carried out from the site of formation (glottis) along the air column and can acquire a metallic tint as a result of resonance in the smooth-walled cavity (amphoric breathing). The cavity, partially containing liquid, is the source of the formation of moist rales, which, as a rule, are loud in nature, since their conduction is enhanced by the surrounding compacted (infiltrated) tissue. In addition, auscultation can detect an independent stenotic noise that enhances bronchial breathing, occurring at the junction of the cavity (cavity) with the draining bronchus.

It should be noted that all of these symptoms characterizing cavity syndrome are often very dynamic, since there is a stage in the development of cavity formation, especially lung abscess: partial or complete emptying is replaced by the accumulation of fluid, which is reflected in the characteristics of the above symptoms of the presence of a cavity containing air or fluid .

Broncho-obstructive syndrome

Broncho-obstructive syndrome (bronchial obstruction syndrome) is manifested by a severe productive, less often non-productive cough, as well as symptoms of the naturally developing consequences of its long-term existence - signs of pulmonary emphysema. The clinical manifestations of broncho-obstructive syndrome are based on impaired bronchial obstruction, associated difficult and uneven ventilation (mainly due to limited expiratory flow) and an increase in residual lung volume. With true bronchial obstruction syndrome, we are talking about a change in the patency of the small bronchi (they are called in this regard the “Achilles heel” of the bronchi). Impaired patency of small bronchi most often occurs due to inflammation and swelling of the bronchial mucosa (chronic bronchitis, allergic component), bronchospasm, usually with swelling of the mucous membrane (bronchial asthma), and less often with diffuse peribronchial fibrosis, compressing the bronchi from the outside.

Chronic bronchitis most often leads to the development of irreversible inflammatory-scarring changes in the small bronchi and represents the basis of chronic obstructive pulmonary disease, the main clinical signs of which are the following:

1. cough with thick and sticky sputum;
2. clinical and functional signs of airway obstruction;
3. increasing shortness of breath;
4. development of “pulmonary heart” (cor pulmonale), terminal respiratory and heart failure.

Cigarette smoking is the most common etiological factor that supports the progression of the disease. Due to the incidence of cyanosis and heart failure, patients with chronic obstructive bronchitis are described as “blue edema.” In this variant of the obstructive syndrome, following inflammatory edema of the mucous membrane of the terminal bronchioles, leading to hypoventilation of the alveoli, a decrease in the partial pressure of oxygen and an increase in the partial pressure of carbon dioxide - hypoxemia and hypercapnia - spasm of the alveolar capillaries and hypertension of the pulmonary circulation occur. A pulmonary heart is formed, the decompensation of which is manifested by peripheral edema.

Hyperairy lung syndrome

Lung hyperairiness syndrome is most often a consequence of long-term difficulty in exhalation (bronchial obstruction), which leads to an increase in the residual volume of the lungs, chronic mechanical effects on the elastic apparatus of the alveoli, their stretching, and irreversible loss of the ability to collapse, increasing the value of the residual volume. A typical variant of this syndrome is pulmonary emphysema, which usually develops gradually. Acute pulmonary distension is rare.

Thus, there is a close connection between broncho-obstructive syndrome and pulmonary emphysema, which therefore most often has an obstructive (obstructive) nature. Much less common is compensatory (including vicarious) emphysema, which develops in response to a slow increase in diffuse pulmonary fibrosis. Due to the fact that broncho-obstructive syndrome is often generalized, pulmonary emphysema is a bilateral process. Its clinical signs are a barrel-shaped chest with reduced respiratory mobility, weak conduction of vocal tremor, the presence of a widespread boxed percussion sound, which can replace the zone of absolute cardiac dullness, downward displacement of the lower edge of the lungs, uniform weakening of vesicular breathing, auscultatory signs of broncho-obstructive syndrome (wheezing, prolonged exhalation).

It should be emphasized that these signs are detected in advanced emphysematous process; Of course, it is important to detect earlier symptoms, which essentially include one - a decrease in the respiratory excursion of the lower pulmonary border, which gradually increases over time, which is detected long before the appearance of signs of severe swelling of the lungs.

Pickwickian syndrome and sleep apnea

Of interest are Pickwickian syndrome and sleep apnea syndrome (a symptom of sleep apnea), which are usually mentioned in the section on diseases of the respiratory system (although they are not directly related to lung diseases), since their main manifestation is respiratory failure with hypoxia and hypoxemia - develops in the absence of primary lung disease.

Pickwickian syndrome is a symptom complex that includes severe alveolar hypoventilation and the resulting hypoxia and hypercapnia (PCO2 above 50 mm Hg), respiratory acidosis, as well as irresistible daytime sleepiness, polycythemia, high hemoglobin levels, and episodes of apnea. The reason for this hypoventilation is considered to be significant obesity with predominant fat deposition in the abdominal area with short stature; Genetic sensitivity to such hypoventilation appears to be important. These patients are characterized by a long period of severe (morbid) obesity with an additional sharp increase in body weight, the development of cor pulmonale, shortness of breath on exertion, cyanosis, swelling of the legs, morning headaches, but the most typical symptom is pathological drowsiness, including during conversation, while eating, reading and in other situations. It is of interest that a decrease in body weight leads in some patients to a reverse development of the main signs of the symptom complex.

Respiratory distress syndrome

Respiratory failure syndrome is one of the largest and most important pulmonary syndromes, since its occurrence indicates the appearance of changes in the main function of the respiratory organs - the gas exchange function, including, as already mentioned, pulmonary ventilation (air flow into the alveoli), diffusion (gas exchange in the alveoli) and perfusion (oxygen transport), as a result of which the maintenance of normal blood gas composition is disrupted, which in the first stages is compensated by more intense work of the external respiration system and heart. Typically, respiratory failure develops in patients suffering from chronic lung diseases, leading to the appearance of emphysema and pneumosclerosis, but it can also occur in patients with acute diseases accompanied by the exclusion of a large mass of the lungs from breathing (pneumonia, pleurisy). Recently, acute distress syndrome in adults has been specifically identified.

Adult respiratory distress syndrome is the most common cause of acute respiratory failure with severe hypoxemia, developing in a person with previously normal lungs due to the rapid accumulation of fluid in the lung tissue at normal pressure in the pulmonary capillaries and a sharply increasing permeability of the alveolar-capillary membranes. This condition is caused by the membrane-damaging influence of toxins and other agents (medicines, especially narcotics, toxic products formed during uremia), heroin, aspirated stomach contents, water (drowning), excessive formation of oxidants, trauma, sepsis caused by gram-negative bacteria, fat embolism, acute pancreatitis, inhalation of smoky or hot air, trauma to the central nervous system, and, apparently, a direct effect on the alveolar membrane of the virus. As a result, lung compliance and gas exchange are impaired.

Acute respiratory failure develops very quickly. Shortness of breath appears and quickly intensifies. Additional muscles are involved in the work, a picture of non-cardiogenic pulmonary edema develops, and a mass of moist rales of various sizes is heard. X-ray reveals a picture of interstitial and alveolar pulmonary edema (diffuse infiltrative changes in the form of “white shutdown” of the pulmonary fields). Signs of respiratory failure with hypoxemia and then hypercapnia increase, fatal heart failure intensifies, disseminated intravascular coagulation (DIC) and infection are possible, which makes the prognosis very difficult.

Systemic syndromes

Systemic paraneoplastic syndromes are manifested by large-scale damage to the body, which affects various organs and systems. The most common manifestations of lung cancer are the following:

1. Cachexia is a depletion of the body's resources. It manifests itself as a rapid decrease in body weight, which is accompanied by a weakening of the nervous and muscular systems. Cachexia is caused by metabolic disorders and a lack of oxygen and nutrients in the tissues. has a detrimental effect on the functioning of the entire organism, gradually causing disturbances in the functioning of various organs that are incompatible with life. To date, exhaustion is the cause of approximately 35% of deaths in patients with cancer of the respiratory tract. The main reason for the development of cachexia is general intoxication of the body during the breakdown of tumor products.
2. Systemic lupus erythematosus is a pathology of the immune system, causing an autoaggression reaction of T and B lymphocytes and the formation of antibodies to the patient’s own cells. The development of lupus can be caused by exposure of the patient to a growing tumor and metastases, taking cytostatic drugs, or penetration of various bacteria and viruses into the tissue. Manifested by damage to blood vessels and connective tissue. The patient develops a rash on the nose and cheeks, peeling of the skin, trophic ulcers, and impaired blood flow in the vessels of the extremities.
3. Orthostatic hypotension is a pathological syndrome that manifests itself with a sharp decrease in blood pressure if the patient tries to assume an upright position. The decrease in indicators is more than 20 mm Hg. Art. The disease is caused by disruption of normal blood flow in the human body and oxygen deficiency in tissues and organs, including the brain.
4. Nonbacterial thrombotic endocarditis is a pathology also called cachetic endocarditis. This disorder develops in people with cancer due to the deposition of proteins and platelets on the valves of the heart and blood vessels. Such disturbances lead to thrombosis and severe disruption of the circulatory system.

Skin syndromes

Skin lesions develop for several reasons. The most common factor that provokes the appearance of various pathologies of the epidermis is the toxic effect of malignant neoplasms and cytostatic drugs on the human body. All this weakens the body’s protective functions and allows various fungi, bacteria and viruses to infect the patient’s skin and epithelium.

Patients with lung carcinoma experience the following syndromes:

hypertrichosis - excessive hair growth throughout the body;

dermatomyositis - inflammatory pathology of connective tissue;

acanthosis - roughening of the skin at the site of the lesion;

hypertrophic pulmonary osteoarthropathy - a lesion leading to deformation of bones and joints;

vasculitis is a secondary inflammation of blood vessels.

Hematological syndromes

Circulatory disorders in patients with cancer develop quite quickly and can appear already at stages I-II of the pathology. This is caused by the sharp negative impact of carcinoma on the functioning of the hematopoietic organs and disruption of the full functioning of the lungs, which causes oxygen starvation of all systems of the human body. Patients with lung cancer exhibit a number of pathological symptoms:

thrombocytopenic purpura - increased bleeding, leading to the appearance of hemorrhages under the skin;

• myloidosis - a disorder of protein metabolism;

  hypercoagulation - increased blood clotting function;

  leukemoid reaction - various changes in the leukocyte formula.

Neurological syndromes

Neurological paraneoplastic syndromes develop due to damage to the central or peripheral nervous system. They arise due to trophic disturbances or due to the growth of metastases in the spinal cord or brain, which is quite often observed in pulmonary carcinomatosis. Patients experience the following disorders:

peripheral neuropathy - damage to the peripheral nerves leading to impaired mobility;

Lampert-Eaton myasthenic syndrome - muscle weakness and atrophy;

necrotizing myelopathy - necrosis of the spinal cord leading to paralysis;

cerebral encephalopathy - brain damage;

loss of vision.

Treatment

Before starting treatment, a diagnosis is carried out to determine the rate of development of the process and other nuances that indicate the patient’s health status. At the initial stage, since therapy involves new drugs, they are used in minimal dosages. Oncologists try to limit themselves to medications, because in this case the risk of new injuries is minimized and the disease progresses more easily.

However, in some cases, when a segment is damaged, a biopsy, radiation, and an ASD drug are used. It is recommended not to use more than 2-3 methods at the initial stage, because this can cause serious harm to the body and provoke syndromes . With a normal start of treatment, the following results will be achieved:

normalization of the respiratory process and elimination of the forced formation of shortness of breath;

relief from unpleasant and painful sensations in the bronchi and pulmonary parenchyma;

stabilization of temperature indicators, which leads to normalization at the initial stage and eliminates negative symptoms and signs.

In order for lung cancer treatment to be effective and the results to last for a long time, it is necessary to constantly consult with an oncologist and carry out diagnostic examinations. This will allow you not only to know everything about how the process develops, but also to determine the time of formation and how long this period will last. If initial treatment for lung cancer is not effective, therapy will be needed in subsequent stages.

For lung cancer, treatment methods can be of several types.

Surgical intervention

This is the most effective method, which is shown only in stages 1 and 2. The following types are divided:

Radical- the primary tumor focus and regional lymph nodes must be removed;

Palliative- aimed at maintaining the patient's condition.

Consists of the following stages:

General strengthening procedures to prepare the patient for surgery - taking vitamin complexes, a protein diet, taking antibiotics to reduce the inflammatory process and performing therapeutic bronchoscopy. In case of cardiovascular failure, medications are prescribed that increase the tone of blood vessels and breathing exercises;

During the postoperative period, the patient should be provided with constant access to oxygen. For the first 2-3 days, lying down and aspiration from the pleural cavity are indicated;

When the patient recovers, he is prescribed taking medications to prevent complications.

For inoperable forms, remote gamma therapy (radiation therapy) and courses of chemotherapy are indicated.

The lesions are directly irradiated, and the doses do not exceed 50-70 Gy. The consequences of radiation therapy are hair loss, nausea, pain and skin rashes. Chemotherapy is used before and after surgery, as well as in the presence of inoperable tumors that are accompanied by damage to the lymph nodes.

Acts in the following areas:

reducing the size of metastases;

weakening of symptoms if it is impossible to remove foci of inflammation;

destruction of cells and affected tissues that were not removed during resection.

Chemotherapy is of the following types:

therapeutic - to reduce metastases;

adjuvant - used for prophylactic purposes to prevent relapse;

inadequate - immediately before surgery to reduce tumors. It also helps to identify the level of sensitivity of cells to drug treatment and establish its effectiveness.

Chemotherapy

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

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

Relatively recently introduced into practical use:

hormonal treatments;

immunological (cytokinetic) methods of combating lung cancer.

Their limited use is due to the complexity of hormonal correction of certain forms of cancer. Immunotherapy and targeted therapy do not effectively fight cancer in an immune-compromised body.

Promising Treatments

Treatment of lung cancer mainly involves surgery. Depending on the size and stage of development, radical or palliative operations are performed. In this case, not only the tumor is usually removed, but also regional lymph nodes and adjacent tissue. In some situations, a lobectomy, aimed at removing a lobe of the lung, or a pneumonectomy, which involves surgical removal of the entire lung, is indicated.

However, it is impossible to imagine treating lung cancer without the use of chemotherapy. Israeli specialists use not only traditional methods of administering medications, but also innovative developments to help their patients. One of them is the procedure of inhalation of cytostatic substances, which provides the most effective effect on the tumor. The new chemotherapy technology used in Israel already offers excellent prospects for improving the effectiveness of lung cancer treatment. The inhalation method of administering cytostatics makes it possible to significantly reduce the severity of side effects, which are often unbearable for patients and force them to stop treatment. That is why a recent discovery in the field of experimental nanomedicine could lead to a real breakthrough in the field of cancer treatment in Israeli clinics. Replacing the traditional intravenous route of administering cytostatics with inhalation is the key to overcoming the problem of side effects of these drugs.

The groundbreaking research used chemotherapy and interferon-based drugs to make atypical cancer cells more sensitive. The drugs were inhaled in the form of nanoparticles, the sizes of which approached the parameters of individual molecules. This administration of the drug allowed the substance to enter directly into the lungs, bypassing the liver, kidneys, and spleen. Thus, the severity of side effects became minimal. This therapy option is much safer for the patient, but at the same time shows excellent results. This can be explained by the fact that the nanoparticles of the drug attach directly to the surface of the tumor cell and increase its sensitivity to the effects of chemotherapy.

It is expected that the new method will find wide application in clinical practice, because today, despite the amazing successes of Israeli surgeons, treatment of lung cancer is impossible to imagine without chemotherapy. However, the biggest problem in its implementation continues to be the severe side effects of most drugs. Fortunately, these difficulties can now be easily resolved.

To treat lung tumors in Israel, multimodal therapy is used, which combines several effective techniques. The specialist’s goal is to completely eliminate the tumor in a given patient and control the course of the disease. Traditionally, surgery, radiation, and chemotherapy are used to treat cancer. However, Israeli doctors constantly use innovative approaches to helping patients, for example, gene, photodynamic, and immune therapy. As a result, it is possible to significantly improve the survival rate and quality of life of patients with lung tumors. Among Israeli doctors, the most effective treatment using surgery, treatment and chemotherapy is considered to be trimodal therapy.

In practice, doctors began to use a combination of different techniques when they discovered that most patients do not have very good survival rates with monotherapy. The use of a combination of techniques made it possible to enhance the positive dynamics. The best results were obtained by combining extrapleural pneumonectomy with radiation and chemotherapy. As a result, the five-year survival rate of patients increased to 45%. In addition, the frequency of detection of metastases in the lymph nodes decreased significantly. Over time, doctors became even more convinced of the effectiveness of the new method.

When developing a multimodal therapy plan, doctors take into account the stage of cancer development, its histological subtype, the degree of involvement of lymph nodes in the pathological process, the general condition of the patient, the potential toxicity of treatment and possible complications. Specific combinations of treatment methods are recommended depending on the characteristics of each clinical situation. If a patient responds poorly to treatment, doctors make the necessary adjustments and achieve improvement.

Radiation therapy

One of the main methods of combating malignant neoplasms is the treatment of lung cancer with radiation therapy. The advantages of this method are its effectiveness and safety.

Radiation therapy, also called radiotherapy, is based on the use of high-energy radiation to fight cancer. This. Currently a common technique used by radiation oncologists to completely get rid of the disease, relieve pain and symptoms caused by the tumor.

Irradiation of a cancer tumor disrupts the reproductive functions of cells, that is, they do not multiply.

Radiation therapy kills cancer cells by interfering with their DNA structure, resulting in their inability to grow and reproduce. Today, radiotherapy is an effective method of combating tumors.

The sensitivity of tumor cells to radiation is explained by:

Dividing speed (faster than healthy cells);

Inability to repair damage.

Radiotherapy for this type of disease is the most used method of combating the tumor, both as an independent method and simultaneously with chemotherapy.

In oncology clinics, this treatment is used before or after surgery. A course of radiation therapy may be prescribed after chemotherapy to prevent brain metastases.

The effects of radiotherapy in combination with other methods can overcome small cell cancer, but have side effects.

Methods of using radiation therapy

Radiation therapy for lung cancer can be used for the following purposes:

• As the main treatment method when localized lung cancer is detected.
• To reduce the size of a cancerous tumor before surgery.
• To eliminate traces of cancer after surgery.
• To destroy cancer metastases that have spread to the brain and other internal organs.

According to these criteria, radiation therapy for lung cancer is divided into two main types, depending on the degree of its effect on the body:

• Radical radiation therapy. Used to completely destroy cancer cells. Typically used in the early stages of the disease or in cases of radiosensitive cancers. For a full course of treatment, it is necessary to attend radiation therapy sessions every day for several days - usually the duration of treatment is up to two weeks.
• Non-radical radiation therapy for lung cancer is used to prevent the growth of cancer, and also, in some cases, to save the patient’s life - for example, when a tumor can block the respiratory tract or destroy the lung. For such therapy, one or several sessions are enough.

Types of radiotherapy

For radiation treatment of lung cancer, the following main types are usually used:

• Remote (external). The radiation source in this case is located at a short distance from the patient, and the rays are projected to the expected location of the tumor;
• Internal radiotherapy. The radiation source is in contact with the cancerous tumor;
• Systemic radiotherapy. It involves irradiation of the whole body and is used when there is a suspicion of associated cancerous bleeding of the blood.

Chemotherapy for lung cancer today is one of the most popular procedures. The fact is that lung cancer is the leading cause of death in the world.

Often this disease affects older people. Diagnosing the problem at an early stage can help resolve the problem. Proper use of diagnostic measures and effective treatment provide a good chance of recovery.

Indications for chemotherapy for lung cancer

Indications for chemotherapy for lung cancer directly depend on the disease itself and its stage. There are a number of factors that influence this. First of all, attention is paid to the size of the tumor, stage of development, growth rate, degree of differentiation, expression, degree of metastasis and involvement of regional lymph nodes, as well as hormonal status.

The individual characteristics of the organism also play a special role. These include age, the presence of chronic diseases, the location of the malignant cancer, as well as the condition of regional lymph nodes and general health.

The doctor always evaluates the risks and complications that treatment may cause. Based on all these factors, the main indications for chemotherapy are given. Basically, this procedure is recommended for people with cancer, leukemia, rhabdomyosarcoma, hemoblastosis, chorionic carcinoma and others. Chemotherapy for lung cancer is a chance for recovery.

The effectiveness of chemotherapy for lung cancer

The effectiveness of chemotherapy for lung cancer is quite high. But for the treatment to really give a positive result, complex combinations must be carried out. The effectiveness of modern treatment methods is in no way related to the severity of side effects. Success during treatment depends on a lot. Thus, the stage of the disease and the period when it was diagnosed play an important role.

The use of medicinal plants in the treatment of disease

In folk medicine there are a sufficient number of plants that have antitumor properties. Moreover, some plants exist in several botanical species. For example, thistle can be vegetable, field and multi-leaved. This plant contains a large amount of rubber, alkaloids, tannins, flavonoids, and essential oil. For lung cancer, a prepared infusion of bergenia is taken orally. To do this, the leaves and tops of the plant on which the flowers are located are collected, dried and crushed. For those who do not have the opportunity to collect herbs, there is an alternative option - to purchase a ready-made collection. To prepare a decoction, you need to add three tablespoons of dry herb to 500 ml of plain water and simmer over low heat for five minutes. The container with the broth should be wrapped and allowed to brew for about two hours. The infusion is consumed four times a day, half a glass thirty minutes before meals. This remedy is used to treat lung cancer and helps stop coughing up blood.

There are plants with very strong effects, so long-term use of decoctions and infusions is not recommended. This applies to creeping thyme. You should brew one tablespoon of herb in a glass of boiling water. The decoction is infused for an hour, while the container must be closed. Take one tablespoon at least four times a day

For preventive and therapeutic purposes, plantain of the large and lanceolate species is used for lung cancer. The plant grows throughout Eurasia and its healing properties have been known since ancient times. First of all, plantain helps to increase immunity, the level of hemoglobin in the blood, thinning sputum, and eliminating harmful organisms from the upper respiratory tract. The use of plantain has a huge effect during human infection with bacteria such as Pseudomonas aeruginosa. The infusion is prepared simply; for this, take a tablespoon of the dried plant and brew it with a glass of boiling water. The product should sit for three hours. Drink one tablespoon of decoction 20 minutes before meals four times a day.

Traditional medicine is rich in another antitumor and hemostatic plant. This is gray wormwood, from which decoctions are also prepared. For one glass of boiling water, take one teaspoon of dry crushed plant. It takes two hours to infuse, then strain the broth and drink two tablespoons before meals at breakfast, lunch and dinner.

One of the leading causes of death in the world is lung cancer, the symptoms of which vary depending on the stage of the disease. The development of a cancerous tumor is promoted by both external factors and internal causes. But, regardless of the treatment, the likelihood of recovery remains low.

Lung cancer is a malignant tumor that develops from the mucous membrane and glandular tissue of the lungs and bronchi. Men are more susceptible to this disease than women, and it has been noted that the older the men, the higher the incidence rate. The risk group includes men with dark skin color.

Symptoms and signs

Symptoms characterizing the development of a cancerous tumor in the lungs are divided into two categories: general and specific.

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• general weakness of the body;
• deterioration or loss of appetite;
• rapid weight loss;
• sweating;
• causeless change of mood;
• development of depression;
• increase in body temperature.

• causeless cough, which can last for some period, exhausting the patient. The nature of the cough may gradually change, become more frequent and prolonged, and be accompanied by sputum production.

A cough can appear spontaneously: it is enough to breathe in cold air, experience prolonged physical activity, or simply walk at a brisk pace.

• dyspnea also indicates changes present in the lungs. It is associated with a narrowing of the lumen of the bronchi, impaired ventilation (atelectasis), developed pneumonia, partial or significant impairment of gas exchange in the lungs.

In the later stages of the disease, atelectasis (impaired ventilation) of the entire lung and its failure may occur.

• hemoptysis, which is a characteristic sign of the presence of lung cancer. The quality of the bloody discharge may vary: it may be active bleeding or the discharge of dark blood clots. It depends on the stage of the disease, the shape and histological features of the tumor.

In some cases, hemoptysis may indicate the development of pulmonary tuberculosis or bronchiectasis. Often heavy and prolonged bleeding leads to death.

• chest pain, which is evidence of tumor growth into the pleura, later into bone tissue and nerve endings. This process is accompanied by characteristic unbearable pain in the chest area.

With some forms of lung cancer, there are no early symptoms of the disease. This significantly complicates the detection and diagnosis of tumors in the early stages. This means they reduce the patient’s chance of recovery.

Video: Unusual signs of lung cancer

Stages of lung cancer

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

However, the duration of any stage is purely individual for each patient. This depends on the size of the tumor and the presence of metastases, as well as on the speed of the disease.

Regardless of these features, there are clear criteria by which one or another stage of the disease is determined. Moreover, the classification of lung cancer is only suitable for non-small cell cancer.

Non-small cell cancer of the left lung, as well as the right, begins its development long before the tumor is visualized.

Hidden stage. At this stage, the presence of cancer cells can only be determined after analysis of sputum or water obtained as a result of bronchoscopy.

Zero stage (0). Cancer cells are detected only in the inner lining of the lung. This stage is characterized as non-invasive cancer.

First stage (1). Symptoms of stage 1 lung cancer are divided into two substages, which are characterized by distinctive features.

1A. The tumor, increasing in size (up to 3 cm), grows into the internal tissues of the lung. This formation is surrounded by healthy tissue, and the lymph nodes and bronchi are not yet affected.

1B. The tumor, increasing in size, grows deeper and deeper, without affecting the lymph nodes. In this case, the size of the cancer exceeds 3 cm and grows into the pleura or spreads to the bronchi.

Second stage (2).Symptoms appear more clearly: shortness of breath, cough with blood in the sputum, noise when breathing, pain.

2A. The tumor measures 5-7 cm without affecting the lymph nodes, or the size remains within 5 cm, but the tumor metastasizes to the lymph nodes;

2B. The size of the tumor is within 7 cm, however, it borders on the lymph nodes, or the size remains within 5 cm, but the tumor affects the pleura, lymph nodes, and cardiac membrane.

Third stage (3). Symptoms of stage 3 lung cancer are characterized by the following features. The process of damage involves the pleura, sternum wall, and lymph nodes. Metastases spread to the vessels, trachea, esophagus, spinal column, and heart.

3A. The tumor exceeds 7 cm, metastasizes to the lymph nodes of the mediastinum, pleura, diaphragm, or causes complications in the lymph nodes near the heart and complicates the respiratory process.

3B. Tumor cells spread to the pericardium, mediastinum, clavicle, or grow into the lymph nodes of the side opposite the sternum.

Fourth stage (4). The terminal stage, in which severe irreversible processes occur, in which distant systems and organs are involved. The disease takes on a severe, incurable form.

Small cell lung cancer, which develops rapidly and affects the body in a short time, is characterized by only 2 stages of development:

• limited stage, when cancer cells are localized in one lung and tissues located in close proximity.
• extensive or extensive stage when the tumor metastasizes to areas outside the lung and to distant organs.

Metastases

Metastases are commonly called secondary tumor nodes that spread to distant and adjacent organs and systems.

Metastases have a more destructive effect on the body than a cancerous tumor.

Metastases spread by lymphogenous, hematogenous or implantation routes. The spread of metastases in most cases outpaces the development of the tumor itself, which significantly reduces the success of lung cancer treatment. For some forms of cancer
metastases appear in the early stages.

Metastases have certain stages of development. The initial stage involves the appearance of metastases in close proximity to the primary tumor. During development, metastases move to more distant areas of the body.

The last stage of metastasis development poses a danger to the patient’s life, since cancer tumors, moving, acquire new properties.

Photo: Stages of lung cancer with metastases

Treatment

Modern medicine has advanced methods of treating cancer, including lung cancer. The treatment tactics are chosen by the attending physician based on the medical history, and subsequently on the results of the examination.

The treatment regimen includes the integrated use of methods for diagnosing and treating lung cancer.

It should be noted that the traditional and only reliable method of treatment, which leaves hope for recovery, is surgical treatment.

Surgery involves surgery to remove the entire cancerous tumor or a separate segment of it. This method is used when non-small cell lung cancer develops.

For small cell cancer, other, more effective methods are used. At earlier stages, it is possible to use more gentle methods of therapy, including radiotherapy (radiation therapy) and chemotherapy.

About what the diet should be during chemotherapy for lung cancer.

Radiation therapy involves irradiating cancer cells with a powerful beam of gamma rays. As a result of this process, cancer cells die or they stop their growth and reproduction. This method is the most common for both forms of lung cancer. Radiotherapy can stop stage 3 squamous cell lung cancer, as well as small cell cancer.

Chemotherapy involves the use of special drugs that can stop or destroy cancer cells in both the initial and later stages.

The group of drugs includes such drugs as:

• "Doxorubicin";
• "5fluorouracil";
• "Metatrixat";
• Bevacizumab.

Chemotherapy is the only therapeutic method that can prolong the patient’s life and alleviate his suffering.

Video: How to treat lung cancer

Forecast

The prognosis for the development of lung cancer directly depends on the stage of the disease and on the histological features of the cancer tumor. However, with complete absence of treatment within two years, the mortality rate among patients reaches 90%.

In the case of the development of small cell cancer, the prognosis is more comforting than in the case of non-small cell cancer. This is due to the high sensitivity of cancer cells of this form of tumor to treatment with chemotherapy and radiation therapy.

A favorable prognosis is possible only after treatment of stage 1 and 2 non-small cell lung cancer. At later stages, in stages 3 and 4, the disease is incurable, and the survival rate of patients is only about 10%. It is not without reason that they say that preventing a disease is easier than treating it.

Timely diagnosis of lung cancer in the early stages makes it possible to cure this terrible disease.

One of the leading causes of death in the world is lung cancer, the symptoms of which vary depending on the stage of the disease. The development of a cancerous tumor is promoted by both external factors and internal causes. But, regardless of the treatment, the likelihood of recovery remains low.

Lung cancer is a malignant tumor that develops from the mucous membrane and glandular tissue of the lungs and bronchi. Men are more susceptible to this disease than women, and it has been noted that the older the men, the higher the incidence rate. The risk group includes men with dark skin color.

Symptoms characterizing the development of a cancerous tumor in the lungs are divided into two categories: general and specific.

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• general weakness of the body;
• deterioration or loss of appetite;
• rapid weight loss;
• sweating;
• causeless change of mood;
• development of depression;
• increase in body temperature.

• an unreasonable cough that can last for some period, exhausting the patient. The nature of the cough may gradually change, become more frequent and prolonged, and be accompanied by sputum production.

A cough can appear spontaneously: it is enough to breathe in cold air, experience prolonged physical activity, or simply walk at a brisk pace.

• shortness of breath also indicates changes present in the lungs. It is associated with a narrowing of the lumen of the bronchi, impaired ventilation (atelectasis), developed pneumonia, partial or significant impairment of gas exchange in the lungs.

In the later stages of the disease, atelectasis (impaired ventilation) of the entire lung and its failure may occur.

• hemoptysis, which is a characteristic sign of lung cancer. The quality of the bloody discharge may vary: it may be active bleeding or the discharge of dark blood clots. It depends on the stage of the disease, the shape and histological features of the tumor.

In some cases, hemoptysis may indicate the development of pulmonary tuberculosis or bronchiectasis. Often heavy and prolonged bleeding leads to death.

• pain behind the sternum, which is evidence of tumor growth into the pleura, later into bone tissue and nerve endings. This process is accompanied by characteristic unbearable pain in the chest area.

With some forms of lung cancer, there are no early symptoms of the disease. This significantly complicates the detection and diagnosis of tumors in the early stages. This means they reduce the patient’s chance of recovery.

: Unusual signs of lung cancer

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

However, the duration of any stage is purely individual for each patient. This depends on the size of the tumor and the presence of metastases, as well as on the speed of the disease.

Regardless of these features, there are clear criteria by which one or another stage of the disease is determined. Moreover, the classification of lung cancer is only suitable for non-small cell cancer.

Non-small cell cancer of the left lung, as well as the right, begins its development long before the tumor is visualized.

Hidden stage. At this stage, the presence of cancer cells can only be determined after analysis of sputum or water obtained as a result of bronchoscopy.

Zero stage (0). Cancer cells are detected only in the inner lining of the lung. This stage is characterized as non-invasive cancer.

First stage (1). Symptoms of stage 1 lung cancer are divided into two substages, which are characterized by distinctive features.

1A. The tumor, increasing in size (up to 3 cm), grows into the internal tissues of the lung. This formation is surrounded by healthy tissue, and the lymph nodes and bronchi are not yet affected.

1B. The tumor, increasing in size, grows deeper and deeper, without affecting the lymph nodes. In this case, the size of the cancer exceeds 3 cm and grows into the pleura or spreads to the bronchi.

Second stage (2).Symptoms appear more clearly: shortness of breath, cough with blood in the sputum, noise when breathing, pain.

2A. The tumor measures 5-7 cm without affecting the lymph nodes, or the size remains within 5 cm, but the tumor metastasizes to the lymph nodes;

2B. The size of the tumor is within 7 cm, however, it borders on the lymph nodes, or the size remains within 5 cm, but the tumor affects the pleura, lymph nodes, and cardiac membrane.

Third stage (3). Symptoms of stage 3 lung cancer are characterized by the following features. The process of damage involves the pleura, sternum wall, and lymph nodes. Metastases spread to the vessels, trachea, esophagus, spinal column, and heart.

3A. The tumor exceeds 7 cm, metastasizes to the lymph nodes of the mediastinum, pleura, diaphragm, or causes complications in the lymph nodes near the heart and complicates the respiratory process.

3B. Tumor cells spread to the pericardium, mediastinum, clavicle, or grow into the lymph nodes of the side opposite the sternum.

Fourth stage (4). The terminal stage, in which severe irreversible processes occur, in which distant systems and organs are involved. The disease takes on a severe, incurable form.

Small cell lung cancer, which develops rapidly and affects the body in a short time, is characterized by only 2 stages of development:

• limited stage, when cancer cells are localized in one lung and tissues located in close proximity.
• extensive or extensive stage when the tumor metastasizes to areas outside the lung and to distant organs.

Metastases

Metastases are commonly called secondary tumor nodes that spread to distant and adjacent organs and systems.

Metastases have a more destructive effect on the body than a cancerous tumor.

Metastases spread by lymphogenous, hematogenous or implantation routes. The spread of metastases in most cases outpaces the development of the tumor itself, which significantly reduces the success of lung cancer treatment. For some forms of cancer
metastases appear in the early stages.

Metastases have certain stages of development. The initial stage involves the appearance of metastases in close proximity to the primary tumor. During development, metastases move to more distant areas of the body.

The last stage of metastasis development poses a danger to the patient’s life, since cancer tumors, moving, acquire new properties.

Stages of lung cancer with metastases

Treatment

Modern medicine has advanced methods of treating cancer, including lung cancer. The treatment tactics are chosen by the attending physician based on the medical history, and subsequently on the results of the examination.

The treatment regimen includes the integrated use of methods for diagnosing and treating lung cancer.

It should be noted that the traditional and only reliable method of treatment, which leaves hope for recovery, is surgical treatment.

Surgery involves surgery to remove the entire cancerous tumor or a separate segment of it. This method is used when non-small cell lung cancer develops.

For small cell cancer, other, more effective methods are used. At earlier stages, it is possible to use more gentle methods of therapy, including radiotherapy (radiation therapy) and chemotherapy.

Radiation therapy involves irradiating cancer cells with a powerful beam of gamma rays.

As a result of this process, cancer cells die or they stop their growth and reproduction. This method is the most common for both forms of lung cancer.

Radiotherapy can stop stage 3 squamous cell lung cancer, as well as small cell cancer.

Chemotherapy involves the use of special drugs that can stop or destroy cancer cells in both the initial and later stages.

The group of drugs includes such drugs as:

• "Doxorubicin";
• "5fluorouracil";
• "Metatrixat";
• Bevacizumab.

Chemotherapy is the only therapeutic method that can prolong the patient’s life and alleviate his suffering.

: How to treat lung cancer

Forecast

The prognosis for the development of lung cancer directly depends on the stage of the disease and on the histological features of the cancer tumor. However, with complete absence of treatment within two years, the mortality rate among patients reaches 90%.

In the case of the development of small cell cancer, the prognosis is more comforting than in the case of non-small cell cancer. This is due to the high sensitivity of cancer cells of this form of tumor to treatment with chemotherapy and radiation therapy.

A favorable prognosis is possible only after treatment of stage 1 and 2 non-small cell lung cancer. At later stages, in stages 3 and 4, the disease is incurable, and the survival rate of patients is only about 10%. It is not without reason that they say that preventing a disease is easier than treating it.

Timely diagnosis of lung cancer in the early stages makes it possible to cure this terrible disease.

Source: http://rak.hvatit-bolet.ru/vid/rak-legkih/stadii-raka-legkih.html

Cancer stage is a measure of how far a tumor has spread in the body. When determining the stage of lung cancer, the size of the tumor and its invasion of surrounding tissues, as well as the presence or absence of metastases in the lymph nodes or other organs, are taken into account.

How many stages of lung cancer are there? There are 4 stages of lung cancer:

The first stages of lung cancer are divided into a and b depending on the size of the tumor node:

– For lung cancer stage 1a, the size of the tumor node does not exceed 3 cm in diameter.

– For lung cancer stage 1b, the size of the tumor node in diameter can reach 5 cm.

First stage of lung cancer is the most favorable stage. If Lung cancer detected at the first stage, the patient’s chance of complete recovery is more than 80%.

At an early stage of lung cancer the tumor is minimal in size. It is because of this that in the first stage of lung cancer there may be no symptoms of the disease. Also, in the first stage of lung cancer, there are no metastases in the lymph nodes and other organs. If you are at risk and have a history of lung cancer in your family, you should rule out risk factors for lung cancer and undergo annual screenings, including a chest x-ray and blood tests.
In the second stage of lung cancer, the tumor node reaches a size of more than five centimeters in diameter. Also, at the second stage of lung cancer, the first symptoms of the disease begin to appear: cough with sputum, chest discomfort, increased body temperature. Patients often complain of lack of air and may begin to lose weight.

Second stage of lung cancer is divided into several types:

– stage 2a lung cancer suggests the presence of a tumor node measuring about 5 cm.

– stage 2b lung cancer suggests the presence of a tumor node measuring about 7 cm, but the tumor has not yet affected the lymph nodes. It is possible for a tumor to grow into tissue near the lung.

Second stage of lung cancer suggests a lower survival rate compared to the first: this is about a third of all patients. Competent treatment can extend the patient’s life to 5-8 years. Small cell lung cancer of the second stage sharply reduces the chances of a favorable outcome of treatment: the survival rate in this case is only 18%.

On second stage lung cancer just like the first, metastasis to distant lymph nodes and distant organs has not yet occurred.

In the third stage of lung cancer The most pronounced symptoms of the disease appear: pain in the chest, hacking cough, coughing up sputum with blood.

To alleviate the patient’s condition, at the third stage of lung cancer it is prescribed symptomatic therapy, various antitussives.

The third stage of lung cancer is divided into two options:

– Stage 3a lung cancer characterized by the presence of a tumor node measuring more than 7 cm. The cancer has already affected the lymph nodes near the lung where the tumor is located. Besides, at the third stage of lung cancer the tumor can grow into the organs closest to the lung: chest, pleura, trachea, blood vessels located near the heart muscle.

– Stage 3b lung cancer suggests the presence of a neoplasm larger than 7 cm in diameter, which affects not only the lymph nodes, but also the walls of the lung. Sometimes metastases can reach the heart muscle, which can lead to the development of pericarditis.

Survival rate per third stage lung cancer small. Only 20% of the total number of patients live more than 5 years. At the third stage of lung cancer, cure is almost impossible, and all therapeutic actions are aimed at prolonging the patient’s life.

Stage four lung cancer is the most advanced stage of the disease
At stage 4 lung cancer the most pronounced symptoms of the disease appear. Significant shortness of breath, severe chest pain, cough, and body temperature rise to 38 degrees. For stage 4 lung cancer the patient can lose significant weight in a short time. Stage 4 lung cancer means that the tumor can no longer be treated surgically and in most cases chemotherapy, or immunotherapy and targeted therapy are prescribed. These treatments for stage four lung cancer provide an impact on all tumor foci scattered throughout the body.
Stage 4 lung cancer, the tumor node measures more than 7 centimeters, and it affects organs close to the lung.

Stage four lung cancer characterized by damage to the lymph nodes and the presence of metastases to distant organs (liver, adrenal gland), as well as metastases to the second lung.

In the fourth stage of lung cancer The prognosis, unfortunately, is unfavorable. Only about 5% of all patients with stage 4 lung cancer survive the 5-year survival threshold.

Source: http://worldofoncology.com/materialy/vidy-raka/vidy-raka-ot-a-do-ya/rak-legkogo/stadii-raka-legkikh/

Lung cancer is a malignant neoplasm, the source of which is the cells of the mucous membrane and glandular cells of the bronchi and lungs. Every year hundreds of thousands of people around the world die from this pathology. According to statistics, men are more likely to get sick; the risk of this cancer is increased in people who work for a long time in hazardous industries and in smokers.

Treatment of stage 3 lung cancer is possible, but antitumor therapy in this case requires a much greater investment of effort in order to have a positive result.

The current survival criterion is how many patients with a certain cancer pathology survive for at least five years.

Of course, this figure is higher at stages 1 and 2, but patients with stage 3 cancer may well overcome this disease.

Clinical manifestations

The clinical picture of this disease includes both general, nonspecific symptoms and those characteristic only of lung cancer. Common ones include:

• Malaise, weakness;
• Loss of appetite, weight loss;
• Frequent mood swings, depression;
• Regular increase in body temperature, sweating.

Specific symptoms of cancer include:

• A prolonged, causeless cough, which debilitates the patient, may be accompanied by sputum, including sputum mixed with blood;
• Shortness of breath - associated with a decrease in the lumen of the bronchi, the addition of inflammation, and impaired gas exchange in the lung tissue;
• Pain in the chest, especially behind the sternum.

The third symptom is a very ominous sign, which indicates that the tumor has begun to grow into the pleura and surrounding tissues. Lung tissue does not contain nerve endings, so pain appears in the later stages of the disease (stages 3-4).

Features of this disease

In total, there are five stages during the course of lung cancer - from 0 to 4, each of them has its own division into degrees.

The stage of the cancer process is determined by the size of the tumor and how widespread it is.

The degree shows how quickly the disease develops - this is determined by the rate of division of tumor cells. There are three degrees in total, and the higher it is, the faster the tumor develops.

Stage zero is placed at the very beginning of the tumor process; the first stage is characterized by the small size of the tumor, its diameter is no more than 5 mm, it does not spread to nearby lymph nodes and neighboring organs.

Stage 3 lung cancer has the following characteristics:

• Tumor cells spread to regional lymph nodes and neighboring organs;
• The tumor size exceeds 7 mm.

This tumor may be grade 1 or grade 2. In the first degree, the spread of the tumor is limited to regional lymph nodes and adjacent anatomical structures (pleura, bronchi, trachea, diaphragm). When a tumor grows into neighboring organs, it can invade, for example, it can penetrate the nearest lobe of the lung, bronchus or trachea.

The second degree is characterized by a larger area of ​​damage. Tumor cells spread to the lymph nodes located on the opposite side of the chest. A larger number of organs are affected - not only the diaphragm, but also the organs of the mediastinum; germination of the membranes of the heart is possible.

Thus, this stage is dangerous because neighboring organs may be affected. Because of this, the development of various life-threatening conditions is likely.

Treatment of stage 3 lung cancer

The choice of appropriate therapy for this stage of lung cancer depends on the course of the pathological process and, at the same time, on the general condition of the patient. All treatment measures are carried out by an oncologist. It is necessary to carry out complex treatment, which includes surgery, radiation therapy and chemotherapy.

Surgical treatment is based on the removal of tumor tissue, which may involve resection of a lobe of the lung, and in some cases the entire organ. Therapeutic tactics depend on how widespread the tumor process is.

Surgery is most often indicated for non-small cell lung cancer.

This is due to the fact that small cell cancer is characterized by the most aggressive growth, as a result of which surgical treatment is not effective enough, and chemotherapy and radiotherapy come to the fore.

Surgical treatment is also not indicated in cases where the tumor grows into nearby organs, the trachea and mediastinal organs are affected, or when the patient has severe somatic diseases that significantly worsen his general condition.

Radiation therapy is a treatment method that involves irradiating a tumor with ionizing rays, which leads to the death of cancer cells. Due to the nature of this method, the radiation dose cannot be too high, which is associated with possible side effects.

The modern CyberKnife technique (hypofractionated stereotactic radiotherapy) makes it possible to target a tumor with a high dose of radiation, which reduces the risk of unwanted effects and increases the likelihood for patients to live at least another five years.

The CyberKnife system automatically adapts to the patient's breathing movements, so he does not have to hold his breath during the procedure. The error of such adjustment does not exceed one millimeter. This is currently the best accuracy rate of any lung cancer treatment.

To detect this disease at an early stage, it is recommended to undergo a fluorographic examination annually. This is especially true for smokers, since they are most susceptible to developing this form of cancer.

Lifespan

Lung cancer stage 3. How long do such patients live on average?

Stage 1 is characterized by a five-year survival rate of 13% for small cell cancer and 20-25% for other types of lung cancer. In the case of second stage lung cancer, survival rate is no more than 10%.

Source: https://OnkoExpert.ru/legkie/rak-legkih-3-stadiya.html

When diagnosed with lung cancer, stages are critical in prognosis and choice of further treatment. Despite the fact that the development of the tumor process occurs gradually and evenly over time, division into stages plays an important role in all further aspects of patient management.

The development of the idea of ​​a staged process appeared with the understanding that patients who had localized forms of the tumor without metastases had higher prognostic chances of survival and recovery.

Classification of pathology

Based on observations of the development of the tumor process in people with different prevalence of pathology, conclusions were drawn that both prognosis and treatment play a secondary role. Timely diagnosis comes to the fore. Therefore, the first conditional classification of lung cancer by stages was adopted:

This classification had limited prognostic and practical significance, but to this day these definitions continue to be used: early stage of lung cancer or late.

Scientists and doctors of the former USSR developed a new classification of organ cancer, which is now actively used in parallel with other more modern systems. The most important sign on which the assignment of a tumor to one or another stage in this classification depends is the presence of metastases.

Classification consists of the following stages:

1. In its greatest dimension, carcinoma does not exceed 3 cm. It is localized in a single segment of the lung or within one segmental bronchus. There are no metastases.
2. The largest tumor size is less than 6 cm. It occupies one segment of the lung or within one segmental bronchus. Single metastases were found in the pulmonary or bronchial lymph nodes.
3. The size of the tumor is more than 6 cm. Spread to adjacent lobes of the lung or the presence of invasion of the segmental or main bronchus. Detection of metastases in the lymph nodes of the bifurcation of the trachea, bronchi and near the trachea.
4. The tumor spread beyond the lung with the development of pleurisy (inflammation of the layers of pleura enveloping the lungs) and pericarditis (inflammation of the pericardial sac with accumulation of fluid between its layers). Metastases are found in distant organs.

TNM - this abbreviation hides 3 Latin words: tumor - tumor, nodus - node, metastasis - metastasis. Section T describes the spread of the primary tumor.

Section N covers lymph node metastases. And section M is responsible for the presence or absence of distant metastases.

This classification is generally accepted throughout the world, approved by the World Health Organization and recommended for use in all countries.

When creating this classification, many goals were pursued, but the main one is to unify the definition of lung stages to enable the exchange of information between doctors and scientists from different countries. Today, in oncology, two classifications are simultaneously used and complement each other: domestic and TNM.

Manifestation of the disease at stages 1 and 2

Symptoms of lung cancer depend on the type of tumor cells, the location of the tumor, and the time that has passed since the abnormal cells appeared.

For example, stage 1 lung cancer is the most favorable in terms of cure, since the prognosis for life and recovery is the highest. However, the first stage of lung cancer virtually never has any external manifestations.

Especially if it is peripheral cancer - a tumor that is located in those parts of the lungs that do not have sensitive innervation.

Despite the fact that treatment is most effective at this stage, detection of such tumors remains very rare.

Central cancer may manifest itself somewhat earlier, since tumor cells develop from the epithelium of large bronchi.

Increasing in size, the tumor leads to irritation of the cough receptors, and the patient begins to complain of a constant, unrelieved dry cough. In this case, a person can seek help earlier and begin treatment faster.

In stage 2 lung cancer, when the tumor becomes larger, it begins to compress the surrounding tissues and grow into neighboring anatomical structures. But even such changes in the body can go unnoticed for a long time, especially when it comes to peripheral cancer.

What differences exist from other stages? In this case, the so-called paraneoplastic syndrome may be expressed, which is often perceived as manifestations of ARVI or influenza and appropriate treatment is prescribed.

These manifestations are very nonspecific.

Symptoms of stages 3 and 4

Stage 3 lung cancer is manifested by a cough with sputum production. It may contain blood impurities.

Over time, it becomes purulent, since the tumor disrupts the normal aeration of the deep parts of the lungs, resulting in a secondary bacterial infection with the development of pneumonia.

Stage 3 lung cancer is accompanied by severe intoxication, a constant increase in body temperature, which cannot be relieved by anything.

Due to the pressure of the tumor on surrounding organs and tissues, in the third degree, chest cavity mass syndrome may appear:

1. Due to compression of the nerve trunks at the apex of the lung, neurological symptoms appear in the form of impaired movement and sensitivity of the upper limb, which can be perceived as symptoms of a cerebrovascular accident, and the wrong treatment will be prescribed.
2. Due to pressure on the superior vena cava or its individual tributaries, stagnation occurs in this venous system, which is manifested by swelling of the superficial vessels of the neck, edema of the upper extremities and face.
3. Due to pressure on the heart, stage 3 lung cancer leads to cardiac symptoms. False diagnosis of pericarditis or myocarditis is possible.

With stage 4 lung cancer, the manifestations of the previous stage only worsen. Intoxication syndrome increases significantly.

Pain occurs not only in the chest, but also in distant parts of the body, where lung cancer can metastasize.

In addition, cancer cachexia develops - a condition when tumor cells use most of the body's nutrients, leaving nothing for healthy tissues.

How can medicine help?

Treatment for lung cancer depends on the stage of the disease. The most favorable in terms of the effectiveness of therapy are stages 1 and 2. Despite the difficulty of timely diagnosis, surgical treatment allows for complete recovery. Later stages are no longer always eliminated promptly.

At stage 3, greater importance is given to chemotherapy and radiation methods. At this stage of the disease, the prognosis is more serious and the chances of complete recovery are low. At the last stage, exclusively palliative therapy is used, aimed at reducing the patient’s suffering, limiting the growth of tumor cells and eliminating serious abnormalities in metabolism.

With cancer, the rule is especially true: prevention is much easier than treatment. Therefore, do not forget about regular preventive examinations and the dangers of smoking.