Tumors of the lungs and bronchi are traditionally considered together, uniting them under the name “bronchopulmonary cancer”.
There are two forms: central lung cancer, originating from the bronchus, and peripheral cancer, developing from the lung tissue itself.
1. The development of lung cancer may be preceded by chronic inflammatory processes (chronic pneumonia, bronchiectasis, chronic bronchitis, scars in the lung as a result of previous tuberculosis, etc.).
2. Smoking also plays a significant role, since, according to most statistics, lung cancer in smokers is observed much more often than in non-smokers. Thus, when smoking 2 or more packs of cigarettes a day, the frequency of lung cancer increases by 15–25 times.
3. Work in the asbestos industry.
The symptoms of the disease are different depending on where the primary tumor occurs – in the bronchus or in the lung tissue.
With central cancer (cancer of the bronchus), the disease traditionally begins with a dry, hacking cough, and then sputum appears, not often with an admixture of blood. Very characteristic of this form is the periodic causeless occurrence of inflammation of the lung, the so-called pneumonitis, accompanied by increased coughing, high fever, general weakness, and sometimes chest pains. The cause of the development of pneumonitis is a short-term blockage of the bronchus by a tumor due to associated inflammation.
In the future, the course of the disease becomes persistent: persistent cough, increasing weakness, fever and chest pain. Respiratory disturbances can be significant if the ventilation of a lung lobe or the entire lung is impaired.
For peripheral lung cancer, which develops in the lung tissue itself, the onset of the disease is almost asymptomatic. In the initial stage, the tumor is not often found by chance during a preventive examination of the diseased when performing a fluorogram or x-ray of the lung. Only with an increase in size, the addition of inflammation, or with the germination of a tumor of the bronchus or pleura (the membrane of the lung), there is a vivid symptomatology of severe pain, coughing with an increase in temperature.
In the advanced stage, due to the spread of the tumor into the cavity of the pleura (lung membrane), cancerous pleurisy (inflammation of the pleura) develops with accumulation of fluid, not often up to several liters, as a result of which, in addition to the above symptoms, shortness of breath appears.
In the early stages of the disease, an external examination of the patient does little to diagnose cancer.
With extensive damage to the lung tissue, shortness of breath, a grayish-pale complexion, weight loss, and weakness occur.
X-ray examination is the main method for detecting lung cancer. With central lung cancer, a shadow of the tumor is revealed on the radiograph, it is likely that a decrease in the airiness of the lung area is detected when the bronchus is blocked by a tumor. It is also possible to detect damage to the lymph nodes by tumor metastases. Any doubtful changes on the radiograph require additional examination.
The method related to X-ray examination – bronchography – allows you to detect the presence of a tumor in the bronchi, compression of the bronchus by a tumor.
Bronchoscopy is a method that is performed if a tumor is suspected in the bronchial tree, also to take material (biopsy) for morphological examination.
CT (X-ray computed tomography), MRI (magnetic resonance imaging, nuclear magnetic resonance imaging) are used to diagnose lung cancer if the diagnosis cannot be made by simpler methods or to clarify the prevalence of the process.
Also, under the control of CT, a puncture (puncture) of a lung tumor is likely to be performed to take cells for a morphological study (biopsy).
The final method of instrumental diagnosis is diagnostic thoracoscopy.
For a comprehensive examination of the patient, to exclude the presence of cancer metastases, ultrasound of the liver, CT scan of the brain, and examination of the bones of the skeleton (scintigraphy) are used.
A blood test does not give clear indicators of the presence of cancer, however, a decrease in hemoglobin and an increase in ESR cannot be ignored.
Determination of the level of oncomarkers (special blood indicators that increase in the presence of a malignant tumor in the body) is important, but is an addition to the main diagnostic methods and is used more often to control the treatment process.
It should be remembered that the detection of any, even a malignant disease at an early stage improves the prognosis of the upcoming treatment.
The choice of treatment depends on the type of cancer, its prevalence, the presence of metastases.
Usually, the treatment of lung cancer is complex and consists of a combination of surgical treatment, chemotherapy, and radiation therapy. The sequence or exclusion of any method is established depending on the type of tumor and the prevalence of the tumor process.
Depending on the indications during the operation, it is possible to remove one (2) lobe of the lung (lobectomy and bilobectomy), the entire lung (pulmonectomy), their combination with lymphadenectomy (removal of lymph nodes).
In the disseminated form of the disease, the main method of treatment is chemotherapy. Radiation therapy is used as an additional method. Surgical intervention is used very rarely.
Metastases affect the lymph nodes of the root of the lung, mediastinum, as well as more distant groups on the neck, in the supraclavicular region. Lung cancer can also spread to the liver, bones, brain, and second lung. The aggressiveness of the tumor in terms of metastasis is determined by its histological structure.
The prognosis for lung cancer depends primarily on the stage of the process, as well as on the histological picture of the tumor.
Preventive measures that should be given widely include the timely and correct treatment of various inflammatory processes in the bronchi and lungs in order to prevent their transition to chronic forms. Smoking cessation is a very important preventive measure. Those working in hazardous industries with high dust content should use personal protection methods in the form of masks, respirators, etc.