Lung cancer

Lung cancer, predominantly caused by smoking, is the reason for the highest number of cancer-related deaths. However, the chance of successful treatment is high  when identified at an early stage.

 What is it?

Lung cancer begins as cells from the normal lung tissue structurally proliferate uncontrollably to an abnormal extent and they then form a bulk (tumor) in the lung.At the beginning the bulk grows in its immediate surroundings, but then, through the bloodstream, it spreads to and damage adjacent tissues or distant organs (liver, bones, brain, etc.). Such damaging occur at an advanced stages. Lung cancer is a common type of cancer, accounting for 12-16% of all cancer cases and 17-28% of all cancer-related deaths. Moreover, it is the cause of the highest number of cancer-related deaths in both men and women.

What are the risk factors?

Cigarettes, cigar or pipe smoking is today the most important and proven risk factor of lung cancer. Those who smoke one pack of cigarettes per day for a period of 30 years, are 20 times more likely to contract lung cancer than those who do not. Also, the risk is high for those who begin smoking under the age of 20, for passive smokers exposed to cigarette smoke even if they do not smoke themselves and for those who smoke cigars or pipes. Although the risk declines 5 years after quitting smoking, it does not fully disappear. Moreover, factors such as air pollution, previous lung disease before or a family history of lung cancer increase the risk.

What are the symptoms?

The disease may not exhibit any significant symptoms until the advanced stages. Its silent progression is the most important factor which renders lung cancer so dangerous. Symptoms that may imply the presence of cancer are: seasonal coughing and phlegm gaining continuity in smokers with chronic bronchitis, blood in the phlegm, gradually increasing dyspnea (difficulty in breathing), a stinging chest pain that spreads, in particular, to between scapulas in the dorsum or shoulders. However, at the early stages of the cancer, before symptoms listed above are experienced, only such symptoms as loss of appetite, exhaustion, loss of weight and sweating can be seen. In some cases, the cancer may be identified with symptoms
related to functional failure of distant organs such as the liver, the brain, adrenal glands or bones.
 

What are methods of diagnosis?

A number of methods are used for the diagnosis of lung cancer: radiological examinations (Pulmonary Function Test, Computed Tomography, Magnetic Resonance Imaging, PET/BT), as well as phlegm specimen analysis, endoscopic evaluation of bronchia (bronchoscope) bronchoscopic biopsy or biopsy from the chest wall, mediastinoscope for the valuation of lymph nodes in the mediastin and video-assisted thoracoscopic surgery. The general procedure is as follows: a patient found to have a bulk in their lungs is first held subject to the Pulmonary Function Test and Computed Tomography; a decision is made how the bulk can be reached by means of generated 3-D images. The patient then undergoes a bronchoscope and lung biopsy. In the bronchoscope, a thin and flexible tube reaches the lungs and takes specimen with a needle. The diagnosis of the cancer is made final after a pathological examination of this biopsy specimen.

Is early diagnosis possible?

As lung cancer rarely displays symptoms before it spreads to the lymph nodes in adjacent areas or other organs, early diagnosis is possible in only 15% of patients. Early diagnosis of lung cancers is mostly coincidental and established during examinations performed because of another disorder. For instance, the disease is diagnosed during pulmonary function tests, lung tomography, ronchoscope (visualization of air ducts in the lungs, known as bronchia, via a flexible, illuminated tube) or cytological examination of the phlegm (examination of cells in the phlegm under the microscope).

How is it treated?

After the lung cancer diagnosis is established, it is crucially important to first determine the extent of the disorder and its phase. Lung cancer is manifested in 4 phases. Among the most important factors related to survival are the lymph nodes and the function of distant organs. The globally known treatment method for the cancer in its early stages (phase 1 and 2) is surgical operation; when it is diagnosed in the third of fourth phases, chemotherapy, radiotherapy or chemoradiotherapy would generally be applied. Again, when diagnosed in the 3rd or 4th phases, a surgical operation may be performed for selected patients in the event that their mediastinal lymph nodes have not failed.