Lung Cancer Research Presentation. Lung cancer symptoms in men and women

"Origin of Species" - Two forms - methodical and unconscious. The laws of unity of type and conditions of existence are covered by the theory of natural selection. Mutual relationship of organisms; morphology; embryology; vestigial organs. The origin of species ... On the incompleteness of the geological record. Instinct. About denudation of granite areas.

"Trees Shrubs Grasses" - Trees Shrubs Grasses. How are trees different from other plants? How do plants affect human health? Trees are: deciduous and coniferous. How are shrubs different from trees and grasses? Plants live everywhere: in meadows, forests, steppes, mountains, seas and oceans. Research plan: Plant diversity.

"Forms of asexual reproduction" - Conjugation Parthenogenesis Heterogamy Oogamy Isogamy. The sexual process occurs according to the type of isogamy. 1. Division. Reproduction by cell division is characteristic of unicellular organisms. When gametes merge, a four-flagellate zygote is formed. Class Ciliated ciliates. Conjugation and sexual reproduction of slipper ciliates occurs under unfavorable conditions.

"Population dynamics" - Population dynamics. Methods for regulating the number of populations. Examples of populations. Fluctuations in the number of individuals. Population growth. Let's repeat the previously studied material. Population dynamics as a biological phenomenon. Biology and Informatics. The amount of the annual catch. Knowledge about population dynamics. Information models of population development.

"Bird Lesson" - Female birds, like reptiles, have one ovary. Bustard Leading. Ritual behavior. Magpie Bullfinch Swallow Crow Jackdaw Nightingale Sparrow Grouse. Laying eggs. Find a match. Cranes - mating dances. Outside, the bird's egg is protected by a leathery shell. Bird mating. Note the signs of high organization and similarities with reptiles.

"Plant growing" - There are also grain growers, vegetable growers, cotton growers. The world. What is agriculture. Plant growing. Take any cultivated plant and describe it. For example, so that there is always bread on our table, plant breeders grow grain crops, wheat, rye and others.

Slide 1

Slide 2

How common is lung cancer? Lung cancer is one of the leading causes of death on earth. According to statistics, every 14th person has encountered or will face this disease in his life. Lung cancer most often affects the elderly. Approximately 70% of all cancer cases are found in people over 65. People under 45 years old rarely suffer from this disease, their share in the total mass of cancer patients is only 3%.

Slide 3

What are the types of lung cancer? Lung cancer is divided into two main types: small cell lung cancer (SCLC) and large cell lung cancer (NSCLC), which in turn is divided into:

Slide 4

- Adenocarcinoma is the most common type of cancer, accounting for about 50% of cases. This type is most common in non-smokers. Most adenocarcinomas arise in the outer or peripheral region of the lungs. - Squamous cell carcinoma. This cancer accounts for about 20% of all lung cancers. This type of cancer most often develops in the central part of the chest or bronchi. -Undifferentiated cancer, the most rare type of cancer.

Slide 5

What are the signs and symptoms of lung cancer? Lung cancer symptoms depend on the location of the cancer and the size of the lung lesion. In addition, sometimes lung cancer develops asymptomatically. In the picture, lung cancer looks like a coin stuck in the lungs. As the cancerous tissue grows, patients develop breathing problems, chest pain, and a bloody cough. If cancer cells have invaded the nerves, it can cause shoulder pain that radiates to the arm. Hoarseness occurs when the vocal cords are affected. Injury to the esophagus can lead to difficulty swallowing. The spread of bone metastases causes excruciating pain in them. Getting metastases in the brain usually causes a decrease in vision, headaches, loss of sensitivity in certain parts of the body. Another sign of cancer is the production of hormone-like substances by tumor cells that increase the level of calcium in the body. In addition to the symptoms listed above, with lung cancer, as well as with other types of cancer, the patient loses weight, feels weak and constantly tired. Depression and mood swings are also quite common.

Slide 6

How is lung cancer diagnosed? Chest X-ray. This is the first thing to do when lung cancer is suspected. In this case, they take a picture not only from the front, but also from the side. X-rays can help pinpoint problem areas in the lungs, but they cannot accurately show cancer or anything else. A chest X-ray is a fairly safe procedure as the patient is exposed to a small amount of radiation.

Slide 7

Computed tomography With the help of a computed tomography, images are taken not only of the chest, but also of the abdomen and brain. All this is done in order to determine if there are metastases in other organs. A CT scanner is more sensitive to nodules in the lungs. Sometimes, for a more accurate detection of problem areas, contrast agents are injected into the patient's blood. The computer scan itself usually goes without any side effects, but the injection of contrast media sometimes causes itching, rashes and hives. Just like a chest x-ray, computed tomography only finds problems in the site, but does not accurately tell whether it is cancer or something else. Additional tests are required to confirm a cancer diagnosis.

Slide 8

Magnetic resonance imaging. This type of study is used when more accurate data on the location of the cancer is needed. Using this method, it is possible to obtain images of very high quality, which allows you to determine the slightest changes in the tissues. Magnetic resonance imaging uses magnetism and radio waves, so it has no side effects. Magnetic resonance imaging is not used if a person has a pacemaker, metal implants, artificial heart valves and other implanted structures, since there is a risk of their displacement under the influence of magnetism.

Slide 9

Cytological examination of sputum The diagnosis of lung cancer should always be confirmed by cytological examination. Sputum is examined under a microscope. This method is the safest, simplest and most inexpensive, but the accuracy of this method is limited, since cancer cells are not always present in sputum. In addition, some cells can sometimes undergo changes in response to inflammation or injury, making them look like cancer cells. Sputum preparation

Slide 10

Bronchoscopy The essence of the method is water in the airways of a thin fiber-optic probe. The probe is inserted through the nose or mouth. The method allows you to take tissue for examination for the presence of cancer cells. Bronchoscopy gives good results when finding a tumor in the central regions of the lungs. The procedure is very painful and is performed under anesthesia. Bronchoscopy is considered a relatively safe research method. After bronchoscopy, coughing up blood is usually observed for 1-2 days. More serious complications such as heavy bleeding, cardiac arrhythmias, and low oxygen levels are rare. After the procedure, there may also be side effects caused by the use of anesthesia.

Slide 11

Biopsy This method is used when it is impossible to get to the affected area of \u200b\u200bthe lungs using bronchoscopy. The procedure is performed under the control of a CT scanner or ultrasound. The procedure gives good results when the affected area is on the upper layers of the lungs. The essence of the method is to water the needle through the chest and suction of liver tissue, which are further examined under a microscope. The biopsy is performed under local anesthesia. A biopsy allows you to fairly accurately determine lung cancer, but only if it was possible to accurately take cells from the affected area.

Slide 12

Surgical removal of tissue Pleurocentosis (puncture biopsy) The essence of the method consists in taking fluid from the pleural cavity for analysis. Sometimes cancer cells build up there. This method is also performed with a needle and under local anesthesia. If none of the above methods can be applied, then in this case they resort to a surgical operation. There are two types of surgery: mediastinoscopy and thoracoscopy. For mediastinoscopy, a mirror with a built-in LED is used. With this method, a biopsy of the lymph nodes is taken and the organs and tissues are examined. With thoracoscopy, the chest is opened and tissue is taken for examination.

Slide 13

Blood tests. Routine blood tests alone cannot diagnose cancer, but they can detect biochemical or metabolic abnormalities in the body that accompany cancer. For example, increased levels of calcium, alkaline phosphatase enzymes.

Slide 14

What are the stages of lung cancer? Cancer stages: stage 1. Cancer affects one segment of the lung. The size of the affected area is not more than 3 cm. Stage 2. Cancer spread is limited to the chest wall. The size of the affected area is not more than 6 cm. Stage 3. The size of the affected area is more than 6 cm. The spread of cancer is limited to the chest. There is extensive involvement of the lymph nodes. Stage 4. Metastases have spread to other organs. Small cell carcinoma also sometimes divides into only two stages. Localized tumor process. Cancer spread is limited to the chest wall. A common form of the tumor process. Metastases have spread to other organs.

Slide 15

How is lung cancer treated? Lung cancer treatments may include surgical removal of the cancer, chemotherapy, and radiation. Typically, all three of these treatments are combined. The decision about which treatment to use depends on the location and size of the cancer, as well as on the general condition of the patient. As in the treatment of other types of cancer, treatment is directed either at the complete removal of cancerous areas or, in cases where this is not possible, at relieving pain and suffering.

Slide 16

Surgery. Surgery is mainly used only during the first or second stage of cancer. Surgical intervention is acceptable in about 10-35% of cases. Unfortunately, surgical intervention does not always give a positive result, very often cancer cells have already entered other organs. After surgery, approximately 25-45% of people live for more than 5 years. Surgery is not possible if the affected tissue is near the trachea or the patient has serious heart disease. Surgery is very rarely prescribed for small cell cancer, because in extremely rare cases, such cancer is localized only in the lungs. The type of surgery depends on the size and location of the tumor. This can remove part of a lung lobe, one lung lobe, or a whole lung. Together with the removal of the lung tissue, the affected lymph nodes are removed. After lung surgery, patients need care for several weeks or months. People who have had surgery usually experience difficulty breathing, shortness of breath, pain, and weakness. In addition, complications due to bleeding are possible after surgery.

Slide 17

Radiation therapy The essence of this method is the use of radiation to destroy cancer cells. Radiation therapy is used when a person refuses to have surgery, if the tumor has spread to the lymph nodes or if surgery is not possible. Radiation therapy usually only shrinks the tumor or limits its growth, but in 10-15% of cases it leads to long-term remission. People who have lung conditions other than cancer are usually not given radiation therapy because radiation can reduce lung function. Radiation therapy does not have the risks of major surgery, but it can have unpleasant side effects, including fatigue, lack of energy, decreased white blood cell counts (a person is more susceptible to infection), and low blood platelets (blood clotting problems). In addition, there may be problems from the digestive organs that have been exposed to radiation.

Slide 18

Chemotherapy. This method, as well as radiation therapy, is applicable to any type of cancer. Chemotherapy refers to treatments that stop cancer cells from growing, killing them, and preventing them from dividing. Chemotherapy is the main treatment for small cell lung cancer, as it covers all organs. Without chemotherapy, only half of people with small cell cancer live for more than 4 months. Chemotherapy is usually given on an outpatient basis. Chemotherapy is given in cycles of several weeks or months, with breaks between cycles. Unfortunately, the drugs used in chemotherapy tend to disrupt the process of cell division in the body, which leads to unpleasant side effects (increased susceptibility to infections, bleeding, etc.). Other side effects include fatigue, weight loss, hair loss, nausea, vomiting, diarrhea, and mouth ulcers. Side effects usually disappear after treatment ends.

Slide 19

What are the causes of lung cancer? Cigarettes. Smoking is the leading cause of lung cancer. People who smoke are 25 times more likely to develop lung cancer than non-smokers. People who smoke 1 or more packs of cigarettes a day for more than 30 years are especially likely to develop lung cancer. Tobacco smoke contains over 4 thousand chemical components, many of which are carcinogenic. Cigar smoking is also a cause of lung cancer. In people who quit smoking, the risk of cancer is reduced as over time, cells damaged by smoking are replaced by healthy cells. However, the restoration of lung cells is a rather long process. Usually, their complete recovery in former smokers occurs within 15 years.

Slide 22

Also the reasons include: Asbestos fibers. Asbestos fibers are not cleared from the lung tissue throughout life. In the past, asbestos was widely used as an insulating material. Today its use is restricted and prohibited in many countries. The risk of developing lung cancer due to asbestos fibers is especially high in people who smoke; more than half of such people develop lung cancer. Radon gas. Radon is a chemically inert gas that is a natural decay product of uranium. Approximately 12% of all lung cancer deaths are associated with this gas. Radon gas easily passes through the soil and enters residential buildings through cracks in the foundation, pipes, drains and other openings. According to some experts, in about every 15 residential buildings, the level of radon exceeds the maximum permissible standards. Radon is an invisible gas, but can be detected with simple instruments. Hereditary predisposition. Hereditary predisposition is also one of the causes of lung cancer. People whose parents or relatives of their parents have died of lung cancer have a high chance of getting the disease. Lung diseases. Any lung disease (pneumonia, pulmonary tuberculosis, etc.) increases the likelihood of lung cancer. The more severe the illness, the higher the risk of developing lung cancer.

Slide 23

Lung cancer is the most common malignant tumor in the world population. 1 million new cases are diagnosed annually (more

Cancer
lung
-
most
widespread
in
world
populations
malignant
education.
1 million are diagnosed annually.
new cases (more than 12% of the
all detected malignant
neoplasms).
In Russia - 15.2%.

In 1997, 65660 patients were diagnosed with a malignant neoplasm of the trachea, bronchi, and lung.

8,6
%
52.5
%
47.5
%
Diagnosis confirmed
Not confirmed
91,4
%
Stage set
Not installed

Lung cancer risk factors

Genetic risk factors:
Primary multiple tumor.
Three cases of lung cancer in the family.
Modifying risk factors:
A. Exogenous: 1. Smoking; 2. Pollution
the environment; 3. Professional
harm.
B. Endogenous: 1. Over 45 years of age;
2. Chronic pulmonary diseases.

Distribution of patients by stage

19.6
%
37.6
%
Stage I-II
III stage

Dynamics of morbidity in men and women

Morbidity
70
60
50
40
30
20
10
0
1945
1955
1965
Men
1975
Women
1985
1997

The gross incidence rate in Russia is 44.7%

Saratov region
Jewish Autonomous Oblast
Altai region
Krasnodar region
Moscow city
Ingush republic
- 56.1% about
- 56.8% about
- 54.5% about
- 40.1% about
- 28.1% about
- 14.6% about

Clinical picture

34
%
In recent years, primary advanced cancer
lung (IV clinical group) in the Russian Federation
detected in 34.2% of patients.

30
%
20
%
65
%
Completing tumor treatment
no more than 30% of identified
sick.
Operability is not
exceeds 20%.
Of the registered
65% of patients do not live for 1 year.

The main reasons for neglect

1. Insufficient oncological
alertness and qualifications
medical personnel (43% of cases);
2. Latent, low-symptom course
diseases (33%);
3. Untimely, late appeal
patients for help (23%).

Causes of neglect, depending on the quality of medical care

15%
errors of radiologists
31%
25%
29%
clinical errors
diagnostics
incomplete examination
sick
long-term examination

Lung cancer symptoms

Primary or local symptoms (cough,
hemoptysis, chest pain, shortness of breath),
due to the growth of the primary node
tumors.
Extrapulmonary thoracic symptoms
caused by the growth of the tumor in
neighboring organs and regions
metastasis (hoarseness, aphonia,
kava syndrome, dysphagia).

Extrathoracic symptoms depending on the pathogenesis
are divided into the following subgroups:
a) caused by distant metastasis (headache,
hemiplegia, bone pain, growth of secondary volume
formations);
b) associated with the interaction of a tumor - an organism (general
weakness, fatigue, weight loss, decrease
performance, loss of interest in the environment,
decreased appetite), i.e. what is defined as “syndrome
small signs ”, or rather the discomfort syndrome;
c) due to non-oncological complications of growth
swelling (fever, night sweats, chills);
d) associated with hormonal and metabolic activity
tumors (paraneoplastic syndromes): rheumatoid
polyarthritis, neuromuscular disorders, pulmonary
osteochondropathy, gynecomastia, etc.

Tactics

1. Any pulmonary complaints in a smoker over 45 years old
should be regarded as possible bronchial cancer.
2. Obturation
pneumonitis
fleeting,
easy
amenable to anti-inflammatory treatment, but often
re-recurs.
3. X-ray diagnosis of early lung cancer
difficult and unreliable. To rule out early cancer
bronchus should be prescribed whenever possible
fibrobronchoscopy.
4. Elderly patients should be repeated
carry out control examinations (call
active!) 1-2 months after the transferred
"Colds", especially with incomplete cure.

Symptoms of distant metastasis

The lymph nodes
Neurological symptoms
Headache
Mental disorders
Membrane and radicular symptoms
Spinal cord injury
Skeletal metastases
Liver damage

Paraneoplastic syndromes

These are symptom complexes due to
mediated (humoral, etc.)
the influence of the tumor on the metabolism,
mechanisms of immunity and functional
activity of the body's regulatory systems.
With solid neoplasms, they are found in
10-50% of cases. By spectrum and variety
such manifestations of lung cancer are unmatched.

Cutaneous and musculoskeletal symptoms

dermatomyositis
acanthosis black
Leser-Trel syndrome
erythema multiforme
Hyperpigmentation
psoriatic acrokeratosis
urticarial rash

Neuromuscular syndromes

Polymyositis
myasthenic syndrome (Eaton Lambert)
Leser-Trel syndrome
peripheral neuropathy
myelopathy

Musculoskeletal Syndromes

hypertrophic
osteoarthropathy
drumstick symptom
rheumatoid arthropathy
arthralgia

Endocrine syndromes

pseudo Cushing's syndrome
gynecomastia
galactorrhea
impaired secretion
antidiuretic hormone
carcinoid syndrome
hyper- or hypoglycemia
hypercalcemia
hypercalcitoninemia
products of STG, TTG

Neurological syndromes

subacute cerebellar degeneration
sensory motor neuropathy
endephalopathy
progressive multifocal
leukoencephalopathy
transverse myelitis
dementia
psychosis

Hematological syndromes

anemia
erythrocyte aplasia
dysproteinemia
leukemoid reactions
granulocytosis
eosinophilia
plasmacytosis
leukoerythroblastosis
thrombopenia
thrombocytosis

Cardiovascular syndromes

superficial and deep
thrombophlebitis
arterial thrombosis
marantic endocarditis
orthostatic hypotension
disseminated syndrome
intravascular coagulation

Immunological syndromes

immunodeficient
fortunes
autoimmune reactions

Other syndromes

nephrotic syndrome
amyloidosis
secretion of vasoactive polypeptide
(watery diarrhea syndrome)
amylase secretion
anorexia - cachexia

Population survey stages

1. Selection from the entire population of persons
predisposed to lung cancer.
2. Identification of persons with pathological
changes in the lungs.
3. Differential diagnosis confirmation or exclusion
malignant lesions or
precancerous pathology.

Examination of the primary patient

Clinical or radiological
suspected cancer
Primary examination
(R-graphy, tomography, sputum analysis)
Bronchoscopy
Transthoracic puncture,
thoraconethesis
Lymph node biopsy
(mediastinal, peripheral)
Histological type and TNM
Abdominal echography, bone scintigraphy
Respiratory function assessment

Three levels of diagnosis

X-ray detection of suspicious
cancer of the shadows in the lungs in the preclinical stage (mainly
large-frame fluorography)
x-ray examination in x-ray
department of institutions of practical medical network
(city, regional hospitals, polyclinics,
anti-tuberculosis and oncological dispensaries
etc.)
examinations in specialized
pulmonary department. Here based on
a combination of X-ray, endoscopic
research and targeted biopsy
the final specification of the diagnosis is achieved.

X-ray research methods can be grouped into two diagnostic complexes

The main complex of methods with which you can
get the optimal amount of information about
X-ray morphological features
pathological focus in the lung and condition
bronchial tree. This includes the combined
the use of fluoroscopy, radiography and
tomography.
A complex of additional methods that do not play
essential role in the initial diagnosis of cancer
easy, but very helpful in clarifying
localization, prevalence of the process and
differential diagnosis.

Central lung cancer

X-ray negative phase
Recurrent pneumonitis
Hypoventilation stage
Valvular emphysema
Stage of atelectasis

Early signs of central lung cancer

Ball node at the root of the lung
Lung root expansion
Violation of the bronchial
passability:
a) strengthening of the pulmonary pattern at the root
lung
b) severity
c) obstructive emphysema
d) segmental atelectasis
e) paramediastinal darkening

Lung root enlargement

Central lung cancer

Central lung cancer

Central cancer

Decrease in the volume of a share (segment)
Lung root expansion
Prolonged course of pneumonia
Recurrent pneumonia
Bronchological examination / CT

Peripheral cancer

Small peripheral cancer
- Tumor shadow shape
- Shadow structure
- The nature of the contours
- Discharge path
- Pleural changes
"Giant" peripheral cancer

Varieties of tumor nodes in peripheral lung cancer

Retngen picture of peripheral cancer

CT picture of peripheral cancer

Peripheral cancer with centralization.

Peripheral tumor growth rate

where d0 and d1 are the average values \u200b\u200bof the tumor diameter
at the first and last research; t -
interval between studies.

Hearth type GGO (ground glass opacity)
(like frosted glass)
Bronchioloalveolar cancer T1N0M0

Bronchioloalveolar cancer

peripheral globular tumor
pseudopneumonic form
multiple nodular and nodular
education
mixed form

Characteristics

variety of clinical and radiological symptoms,
causing the allocation of four forms of peripheral disease, pseudopneumonic, nodular,
mixed
absence of changes on tomograms and bronchograms
bronchial tree
the presence of enlightenment with clear contours and
"Lattice" structure against the background of darkening
with peripheral bronchioloalveolar cancer
slow growth rates, subpleural localization,
heterogeneous "spongy" structure, uneven
contours, characteristic pleural reaction
with the most advanced mixed form of the disease
simultaneous manifestation of spherical,
pneumonia-like and nodular changes
with early recognition of limited forms, you can
prevent the process from becoming widespread
defeat and timely start treatment

Atypical forms

Peripheral cancer with
Pancost's syndrome
Mediastinal cancer
lung
Primary carcinomatosis

Peripheral cancer with Pancost's syndrome

1) radiographically defined shadow in the area
apex of the lung;
2) pain in the shoulder girdle;
3) violation of skin sensitivity;
4) muscle atrophy of the upper limb;
5) Horner's syndrome;
6) seal in the supraclavicular zone;
7) radiographically
determined
destruction
upper ribs;
8) destruction of the transverse processes and vertebral bodies.

Primary carcinomatosis

Primary carcinomatosis

Differential
diagnostics
lung cancer

Indications for CT of the chest

questionable data
X-ray examination,
the need to increase sensitivity
method
identification of hidden metastases in their
high probability if it changes
treatment tactics
assessment of prognostic factors
the need for transthoracic puncture
under CT control
radiation therapy planning and marking
irradiation fields, diagnostics of relapses
tumors

Indications for bronchoscopy

if a tumor is suspected
all lung cancer patients, including
peripheral
after radical treatment of oncological
lung lesions (endoscopic
monitoring for early detection
relapses)
in assessing the effectiveness of radiation and
drug treatment (confirmation of complete
remission)
when identifying synchronous and metachronous
foci of primary tumor multiplicity

research methods

Cytological methods
Fibrobronchoscopy
CT scan
Echography
Surgical methods

Surgical diagnosis of lung cancer

Prescaled biopsy
Mediastinoscopy
Anterior parasternal
mediatinotomy
Videothoracoscopy
Diagnostic thoracotomy

Additional research methods

Angiography
Radionucleide diagnostics:
Perfusion pulmonary scintigraphy,
ventilation pulmonary scintigraphy,
positive pulmonary scintigraphy,
Complex pulmonary scintigraphy,
Radioimmunoscintigraphy, Indirect
radionucleide lymphography.
Determination of humoral tumor markers

PET in differential diagnosis
solitary formation in the lung

PET - assessment of lymph nodes

CT scan
PAT

Statistics

Stage
5 year old
survival rate (%)
Ia
70-80
Ib
60-70
II a
35
II b
25
III a
10
III b
5
IV
1
13% 5 year old
survival
13% detection
Stage I
Mountein, Chest (1997) 111; 1701-17

Central cancer (polypoid,
endobronchial, peribronchial,
ramified).
Peripheral cancer: nodular, cavity
(cavernous), pneumonia-like.
Atypical forms: peripheral cancer with
Pancost syndrome (Pancoast cancer),
mediastinal lung cancer,
primary lung cancer.

Epithelial tumors

1. Benign
Papilloma
- squamous

Adenoma
- polymorphic (mixed tumor)
- monomorphic
- other types
Dysplasia
- Preinvasive cancer (carcinoma in situ)

2. Malignant
Squamous cell carcinoma (epidermoid)
- Highly differentiated
- Moderately differentiated
- low-grade
Small cell carcinoma
- oatmeal
- from cells of intermediate type
- combined

3. Adenocarcinoma
acinar
papillary
bronchioloalveolar cancer
solid crayfish mucus production
- highly differentiated
- moderately differentiated
- poorly differentiated
- bronchioloalveolar

4. Large cell carcinoma
giant cell variant
clear cell variant
5. Glandular - squamous cell carcinoma
6. Carcinoid tumor
7. Cancer of the bronchial glands
a) adenocystic
b) mucoepidermoid
c) other types
8. Others

The incidence of different types of lung cancer

Squamous
Small cell
Adenocarcinoma
Croccellular
others
50%
20%
21%
7%
2%

New TNM classification

T - primary tumor.
TiS - pre-invasive carcinoma (carcinoma in situ).
TO - the primary tumor is not detected.
T1 - tumor no more than 3 cm in greatest dimension,
surrounded by lung tissue or visceral pleura,
without signs of invasion proximal to the lobar bronchus with
bronchoscopy or unusual invasive tumor of any
sizes with surface spread within
bronchial walls, including the main one.
T2 - tumor more than 3 cm in greatest dimension or
a tumor of any size causing atelectasis or
obstructive pneumonitis extending to
root area. According to bronchoscopy, proximal
the edge of the tumor is located 2 cm distal to the carina.
Any concomitant atelectasis or obstructive
pneumonitis does not spread to the entire lung.

TK - a tumor of any size, invading the breast
wall (including cancer with Pancost's syndrome), diaphragm,
mediastinal pleura or pericardium without lesion
heart, large vessels, trachea, esophagus or bodies
vertebrae, or a tumor that spreads to
the main bronchus is 2 cm proximal to the carina without it
infiltration.
T4 - a tumor of any size with damage to the mediastinum,
heart, large vessels, trachea, esophagus, bodies
vertebrae or carina bifurcation or presence
malignant pleural effusion (in the absence
tumor elements in punctate, hemorrhagic coloration
him or signs indicating exudate, swelling
referred to category T1-3).

1.Top
mediastinal
2.Paratracheal
3.Pretracheal
4.Tracheobronchial
5.Subaortic
6.Paraortal
7 bifurcation
8.Paraesophageal
9.Pulmonary ligament
10 root of the lung
11.Interlobar
12.Equity
13. Segmental
14.Subsegmental

N - regional lymph nodes
NO - there are no signs of damage to regional
lymph nodes.
N1 - metastases in the peribronchial and (or)
lymph nodes of the root of the lung on the side
lesions including direct germination
primary tumor.
N2 - metastases in bifurcation and
mediastinal lymph nodes on
side of defeat.
N3 - lymph node metastases
mediastinum or root on the opposite
side, in the pre-scalded or supraclavicular
zones,

Grouping by stage

Hidden cancer - TxNOMO
Stage - TiS, carcinoma in situ
Stage I - T1NOMO
Stage Ib - T2NOMO
Stage IIa - T1N1MO
Stage IIb - T2N1MO
Stage IIIА - T3NOMO, T3N1MO, T1-3N2MO
Stage IIIВ - T1-4N3MO, T4NO-3MO
Stage IV - T1-4NO-3M1

Dembo classification of respiratory failure

latent (no violations of gas
resting blood composition)
partial (hypoxemia without
hypercapnia) and global (hypoxemia, with
hypercapnia)

The degree of respiratory failure

I degree of respiratory failure
(shortness of breath with significant physical
loads)
II degree (shortness of breath during normal exercise walking)
III degree (shortness of breath when dressing and
washing) and IV degree (dyspnea at rest).

A simplified method for preliminary assessment of operational risk by identifying three groups of patients

First group (low risk): normal size and
heart function, normal blood pressure and
ECG, normal blood gas,
satisfactory indicators of lung function.
The second group (very high risk, inoperability):
congestive heart failure, refractory
arrhythmia, severe hypertension, fresh myocardial infarction,
low spirometric parameters (FEV1 less
35%), Рco2 more than 45 mm Hg. Art., pulmonary hypertension.
Group 3 (moderate risk): angina pectoris, heart attack
a history of myocardium, arrhythmias, systemic hypertension,
heart defects, low cardiac output, hypoxia with
normal Pco2 values, moderate decrease
lung function (FEV1 35-70%).

Hematogenous metastasis

Into the brain - in 40% of patients, in 30%
solitary cases, more often in the frontal and
occipital areas.
In the liver - in 40% of patients, more often
multiple.
In the skeleton - in 30%, thoracic and lumbar
spine, pelvic bones, ribs,
tubular bones.
In the adrenal glands - in 30%.
In the kidneys - in 20%.

Lung Cancer Treatment Standards

Stage
Conventional treatment
I
Surgical
II
Surgical
IIIa
Radiation and / or chemotherapy with
subsequent resection
IIIb
Radiation and chemotherapy
IV
Chemotherapy

Statistics

Stage
5 year old
survival rate (%)
Ia
70-80
Ib
60-70
II a
35
II b
25
III a
10
III b
5
IV
1
13% 5 year old
survival
13% detection
Stage I
Mountein, Chest (1997) 111; 1701-17

The pathological process involves lung tissue, bronchial glands, mucous membrane of the organ, pleura. As the disease progresses at a rapid pace, diagnosis and treatment must be timely.

A malignant tumor is formed from the affected mucous membrane, which is dangerous with early metastasis. Such extensive pathologies as pleurisy, pericarditis, superior vena cava syndrome develop, pulmonary hemorrhages open.

Lung cancer causes

It is almost impossible to detect cancer of the lung tissue system at an early stage, but it is important to consciously understand that the tumor is spreading, provoking extensive damage to the lymphatic system. To detect cancer, the first step is to determine the etiology of the pathological process, to completely exterminate the provoking factor from the body. The main causes of lung oncology are presented below:

• environmental factor;
• viral pathologies;
• the presence of bad habits;
• chronic inflammation of the respiratory system;
• genetic predisposition (hereditary factor);
• as a complication of the long course of infectious diseases;
• professional factor (work in hazardous production).

The factors of occurrence and mechanisms of development of lung cancer do not differ from the etiology and pathogenesis of other malignant lung tumors. In the development of lung cancer, the main role is assigned to exogenous factors: smoking, air pollution with carcinogenic substances, exposure to radiation (especially radon).

It is estimated that approximately 80-90% of lung cancer cases are caused by smoking. Both active smoking and passive inhalation of substances contained in tobacco smoke are harmful. People who live together as tobacco smokers and regularly inhale cigarette smoke are especially vulnerable.

Because of this, lung cancer occurs more often in men than in women. This is a disease of mature age, associated with long-term exposure to adverse conditions. The average age of the disease is about 60 years.

Smoking cigarettes greatly increases the risk of developing lung cancer. Smoking up to ten cigarettes a day leads to a fivefold increase in the likelihood of developing lung cancer, and in the case of smoking thirty-five cigarettes a day, the disease becomes almost inevitable. In addition, living with a smoker increases the risk of developing this type of cancer by 30%.

To prevent lung cancer, you should quit smoking. Fifteen years after quitting smoking, the risk of lung cancer in former tobacco smokers equals the risk of people who have never smoked.

Other factors contributing to the development of lung cancer are occupational factors (exposure to harmful substances and chemical compounds formed during the production of coke, coal gasification, processing of substances containing lead, beryllium, chromium, nickel, asbestos, ether or aromatic hydrocarbons), environmental factors (car exhaust, smog, air pollution) as well as other toxic substances inhaled into the lungs. Genetic predisposition is also of some importance.

The development of lung cancer is influenced by environmental factors, working conditions and lifestyle. A predisposition to malignant lung tumors is observed in people whose close relatives suffered from cancer.

Smoking causes lung cancer in about 90% of all cases, lung tumors in nonsmokers are very rare. Tobacco contains over 60 toxic substances that can cause lung cancer. These substances are called carcinogenic.

Although cigarette smoking is a major risk factor, the use of other types of tobacco products also increases the risk of cancer in both the lungs and other organs, such as esophageal and oral cancers. These products include:

• cigars;
• pipe tobacco;
• snuff;
• chewing tobacco.

Smoking cannabis also increases the risk of lung cancer. Most cannabis smokers mix it with tobacco. Although they smoke less often than those who smoke cigarettes, they usually inhale deeper and hold the smoke in their lungs longer.

By some estimates, smoking 4 homemade cannabis cigarettes is comparable to 20 regular cigarettes in terms of lung damage. Even smoking pure hemp is potentially dangerous as it also contains carcinogens.

Secondhand smoke also increases the risk of cancer. For example, the results of a study showed that non-smoking women living with a smoker have a 25% higher risk of developing lung cancer than non-smoking women whose husbands are not associated with this bad habit.

Air pollution and occupational hazards can negatively affect the health of the respiratory system. Exposure to certain substances such as arsenic, asbestos, beryllium, cadmium, smoke from coal (coke) and coal dust, silicon and nickel increase the risk of lung cancer.

Research suggests that exposure to high volumes of exhaust fumes over the years increases the risk of lung cancer by 50%. One study showed that the risk of lung cancer increases by 30% if you live in an area with high concentrations of nitrogen oxides, mainly produced by cars and other vehicles.

Radon is a naturally occurring radioactive gas produced by the decay of the smallest particles of radioactive uranium found in rocks and soil. This gas is used for medicinal purposes, but in high concentrations it is dangerous as it can damage the lungs.

The following factors affect the development of malignant tumors:

• Smoking. Tobacco products contain a large amount of carcinogens.
• Poor environmental conditions, lack of adequate nutrition. The incidence rate is especially high among residents of megacities.
• The presence of chronic pathologies of an infectious or bacterial nature (bronchitis, tuberculosis).
• Hereditary predisposition.
• Weakened immunity associated with HIV, chemotherapy.

The risk group includes people working in hazardous industries, where chemical vapors hazardous to health are present.

Under the influence of these factors, pathological changes in DNA occur in women and men, as a result of which the cells of the bronchial epithelium begin to mutate, forming a tumor. With a certain degree of organ damage leading to disability, a person is issued a disability. It is important to know how lung cancer manifests itself in order to see a doctor at the first sign.

The more advanced oncology becomes, the more causes of death arise.

Here's how to die of lung cancer:

1. Severe intoxication. This is due to the release of toxins by the tumor that injure cells and provoke their necrosis and oxygen starvation.
2. A sharp loss of body weight. Waste can be quite severe (up to 50% of total weight), as a result of which the body is significantly weakened, increasing the likelihood of death.
3. Pronounced soreness. It arises in the process of damage to the pleura of the lung, which is endowed with a large number of nerve endings (which is why pleural cancer appears so easily). The pain syndrome is explained by the growth of the tumor into the pulmonary membrane.
4. Acute respiratory failure... It occurs when a tumor (due to its size) begins to block the lumen of the bronchus. This makes it difficult for the patient to breathe..
5. Massive pulmonary bleeding. It comes from a lung damaged by a neoplasm.
6. Formation of secondary foci of oncology. In the later stages of the disease, multiple organ failure develops. Metastasis is one of the most common causes of patient death.

Please note that these phenomena rarely occur in isolation. Exhaustion, pleural cancer and intoxication significantly worsen the general condition of the body, as a result of which a person can live quite a little.

Due to its constantly increasing size, the tumor can injure the bloodstream. The lung tissue contains a number of vessels, damage to which causes extensive bleeding.

It is often difficult to stop it. The patient needs to provide timely high-quality medical care. Otherwise, he will die within 5 minutes after the first symptoms of pathology appear.

The manifestation of sputum discharge with blood in the patient indicates damage to the wall of one of the vessels. And do not ignore even small blotches. As soon as the vessel is completely injured, extensive bleeding will not take long.

Sometimes people confuse bleeding from small vessels by symptomatology with a similar one in the gastrointestinal tract. Incorrectly selected therapy is also fatal.

This pathology begins to develop when an enlarged tumor blocks the lumen of the trachea and bronchi. At first, the patient who has received this ailment suffers from shortness of breath and gradually increasing shortness of breath.

As soon as the lumen of the bronchi is completely blocked, the patient loses the ability to breathe. You can try to prepare in advance for this situation. If you do not provide a person with emergency medical care, he will die within 30 minutes.

Metastasis

One of the causes of death. Attempts to remove metastases through surgery are fraught with their reappearance at a faster rate. With the spread of cancer to other organs, the patient has no chance of recovery.

The greatest possible danger is brain damage. If a secondary tumor develops, which is concentrated in this area, it will not be possible to prevent death.

Metastases localized in other parts of the body disrupt the functioning of all organs and systems, causing a serious pain syndrome. Usually this symptomatology, which also accelerates the death of the patient, is inherent in small cell cancer.

Why is this disease? The risk of developing lung carcinoma depends on various contributing factors, among which are the following: the place where a person lives, environmental and industrial conditions, gender and age characteristics, hereditary predisposition and a number of others.

Stages and types of lung cancer

According to the histological classification, the disease has several varieties, due to the characteristics of the focus of the pathology. Do not confuse a lung tumor with mild tuberculosis, and the types of a characteristic ailment are presented below:

1. In peripheral cancer, symptoms are absent for a long time, since the composition of the bronchial epithelium does not provide for nerve endings.
2. Small cell carcinoma occurs when individual segments of the bronchi are involved in the pathological process.
3. Non-small cell cancer is the opposite diagnosis to its predecessor, which has caused a lot of controversy in medicine.
4. Central cancer, on the other hand, allows you to feel early clinical symptoms due to irritation of the mucous membrane of the inflamed bronchus.

Malignant neoplasms in the lung are one of the most common cancers. According to statistics, more than 60 thousand cases are detected annually in the Russian Federation. Most often, the disease affects people over the age of 50.

Until recently, the problem was considered predominantly "male", but today, due to the prevalence of smoking among women, the incidence of women is increasing. Over the past decade, growth has been 10%. Due to the pollution of the atmosphere, lung cancer is often diagnosed in children.

Pathology affects the lungs in the right, left, center, in the peripheral regions, the symptoms and treatment depend on this.

There are two options:

1. Peripheral lung cancer symptoms are mild. The neoplasm develops for a long time without noticeable "by eye" manifestations. Pain begins to appear only at the 4th stage. The prognosis is favorable: patients with pathology live up to 10 years.
2. The central form of the disease - the lungs are affected in the place where the nerve endings, large blood vessels are concentrated. In patients, early signs of hemoptysis begin in lung cancer, and intense pain syndrome follows. Life expectancy does not exceed five years.

There is no effective treatment for the disease in the central location.

The main symptoms of early lung cancer vary depending on whether the problem is diagnosed in an adult or a child, in what form it occurs. For example, cancer of the right lung and cancer of the apex of the lung have excellent clinical features.

• Small cell carcinoma - the most terrible and aggressively developing tumor and giving metastases even on a small size of the tumor itself. It is rare, usually in smokers.
• Squamous cell carcinoma - the most common type of tumor that develops from flat epithelial cells.
• Adenocarcinoma is rare, formed from the mucous membrane.
• Large cell - more often affects women than men. A feature is the onset of the development of cancer in the subsegmental bronchi and the early formation of metastases in the lymph nodes of the mediastinum, in addition, peripheral lesions of the adrenal glands, pleura, bones, and also the brain occur.

Depending on the place of appearance (anatomical classification), there is a central cancer (the tumor is located in the center of the lung, where large bronchi and blood vessels are located) and peripheral (the tumor grows on the periphery of the lung).

They also distinguish mixed lung cancer and mediastinal, or apical - this is a variant of peripheral cancer, when the tumor is located at the apex of the lung. Cancer of the right lung or left lung is possible, or both lungs are involved.

When conducting a histological analysis, the type of tumor cells is established.

Most often (up to 95% of cases), the tumor develops from epithelial cells that line the large and medium bronchi (therefore, sometimes they speak of bronchial cancer or bronchogenic carcinoma).

Less commonly, a tumor develops from pleural cells (then it is called mesothelioma).

small cell carcinoma:

• oatmeal
• intermediate
• combined;

non-small cell carcinoma:

• squamous
• adenocarcinoma
• large cell.

Morphological classification is important for determining the degree of tumor malignancy. Small cell lung cancer grows faster (almost three times) and metastasizes more actively.

According to the histological structure, 4 types of lung cancer are distinguished: squamous cell, large cell, small cell and glandular (adenocarcinoma). Knowledge of the histological form of lung cancer is important in terms of the choice of treatment and prognosis of the disease.

It is known that squamous cell lung cancer develops relatively slowly and usually does not give early metastases. Adenocarcinoma is also characterized by a relatively slow development, but it is characterized by early hematogenous dissemination.

Small cell and other undifferentiated forms of lung cancer are transient, with early extensive lymphogenous and hematogenous metastasis. It is noticed that the lower the degree of tumor differentiation, the more malignant its course.

By localization relative to the bronchi, lung cancer can be central, arising in large bronchi (main, lobar, segmental), and peripheral, originating from the subsegmental bronchi and their branches, as well as from the alveolar tissue. Central lung cancer is more common (70%), peripheral - much less common (30%).

The form of central lung cancer is endobronchial, peribronchial nodular and peribronchial branched. Peripheral cancer can develop in the form of "globular" cancer (round tumor), pneumonia-like cancer, cancer of the apex of the lung (Pancost).

There are many malignant neoplasms of the lungs, which differ in structure, location, growth rate and the likelihood of metastases, as well as sensitivity to treatment. In order to select the most effective treatment and make a prognosis for lung cancer, all tumors are divided into stages and types.

Non-small cell lung cancer is the most common type, accounting for 80% of malignant lung tumors. This type includes squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.

Stage 1 lung cancer - the tumor is located inside the lung and does not spread to the nearest lymph nodes:

• stage 1A - tumor less than 3 cm;
• stage 1B - tumor 3-5 cm.

Stage 2 lung cancer - divided into two subcategories 2A and 2B.

Stage 2A characteristics:

• tumor 5-7 cm;
• the tumor is less than 5 cm and cancer cells have spread to nearby lymph nodes.

Stage 2B characteristics:

• the tumor is larger than 7 cm;
• the tumor is 5–7 cm long and cancer cells have spread to the nearest lymph nodes;
• cancer cells have not spread to the lymph nodes, but have affected the surrounding muscles and tissues;
• cancer has spread to one of the bronchi;
• the cancer has caused the collapse (compression) of the lung;
• several small tumors are present in the lung.

Stage 3 Lung Cancer - Divided into two subcategories 3A and 3B.

In stage 3A, lung cancer has spread either to the lymph nodes in the mediastinum or to surrounding tissues, namely:

• the membrane of the lung (pleura);
• chest wall;
• center of the sternum;
• other lymph nodes near the affected lung.

In stage 3B, lung cancer has spread to any of the following organs or tissues:

• lymph nodes on either side of the chest above the collarbones;
• any important organ such as esophagus, trachea, heart

  or a major blood vessel.

Stage 4 Lung Cancer - Cancer has affected either both lungs or another organ or tissue (bone, liver, or brain), or has caused fluid to accumulate around the heart or lungs.

Small cell lung cancer is less common than non-small cell lung cancer. Cancer cells that cause disease are smaller and divide much faster, so the tumor spreads more actively. There are only two stages of small cell lung cancer:

• limited - cancer within the lung;
• widespread - the cancer has gone beyond the lung.

Modern medicine classifies lung cancer according to many parameters. The most common among them are classifications by the place of manifestation of pathology and by the stage of development.

According to this classification, there are three types of lung cancer:

• central - the main influence of the oncological process falls on the large bronchi. A malignant neoplasm eventually blocks the lumen of the bronchus, which leads to the collapse of part of the lung;
• peripheral - oncology develops on small peripheral bronchi, and the neoplasm grows outside the lungs. Because of this, peripheral lung cancer is often called pneumonia-like. This type of pathology is characterized by a prolonged absence of external manifestations - up to five years, which is why its diagnosis occurs already at later stages;
• the mixed type is quite rare - in five percent of cases. Its development is characterized by the formation of soft, whitish tissue of a malignant nature, which fills the lobe of the lung, and sometimes the entire organ.

This classification is based on the degree of development of the tumor or tumors. Mainly, four stages of pathology are distinguished, but at the same time there are more detailed schemes in which the development of lung cancer is divided into six stages:

• Zero stage. The earliest, in most cases asymptomatic form of the disease. Carcinoma due to its small size is poorly visible even on fluorography, there is no damage to the lymph nodes.
• First stage. The tumor at this stage of the development of the pathology does not exceed three centimeters in size. The pleura and lymph nodes at the first stage are not yet involved in the pathological process. Diagnosis of lung cancer at this stage is considered early and allows for favorable treatment projections. At the same time, the disease is diagnosed at this stage in only ten percent of patients.
• Second stage. The diameter of the tumor is in the range of three to five centimeters, metastases are recorded in the bronchial lymph nodes. Explicit symptoms of pathology begin to appear in most patients. A third of cases of lung cancer detection are recorded at this stage.
• Stage 3a. The tumor is more than five centimeters in diameter. The pleura and chest wall are involved in the pathological process. The presence of metastases is recorded in the bronchial and lymph nodes. The manifestation of the symptoms of pathology is obvious, more than half of the cases of pathology are found at this stage. The frequency of a favorable prognosis does not exceed 30 percent.
• Stage 3b. A characteristic difference is the involvement of the vessels, esophagus, spine and heart in the pathological process. The size of the tumor is not a clear indication.
• Stage four. Metastases spread throughout the body. In the vast majority of cases, the prognosis is poor. The chances of remission, let alone complete recovery, are virtually nil.

How is stage 4 lung cancer treated?

Stage 1 lung cancer is the initial stage of non-small cell cancer that does not extend beyond the lung, does not affect the lymph nodes, or other organs or tissues. The first degree includes two subclasses: stage 1A, stage 1B.

Features and characteristics of subclasses:

• Stage 1A lung cancer. The tumor is located only in the lung tissues and has a size of up to 3 cm.
• Stage 1B lung cancer. The size of the neoplasm does not exceed 5 cm and can spread to: a) the lung membrane, b) the central bronchus, or destroy part of the lung.

The level of cancer incidence is growing every year, so it is important to control your own well-being, to follow the elementary rules of prevention. Lung oncology develops gradually, in modern medicine four stages are described smoothly replacing each other:

1. At the first stage, the malignant neoplasm does not exceed 3 cm in diameter, metastases are not found, and the lymph nodes are not inflamed.
2. The second stage of cancer is characterized by a tumor diameter from 3 to 6 cm, while lymph nodes are already involved in the pathological process. on x-rays, it is problematic to determine cancer in peripheral lesions and the apex of the lung.
3. At the third stage, the tumor grows in size, reaches a parameter of 6 cm in diameter, metastases appear in neighboring organs.
4. The fourth stage of cancer is already considered incurable, since the bronchial membrane cannot be recognized in laboratory studies - it collapses, changes its previous structure.

Non-small cell cancer develops in 4 stages, each of which is characterized by a certain size of the tumor, its prevalence and the presence of metastases. In general, the effectiveness of complex treatment is estimated at 40%.

Depending on the signs of the disease, the treatment regimen may be different. The chances of recovery are increased by following a special diet during the treatment period. The diet should be balanced, the food should be healthy and natural. Chemotherapy is the most effective treatment for squamous cell carcinoma.

At the first or second stage, surgical removal of the tumor is effective. At this time, it is possible to radically remove the neoplasm, which contributes to the complete recovery of the patient. If the operation fails for any reason, radiation therapy is prescribed.

Directed beams are capable of destroying a tumor if it is small in size. Chemotherapy is used as an additional treatment. It is performed both before and after the operation. Cytostatics are concentrated in tumor tissues, gradually destroying its cells.

The second stage in the development of a malignant neoplasm is an indication for surgical intervention. If there are contraindications to the operation, a course of chemotherapy and radiation is prescribed. Chemotherapy involves the use of drugs that are different from those used in the first stage.

Doctors prefer complex methods in which chemotherapy is combined with surgery and radiation. This method is considered the most effective, however, with a common pathological process, operations are extremely rare. Chemotherapy and radiation are the only methods possible in this case.

Is fourth degree lung cancer cured? In the last stage of the disease, complete recovery is considered impossible. All measures prescribed by oncologists are aimed at relieving the symptoms of the disease and increasing the patient's life expectancy.

Radiation and chemotherapy help reduce the size of the tumor, reduce the intensity of pain. The most effective way to improve the condition of a cancer patient is palliative treatment, which consists of several stages.

Symptomatic treatment involves the use of narcotic painkillers and antitussive drugs, sedatives. At this stage of the disease, a psychologist must work with the patient. No less important is the prevention and timely treatment of infectious diseases.

There are only four stages of cancer, each of these stages is characterized by certain symptoms and manifestations. For each stage, an individual treatment by an oncologist is selected. It is possible to completely get rid of this pathology only in the early stages.

• First stage 1A. The neoplasm should not exceed 3 cm in diameter. This stage proceeds without coughing. It is very difficult to identify.
• First stage 1B. The size of the tumor can reach up to 5 centimeters in diameter, but the malignant neoplasm does not release tumor markers into the blood, which means that it can still be completely removed.

If this disease is detected at this stage, then the prognosis of the disease in 70 cases out of 100 will be favorable. Unfortunately, as mentioned above, it is very difficult and almost impossible to recognize at the initial stage, since the tumor is very small and there are no obvious symptoms.

It is always worth paying attention to the alarming symptoms in both adults and children: the degree of cough and the consistency and smell of sputum, it can be putrid and greenish.

Small cell cancer can be a huge danger, spreading metastases throughout the body almost instantly. If you suspect such a cancerous lesion, you should immediately resort to treatment: chemotherapy or surgical intervention.

Stage II cancer begins when a tumor is more than five centimeters in diameter. Among the main symptoms, one can distinguish an increased cough with sputum interspersed with blood, fever, rapid breathing, and a possible "lack of air". At this stage, dramatic weight loss often occurs.

• Stage 2A. The malignant growth in diameter has grown for 5 centimeters. Lymph nodes are almost reached, but not yet affected.
• Stage 2B. The malignant tumor reaches 7 cm, but the neoplasm, as in stage 2A, has not yet spread to the lymph nodes. There may be a digestive upset. Metastases to the chest cavity are possible.

Percentage of survival in the second stage: 30 patients out of 100. Correctly chosen treatment can increase life expectancy: up to about 4-6 years. In small cell cancer, the prognosis at this stage is even worse: 18 out of 100 patients.

THIRD stage of cancer. At this stage, treatment practically does not help.

• Stage 3A. The tumor is more than 7 centimeters. It has already reached the adjacent tissue and the lymph nodes near the lung are affected. Metastases appear, their area of \u200b\u200bappearance expands noticeably and covers the chest, trachea, blood vessels, even near the heart and can penetrate into the thoracic fascia.
• Stage 3B. A malignant tumor more than 7 cm in diameter, it can already affect even the walls of the lung. Rarely, metastases can reach the heart, tracheal vessels, which cause the development of pericarditis.

Symptoms in the third stage are pronounced. Severe coughing up blood, severe chest pain, chest pain. At this stage, doctors prescribe drugs to suppress coughs. The main treatment is to suppress the growth of cancer cells with chemotherapy, but unfortunately, the treatment is ineffective, the tumor grows and destroys the body.

The survival rate at this stage is very low. Only 9 out of 100 patients manage to escape with the help of a loading dose of chemotherapy and the latest technologies in the treatment of oncology.

The FOURTH stage of lung cancer is no longer amenable to treatment and in 100% of cases is fatal. At this stage, metastatic lesions of both nearby and distant organs are noted. Other oncological diseases of organs are also attached to lung cancer: liver, kidney, breast and other organs.

How long they live with lung cancer, no specialist will be able to answer you with accuracy, since it depends on many factors, on the human body, on immunity, on forms of lung cancer (carcinoma).

The stage of lung cancer is determined depending on the size of the tumor, its morphology, the degree of growth in the surrounding tissues, as well as the presence of damage to the lymph nodes or distant metastases.

The stage of the tumor determines the methods of treatment for lung cancer, their expected effectiveness and prognosis.

First stage

The tumor is small (on the roentgenogram up to 3 cm), without invasion into the pleura, without affecting regional lymph nodes and distant metastases

Stage two

Tumor size from 3 to 6 cm or any other tumor size sufficient to block (obstruction) the bronchus, or induration of lung tissue within one lobe of the lung. It is possible to involve regional lymph nodes in the process on one side.

Third stage

The size is more than 6 cm, or the tumor spreads to the chest wall, affects the area of \u200b\u200bseparation (bifurcation) of the main bronchi, affects the diaphragm, distant lymph nodes on the affected side or in the bifurcation area are affected, or there are signs of distant metastases.

Fourth stage

The size of the tumor is not important, it is spread to neighboring organs (heart, esophagus, stomach), many lymph nodes are affected both on the diseased side and on the opposite side, there are multiple distant metastases.

Depending on the clinical characteristics, the classification of lung cancer distinguishes several types of non-small cell form:

• Adenocarcinoma - forms in the peripheral region. The tumor is formed on the basis of mucous and glandular tissue.
• Squamous cell carcinoma. The neoplasm in this case consists of flat epithelial cells. Central cancer of the right lung is often diagnosed when large bronchi are affected.
• Large-cell - The tumor consists of large cells and spreads very quickly.
• Mixed, combining several types.

• At the first stage of the development of the disease, the tumor is small in size and consists of a part of the bronchus with no metastases;
• At the second stage (2a), a small-sized single formation with separate regional metastatic foci is observed;
• At stage 3, the tumor grows outside the lung and has many metastases;
• At the fourth stage, the blastomatous process covers the pulmonary pleura, adjacent tissues and has distant metastases. The process of metastasis in lung cancer differs in its speed, since the pulmonary organ is supplied with good blood and lymph flow, which ensures the rapid spread of cancer cells to other organs. Metastases usually occur in the brain, liver and the second part of the lung.

How fast it develops

The defeat of the lymphatic vessels is characteristic of progressive cancer, but at an early stage, lung cancer develops moderately. At first, the patient does not even know about the localization of the tumor, but later on, the malignant neoplasm exerts increased pressure on the neighboring organs and systems.

It is important to take into account all risk factors, and then the early stage of oncology will be diagnosed from a meaningful photo during an X-ray examination. This is important because it is related to patient survival and clinical outcome.

In total, there are 4 stages of lung cancer:

1. A neoplasm on one of the bronchi is no more than 3 cm in size. In stage 1 lung cancer, metastases are usually absent, the lymph nodes and bronchi are not damaged.
2. The tumor increases and takes on sizes from 3 to 6 cm. Lung cancer of the 2nd degree is characterized by the appearance of single metastases.
3. The tumor becomes more than 6 cm, can occupy a neighboring lobe. Lung cancer of the 3rd degree is given by metastases found in the diagnosis, appearing in the bifurcation lymph nodes.
4. Terminal stage - the tumor grows into nearby organs and tissues. At the last stage of the disease, pericarditis and pleurisy are added, which further worsens the patient's condition.

At different stages, treatment has its own characteristics.

Small cell lung cancer develops in a short period of time, passing through only 2 stages:

• Limited. Pathological cells are localized in one organ and nearby tissues.
• Extensive, when metastases are directed to more distant organs.

The fourth stage is not always treatable, therefore it is considered the most dangerous.

Video: Unusual Signs of Lung Cancer

Symptoms of lung cancer in women and men in the initial stages are almost the same.

Problems can start with non-specific symptoms:

• tiredness, lethargy;
• decreased performance;
• loss of appetite;
• losing weight.

Most patients do not attach importance to the malaise, do not go to the doctor. There are no signs of pathology on examination. There is only a slight pallor of the skin, characteristic of many diseases.

The first signs of lung cancer in men and women require special attention. When diagnosing a malignant tumor in the early stages (first or second), the probability of recovery is 90%, when determining the disease in the third - 40%, in the fourth - only 15%.

Serious problems with the body begin with prolonged malaise, so you must definitely visit a doctor. The oncologist will diagnose and advise what to do in the current situation.

As the disease progresses, a certain list of developing nonspecific symptoms is observed: cough, painful sensations in the chest, hemoptysis, difficulty breathing. If they are available, it is worth paying special attention to your condition and contacting specialists so that doctors can take timely measures.

Consider how lung cancer manifests itself. At the beginning of the formation of a tumor, the symptoms are subtle, or may be completely absent, which is why most lose a lot of time, and the cancer passes into another stage.

Lung cancer symptoms and signs:

1. Dry, prolonged cough. This symptom is the main one. It increases with physical exertion, hypothermia, during sleep, while lying on your stomach, on your back or on your side.
2. Allocations. Specific discharge when coughing up mucus with pus or flakes of protein.
3. Bleeding (hemoptysis). Sputum interspersed with blood.
4. Shortness of breath. On physical exertion, the manifestations of shortness of breath intensify. With the growth of the tumor, the symptom becomes more frequent.
5. Chest pain. Indicates metastases to the organs of the chest cavity or the growth of a tumor into the very parenchyma of the lung. With the cough, there is an increase.
6. Decreased appetite.

Lung cancer, stage 3 of which has passed unnoticed, reveals itself at the next stage with symptoms that are more pronounced. The patient begins to complain of chest pains arising during breathing, lack of appetite, coughing fits with the release of purulent and bloody sputum.

Typical symptoms of stage 4 lung cancer before death:

• Shortness of breath that occurs even at rest is the first symptom to look out for. Due to the accumulation of exudate, the growth of the tumor, the patient's breathing becomes intermittent.

• Difficulty of speech caused by damage to the cervical lymph nodes. As a result of metastasis, paralysis of the vocal cords is formed, the voice becomes hoarse.
• Decreased or complete lack of appetite.
• Drowsiness. Against the background of dehydration and slow metabolism, fatigue occurs, the patient sleeps a lot.
• Apathy. The person loses interest in life.
• Disorientation, hallucinations - characteristic of stage 4 lung cancer symptoms before death. Memory lapses are possible, speech becomes incoherent. The oxygen deprivation that causes lung cancer affects the brain.
• Swelling. As a result of kidney failure, they form on the lower extremities. In lung cancer of grade 4 with metastases, the latter penetrate into the mediastinum, which leads to compression of the veins and the occurrence of edema on the face and neck.
• Unbearable pain is another symptom of death. They arise as a result of metastatic lesions of other organs. Pain can often be managed only with the help of narcotic drugs.

The spread of metastases leads to the appearance of diseases that are not related to oncology. It can be pyelonephritis, jaundice, arrhythmia, angina pectoris, disturbances of peristalsis. Metastasis affects the bones, causing their deformation, severe pain.

Symptoms of lung cancer in men and women are the same, without specific manifestations. A timely visit to a doctor will prevent the development of the disease, the result of which may be not only disability, but also death.

What symptoms can be observed at an early stage of lung cancer and how to recognize them? At the beginning of its appearance, lung cancer is not associated with respiratory functions, as a result of which patients begin to turn to other specialists and, as a result, receive an erroneous diagnosis and incorrect treatment.

Obvious symptoms of damage to the respiratory system are detected even when the formation spreads to a significant part of the lung and begins to damage healthy tissue. Based on the similar specificity of diagnosing lung cancer, experts believe that in the presence of inaccurate signs, it is necessary to undergo a course of delivery of complex tests and do fluorography annually.

First symptoms

At first, the disease can proceed in a latent form, but special attention should be paid to the initial signs of a characteristic ailment. This is a cough for no reason, impaired breathing, sputum with blood impurities, acute pain in the chest, sudden weight loss.

The appearance changes noticeably, and the patient looks dry, tired, haggard. A biopsy of a tumor will clarify the clinical picture, but first you need to remember the following symptoms that are directly involved in collecting anamnesis data. It:

• cough with purulent mucous sputum;
• frequent shortness of breath without exertion;
• increased subfebrile body temperature;
• hemoptysis;
• acute pain in the sternum area;
• increased pressure on the chest;
• respiratory diseases.

Sputum

The patient coughs more and more often, and the mucous masses of sputum are supplemented with streaks of blood. The growth and spread of malignant cells intensifies the manifestation of clinical symptoms. The phlegm changes its consistency, becomes viscous, is difficult to separate, disrupts breathing, and can become the main cancerous tumors.

Bleeding

The course of the characteristic ailment is accompanied by the formation of blood streaks when trying to cough up. Stagnation occurs in the tissues of the lungs, and the accumulated sputum does not come out. When trying to cough, an acute cough reflex develops, and blood is present in the consistency of the sputum.

The disease often develops in adulthood, and a number of provoking factors of the external and internal environment precedes the onset of malignant tumors. Not only the etiology of lung cancer depends on these, but also the characteristic symptoms, the speed of initiation of intensive therapy, potential complications and clinical outcome.

In men

The smoker's cough helps to suspect the presence of malignant neoplasms, which only intensifies after each portion of nicotine. It is an external causative agent of the pathological process, actively producing in the tissues of the bronchi. Other symptoms of lung cancer in men are listed below:

• pigmentation of the iris of the eyes;
• heart pain and shortness of breath in the absence of physical activity;
• pronounced wheezing with even breathing;
• more frequent migraine attacks;
• hoarseness of voice;
• pathological induration in the lymph node;
• general weakness, a sharp decrease in body weight.

Among women

Extensive damage to the epithelium of the bronchi in the fairer sex occurs more and more often, and the lung cancer itself is getting younger almost every year. The age of the patients is 35 and older. It is important to observe preventive measures and avoid risk groups, and in the case of malignant tumors, pay attention to the following changes in general health, and promptly seek help from a local therapist. Complaints can be as follows:

• more frequent respiratory diseases;
• frequent relapses of pulmonary diseases;
• pronounced hoarseness of the voice;
• blood impurities affecting the bronchial mucosa;
• slightly increased body temperature;
• instability of the central nervous system;
• chronic cough.

Signs of lung cancer are not always present; they are difficult to identify and distinguish from symptoms of other diseases of the respiratory system.

The appearance of such signs as persistent cough, streaks of blood in sputum, shortness of breath, chest pain, weight loss, accompanied by lethargy, increased fatigue, apathy - requires a visit to the doctor and an examination.

In 15% of cases, in the initial stages, a lung tumor does not appear in any way, and it can only be detected with a thorough X-ray or MRI.

Experienced smokers, be careful! A persistent cough, blood-streaked phlegm, chest pains, and recurrent pneumonia and bronchitis are not just unpleasant symptoms. It is possible that a serious disease-causing process is developing in your lungs: lung cancer.

Unfortunately, the majority of patients go to doctors at the advanced stages of lung cancer. Therefore, it is very important to regularly undergo preventive examinations, do fluorography and consult a pulmonologist for any symptoms of pulmonary diseases lasting more than 3 days.

The clinical picture of lung cancer is similar to the manifestations of other malignant lung tumors. Typical symptoms are persistent cough with mucopurulent sputum, shortness of breath, subfebrile body temperature, chest pain, hemoptysis. Some differences in the clinical picture of lung cancer are due to the anatomical localization of the tumor.

A cancerous tumor localized in a large bronchus gives early clinical symptoms due to irritation of the bronchial mucosa, impairment of its patency and ventilation of the corresponding segment, lobe or whole lung.

The interest of the pleura and nerve trunks causes the appearance of pain syndrome, cancerous pleurisy and disorders in the innervation zones of the corresponding nerves (phrenic, vagus or recurrent).

Germination of the bronchus tumor causes the appearance of a cough with phlegm and often mixed with blood. When hypoventilation occurs, and then atelectasis of a segment or lobe of the lung, cancerous pneumonia joins, manifested by increased body temperature, the appearance of purulent sputum and shortness of breath.

Germination or compression of the vagus nerve by a tumor causes paralysis of the vocal muscles and is manifested by hoarseness. Damage to the phrenic nerve leads to paralysis of the diaphragm. Germination of a cancerous tumor into the pericardium causes pain in the heart, pericarditis.

The interest of the superior vena cava leads to impaired venous and lymphatic outflow from the upper half of the body. The so-called superior vena cava syndrome is manifested by puffiness and swelling of the face, hyperemia with a cyanotic tinge, swelling of the veins in the arms, neck, chest, shortness of breath, in severe cases - headache, visual disturbances and impaired consciousness.

Peripheral lung cancer in the early stages of its development is asymptomatic, since pain receptors in the lung tissue are absent. As the tumor node increases, the bronchi, pleura, and neighboring organs are involved in the process.

Local symptoms of peripheral lung cancer include cough with sputum and blood streaks, compression of the superior vena cava syndrome, and hoarseness. The growth of the tumor into the pleura is accompanied by cancerous pleurisy and compression of the lung by pleural effusion.

The development of lung cancer is accompanied by an increase in general symptoms: intoxication, shortness of breath, weakness, weight loss, increased body temperature. In advanced forms of lung cancer, complications from the organs affected by metastases, the decay of the primary tumor, the phenomena of bronchial obstruction, atelectasis, and profuse pulmonary hemorrhages join.

Lung cancer is one of the high mortality cancers. This is caused, to a large extent, by its asymptomatic development in the early stages. At the moment when it comes to the appearance of obvious alarming symptoms, the disease is already sufficiently developed and does not give a chance for effective treatment.

Lung cancer symptoms are divided into three groups. First, the symptoms associated with tumor growth are isolated. Secondly, in an advanced stage of cancer development, symptoms associated with metastases in other tissues and organs may appear.

The most common symptom of a primary tumor is a cough that has no known cause. This occurs in most patients. In tobacco smokers who suffer from smoking-related cough, it can change in character, which should be a cause for concern.

Recurrent pneumonia is often the first sign of lung cancer. If pneumonia recurs after treatment, it is recommended that lung cancer angle diagnostics be carried out, especially in people at risk.

The tumor can also cause shortness of breath due to narrowing of the bronchial canal. Patients may experience chest pain (if the cancer affects the pleura). A tumor located in the upper part of the lungs can cause shoulder pain.

Quite specific symptoms are metastases of lung cancer within the chest. If it comes to metastases of the heart and pericardium, this can lead to heart rhythm disturbances. If it comes to metastases of the pleura or chest wall, then these places become painful. Metastases in the mediastinal nodes can lead to damage to the optic nerve.

More nonspecific symptoms cause distant metastases. Lung cancer most often affects the brain, liver and bones. Brain damage will give a number of neurological symptoms, the form of which depends on the scale and exact location: the most common are headache, seizures, epilepsy, personality disorders.

Liver metastases cause abdominal pain, nausea, weakness, decreased appetite, weight loss, and jaundice. Bone metastases can cause chronic bone pain, pathologic fractures that occur in situations in which healthy, strong bone should not break.

Diagnostic methods

For the successful treatment of non-small cell neoplasms and in the fight against small cell cancer, it is necessary to undergo a full diagnosis, which starts with the standard collection of anamnesis data. Early detection of a characteristic ailment is facilitated by the following analyzes, routine examinations. It:

• clinical examination to collect history data;
• Ultrasound and X-ray diagnostics in order to recognize the pathological focus in time;
• bronchoscopy;
• transthoracic biopsy to identify the nature of the focus of pathology;
• determination of the mutational status of the epidermal growth factor receptor.

Diagnosis of pathology can be difficult due to the fact that it is disguised as colds. If the back hurts with lung cancer, the patient turns to a neurologist or osteopath, but does not attend an oncologist's appointment.

The doctor's task is to notice nonspecific signs, which together, in a certain scenario, form a clear clinical picture. When lung cancer metastases begin, the disease is most easily identified, but effective treatment is possible only if the diagnosis is made at an early stage.

The patient is assigned the following studies:

• radiograph in several projections;
• CT and / or MRI of the chest area;
• sputum examination;
• a blood test for tumor markers;
• blood chemistry;
• study of blood, urine;
• biopsy, etc.

The insidiousness of the disease lies in the fact that at the initial stages it manifests itself as scanty symptoms. The onset of edema of the legs with lung cancer, cough, hemoptysis and other eloquent symptoms occurs at 3-4 stages, when the probability of healing is low.

What lung cancer looks like depends on the characteristics of the case, and the diagnosis is the work of a specialist. However, ordinary citizens need to know what symptoms and signs given by the body to pay attention to.

A known way to detect lung cancer is to take an x-ray of the lungs. However, this method is not always effective in the early stages of the disease, when the tumor is very small, or with an atypical location.

Computed tomography (CT) or magnetic resonance imaging (MRI) of the lung may be required to make a diagnosis.

The most modern diagnostic methods are used early in the process to clarify the diagnosis and include:

• Multilayer spiral computed tomography, which can detect tumors up to 1-3 mm
• Positron emission tomography combined with computed tomography (PET-CT), the minimum size of the detected tumor is 5-7 mm.

To clarify the diagnosis, endoscopic bronchography is used, which allows you to find out the location of the tumor and its size, as well as make a biopsy - take a piece of tissue for cytological examination.

See a therapist if you have frequent shortness of breath or persistent coughing. These complaints may indicate various diseases, but in rare cases they become the first symptoms of lung cancer.

The therapist is a general practitioner. He will conduct an initial examination: a general examination and measurement of the most important indicators of health (pressure, pulse, body temperature), listen to the lungs and heart, ask you in detail about complaints and well-being, factors that could cause the disease. And he will also prescribe general analyzes and studies.

You may be referred for a vital lung capacity test - spirometry. This is a painless and simple examination to assess how the respiratory system is functioning. Most likely, you will need to pass a general blood test, possibly sputum, in order to exclude inflammatory or infectious diseases. One of the main tests for suspected lung cancer will be a chest x-ray.

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