Lung cancer is one of the most common types of cancer. Malignant lung tumors are difficult to treat because they are difficult to detect at an early stage. The disease is asymptomatic for a long time. Lung cancer in the photo looks like a space-occupying formation. It is prone to an aggressive course, metastasizes early and relapses.
Doctors at the Oncology Clinic of the Yusupov Hospital diagnose malignant lung tumors using modern equipment from leading companies in the USA and European countries. Professors and doctors of the highest category provide complex therapy, which includes surgery, radiation and chemotherapy. If there is a tumor in both lungs, the prognosis is less optimistic. If lung cancer is detected at an early stage, recovery occurs in 90% of patients.
Classification
The types of lung tumors are classified according to the location of the primary focus.
Central cancer is localized in the proximal (central) parts of the bronchial tree. The first signs of lung cancer (symptoms), which should alert you, in this case are clearly expressed:
- dry, prolonged cough that cannot be treated.
- hemoptysis begins with the addition of sputum.
- blockage of the bronchial lumen by tumor masses leads to shortness of breath even at rest. In some cases, the temperature may rise.
Photo 1 - Central cancer of the right lower lobe bronchus (1) with obstruction and metastases (2) to the bifurcation lymph nodes
Peripheral cancer gradually forms in the lateral parts of the lungs, slowly germinating and not detecting itself. This lung tumor may not produce symptoms for a long time; they appear with significant local spread, involvement of neighboring organs and structures, and invasion of the bronchi. Diagnosis of lung cancer of this type of localization is most often possible during a preventive examination (x-ray or computed tomography).
Photo 2 - Peripheral cancer (1) of the upper lobe of the right lung
1st symptom – persistent cough
The first sign is a constant cough . Pay attention to how you cough. If the cough goes away after one or two weeks , it means it was the result of a respiratory infection or cold. However, if the symptom does not disappear even after two weeks, it may indicate the development of lung cancer. A cough with mucus is a mandatory reason to see a doctor and undergo appropriate examinations of the lungs and chest - for example, an x-ray. A hoarse or bloody cough, as well as the discharge of a large amount of mucus, are very alarming signs and you should consult a doctor immediately. In such cases, we advise you to undergo examination by Israeli doctors.
Surgical method for treating lung cancer
- the main radical method for stages 1-3 of the disease. Operations performed for this disease are classified:
- by volume of resection (lobectomy (removal of a lobe of the lung), bilobectomy (removal of two lobes of the lung), pneumonectomy (removal of the entire lung)),
Photo 3 - Lobectomy
Photo 4 - Pneumonectomy
- by volume of removal of lymph nodes of the thoracic cavity (standard, expanded, super-expanded),
- by the presence of resection of adjacent organs and structures (combined operations are performed when the tumor grows into the pericardium, trachea, superior vena cava, esophagus, aorta, atrium, chest wall, spine). In addition to surgical treatment, it is possible to use an integrated approach, including radiation and chemotherapy.
When treating locally advanced malignant tumors with transition to the main bronchus and pulmonary artery, in cases where previously the only option for surgical treatment was pneumonectomy, it is now possible to perform organ-preserving operations. In this case, the affected area of the main bronchus is excised, followed by restoration of continuity (bronchoplastic and angioplastic lobectomies)
Photo 5 - Scheme of upper bronchoplastic lobectomy
Rehabilitation
After complex and long-term treatment, the patient often requires rehabilitation, which is most successful under the supervision of doctors and includes:
- anesthesia;
- drug therapy to accelerate tissue regeneration;
- physiotherapeutic procedures;
- physical therapy to restore physical activity;
- psychotherapeutic treatment.
As a result, the patient is completely restored to normal life and overcomes the consequences of the disease.
Radiation therapy for lung cancer
Today, such modern methods of radiotherapy as IMRT (radiation therapy with the possibility of changing the radiation dose), 3D conformal radiation therapy (three-dimensional computer planning of selective irradiation) and stereotactic (precisely focused) radiation therapy are being actively implemented. In addition to oncologists, medical physicists, radiologists, dosimetrist physicists and other specialists participate in these manipulations.
Method shown:
- patients with a resectable lung tumor for whom surgical treatment cannot be performed due to contraindications from the cardiovascular system or for other reasons;
- as an alternative to surgery;
- to reduce the risk of relapse in case of damage to the mediastinal lymph nodes, a positive resection margin according to histological examination.
Where can I buy Israeli medicines?
- In Israel - after examination at the oncology center. During the consultation, the oncologist will prescribe medications for you, which can be purchased at an Israeli pharmacy.
- In any locality in the world where the patient lives. The telemedicine program allows patients of the Ichilov Cancer Center to undergo examination by Israeli specialists without leaving home. After diagnosis, the patient will be able to order prescribed medications at home.
Find out if the treatment is prescribed correctly
Chemotherapy
Planning the course of treatment for non-small cell lung cancer includes the use of pharmacological agents. It is used for prevention purposes: adjuvant (auxiliary), postoperative chemotherapy for stages 2-3 of the disease and in the therapeutic course.
Depending on the histological type of tumor, stage of the disease and expected sensitivity to effects, various regimens for the use of chemotherapy have been developed.
Targeted therapy (eng. target - target, goal)
A separate type of pharmacological treatment, which consists in prescribing inhibitor drugs that act only on tumor cells in which various disorders have been identified, delaying or even blocking further growth.
- Tyrosine kinase inhibitors (gefitinib, erlotinib, afatinib) are used in the treatment of patients whose tumor tissue has mutations in the EGFR gene.
- If the EGFR mutation status is negative, use ALK inhibitors (crizotinib, alectinib).
There are targeted drugs, the prescription of which does not require the identification of any abnormalities in tumor cells. These include bevacizumab (VEGF inhibitor), nivolumab and pembrolizumab (anti-PDL1 antibodies).
Fourth
At the fourth stage of oncology development, processes are no longer controllable. A malignant tumor rapidly spreads to all organs of the body and penetrates all cells of the body. Metastases increase in number, and new cancers form. The liver, brain, bones and other vital organs may be affected.
Manifestation of pathology:
• cough becomes paroxysmal; • a large amount of blood and pus in the sputum; • pain in the sternum; • increased shortness of breath.
In a terminal condition, the functioning of the lungs becomes difficult. Consequently, oxygen enters the organs in smaller quantities, and, as you know, it is extremely necessary for the normal functioning of the body and life in general. This is where all the above violations arise. Digestive problems often appear, because... tumor formation can push back the esophagus and impede its food passage.
Life forecast
The prognosis of lung cancer in NSCLC includes symptoms, tumor size (> 3 cm), non-squamous histology, extent of spread (stage), lymph node metastasis and vascular invasion. Inoperability of the disease, severe symptoms and weight loss of more than 10% give lower results. Prognostic factors for small cell lung cancer include condition status, sex, stage of disease, and involvement of the central nervous system or liver at the time of diagnosis.
For non-small cell lung cancer, the prognosis for life with complete surgical resection of stage IA (early stage of the disease) is 70% five-year survival.
2nd symptom – shortness of breath
This symptom may also indicate lung cancer. Difficulty breathing in this case can have two reasons: either fluid has accumulated in the chest as a result of the development of a cancerous tumor, or a narrowing or obstruction of the airways has occurred. Thus, if, as a result of normal, everyday activities, you suddenly begin to feel short of breath - and everyday activities include going to the store, climbing stairs, and similar simple actions - it is strongly recommended to consult a specialist.
Symptoms
In the first stages of the disease in question, its course may go unnoticed. May manifest as vague symptoms such as shortness of breath, cough, hoarseness. Over time, the following signs appear:
• Horner's syndrome – as a rule, it affects the visual system (a person begins to react poorly to light, conjunctivitis forms, the iris changes color);
• dysphagia – formed against the background of inflammation in the oral cavity and pharynx; causes difficulty swallowing;
• respiratory failure – the blood begins to be poorly saturated with oxygen, its gas composition is disrupted.
Hypertrophic pulmonary osteoarthropathy is present in approximately 10% of cases.
Diet
Diet for cancer
- Efficacy: no data
- Duration: until recovery or lifelong
- Groceries cost: 2500 - 4800 per week
It is important for patients to provide not only timely treatment, but also proper nutrition for lung cancer. After all, nutrition is an important factor in the treatment and recovery of the patient.
If you have cancer, you should maintain a healthy weight, eat a variety of foods with the right amount of nutrients, and avoid foods that may adversely affect your overall health.
For lung pathologies, it is recommended to introduce the following products into the diet:
- Dairy products.
- Stewed and boiled vegetables.
- White bread, pasta, crackers.
- Oatmeal, rice.
- Poultry, lean fish.
- Eggs.
- Butter.
- Soups and low-fat broths.
- Vegetable and fruit juices.
It is recommended to exclude the following foods from your diet:
- Any products with preservatives.
- Fatty dishes.
- Dishes high in sugar.
- Refractory cheeses.
It is very important to properly formulate the diet for those undergoing chemotherapy. The doctor will give individual recommendations regarding nutrition in such a situation. The general rules are as follows:
- It is recommended to eat in small portions.
- The basis of the menu should be liquid dishes, purees, and foods that are easily digested. This is relevant for nausea and problems with swallowing.
- Food should be eaten warm.
- It is recommended to drink tea with ginger and mint if you are worried about intestinal disorders.
- To prevent constipation, you need to regularly eat foods with fiber.
- Any food should be washed very thoroughly before cooking.
- Proper heat treatment of all products is important, since in patients after chemotherapy the immune system is not active enough, and there is a risk of infection by pathogens.
Characteristics of the small cell type
Small cell lung carcinoma is an extremely unfavorable tumor, often developing against the background of tobacco product abuse. It occurs in 16% of cases, and every year it affects more and more women. For several decades, before the development of effective treatment methods, the average life expectancy after diagnosis was about 12 weeks.
The main problem of such carcinoma is that it grows very quickly, and the formation of metastases requires a minimum of time. This type of cancer without metastases is diagnosed only in 5% of cases. This statistics explains the futility of local treatment (meaning surgery and radiotherapy). Due to the rapid spread of cancer cells, the best method of control is the use of oncology vaccines.
