Lung Cancer
Lung cancer occurs when some cells in the lungs and small airways turn into malignant cells as a result of a change in their genetics due to various internal or external factors, resulting in abnormal proliferation and the formation of a tumor. It is the most common type of cancer globally and in our country. It is the most common cause of death among all cancers. Approximately 80,000 new lung cancer patients are diagnosed yearly in our country. Especially those who smoke for many years are at serious risk for lung cancer.
There are mainly 2 types of lung cancer. These are;
– Small cell lung cancer,
– Non-small cell lung cancer.
– Non-small cell lung cancers are divided into 3 types. These are;
– epidermoid carcinoma
– adenocarcinoma
– large cell lung carcinoma.
What are the symptoms of lung cancer?
Lung cancer manifests itself with symptoms such as
– cough,
– sputum (especially the appearance of blood in sputum),
– pain in the chest,
– loss of appetite,
– weight loss
In particular, mixed blood in sputum is a very important finding and in a smoker for many years, it strongly suggests lung cancer.
What are the diagnostic methods in lung cancer?
In lung cancer, the diagnostic process begins when people are admitted to hospital after the onset of symptoms. The most important initial diagnostic tool is radiological examinations. Although large tumors can be easily seen with direct chest X-ray, some small tumors or tumors that can be hidden due to their location may not be seen with direct film. Computed tomography is now much more widely used due to its widespread availability, fast shooting and the fact that it can now be shot with very low radiation. When a mass is seen radiologically, further tests are required for diagnosis. These include sputum cancer cell search, bronchoscopy, needle biopsy under tomography, PET CT and other tests.
Why is PET-CT necessary in lung cancer?
Another very valuable tool in patients with diagnosed or suspected lung cancer is Positron Emission Tomography combined with Computed Tomography (PET-CT). With PET-CT, it is possible to define at a very high rate whether the lung mass is cancerous or not, as well as whether there is metastasis of lung cancer or other cancer elsewhere in the body. PET-CT should be performed in both diagnosed and undiagnosed cases where there is a high suspicion of lung cancer.
Needle biopsy in lung cancer
Tumors located near the outer surfaces of the lungs are difficult to reach by bronchoscopy. In some cases, it may be necessary to take a biopsy of these tumors with an externally inserted needle under tomography. The biopsy determines whether the mass is cancerous or not and the cell type.
What is staging in lung cancer?
Staging of lung cancer is necessary to know at what stage lung cancer is, whether it is initially new cancer or an advanced cancer that has spread, to decide which method to use for the treatment of the disease, to have information about the progression of the disease and life expectancy. There are roughly 4 stages in lung cancer. To put it very roughly, in the first and second stages the cancer is confined to one lung, in the third stage it has spread to extrapulmonary lymph nodes and in the fourth stage it has spread to distant regions. For this reason, the disease in the first 2 stages is considered local disease – early stage and can be treated with surgery, while the later stages are considered advanced stage and systemic treatments (chemotherapy, etc.) are used.
How is staging performed in lung cancer?
Lung cancer staging is based on the TNM classification.
1. Tumor diameter and location-T
In lung cancer, the size of the tumor is an important criterion for staging the disease: for example, a 2 cm tumor is at different stages than a 5 cm or 8 cm tumor. A cancer located in the main trachea and a cancer located in outer part of the lung also have different stages.
2. Whether there is spread to the lymph nodes-N
No spread to the lymph nodes indicates an earlier stage (stage 1), while spread to the lymph nodes indicates a more advanced stage (stage 2 or 3).
3. Whether it has spread (metastasized) to other organs-M
If lung cancer is not detected early, it can spread to other organ such as to other lung, to the brain, bone, adrenal glands, liver or other parts of the body. In this case, the cancer reaches the most advanced stage, stage 4.
What happens in stage 4 lung cancer?
Stage 4 lung cancer is the most advanced stage. In this case, the cancer has metastasized, that is, spread to other organs and tissues of the body as well as the lung. At this stage, when surgical option does not seem possible, medication or other treatment options can be applied firs, according to the guidance of an oncologist.
What is used in the treatment of lung cancer?
Stage 4 lung cancer is the most advanced stage. In this case, the cancer has metastasized, that is, spread to other organs and tissues of the body as well as the lung. At this stage, when surgical option does not seem possible, medication or other treatment options can be applied firs, according to the guidance of an oncologist.
What is used in the treatment of lung cancer?
Main treatment options for lung cancer
– surgery (surgical treatment),
– chemotherapy (drug treatment),
– immunotherapy and
– radiotherapy (radiation therapy).
Surgery is the treatment that gives the best results in lung cancer and gives hope of getting rid of this disease completely. However, only 20-25% of patients having lung cancer are suitable for surgical treatment. This is because lung cancer must be at an early stage (stage 1 and stage 2, very rarely stage 3) for the surgical option to be used.
In which cases can surgery be performed in lung cancer?
– The cancer must only be in one part of the lung and must not have spread (metastasized) to the lymph nodes near the trachea, called mediastinum, or to other parts of the body. If necessary, it may be necessary to take pieces from these lymph nodes by mediastinoscopy, mediastinotomy, etc. to determine whether there is spread to the lymph nodes.
– The patient’s general condition and performance (heart and other lung condition and competence) must be suitable for this operation.
Surgical treatment is appropriate in stages 1 and 2 of the 4 stages of lung cancer and life expectancy (5 years) can reach 80-90% in these patients. Therefore, surgical treatment in patients caught in the early stages is a very important opportunity and should not be missed.
How is lung cancer surgery performed?
– Surgery for lung cancer is mainly of two types: open (thoracotomy) and closed (thoracoscopy – videothoracoscopy – VATS).
– The closed (videothoracoscopic-VATS) method used in advanced centers around the world has many advantages for the patient.
Is chemotherapy necessary after lung cancer surgery?
With lung cancer surgery, the cancerous area located in the lung (mostly lung lobe) togather with all the lymph nodes around are removed and sent to pathology. As a result of the pathology reports after the surgery and final staging of the tumour is done,. Then, the patient’s surgeon, medical oncologist and radiation oncologist jointly decide ( on tumour board) whether the patient needs additional treatment and which additional treatment should be done and how.
What is the cure rate for lung cancer?
Most of the patients who are diagnosed at an early stage and who can be operated on can completely recover from this disease. Even if there is a recurrence in some patients after surgery, the life expectancy of these patients is much longer than those who have not undergone surgery.
For those with advanced diseases that is not appropriate for them to undergo surgery, new chemotherapy and radiotherapy methods significantly increase the life expectancy of patients compared to those who do not receive any treatment.
Fourth Stage Lung Cancer Survival (Prognosis)
The question that patients and their relatives often ask is ‘what are the chances of surviving this disease with the treatment at stage 4 ? The statistics below reflect the results of international studies of the treatment of very large numbers of patients.
• One-year survival probability (British Cancer Research UK results) for patients with stage four lung cancer is 14%.
• The five-year survival probability (American National Cancer Institute results) is 1% for patients with stage four lung cancer.
