In Western countries the number of lung cancer cases increases for years. Although the trend is declining for men since the 80's, that women exhibit every year new sad record numbers. Meanwhile, lung cancer is the third most common form of cancer in both sexes.
These figures are all the more tragic than that of lung cancer is one of the few malignant tumors, in which the main risk factor is known for a long time: about 90% of lung cancer patients are smokers. Passing, is that according to a study almost every third 15-year-old smokes, where Germany is one of the sad leaders in international comparison, the probability is high that the number of lung cancer patients in the future will not fall.
What is lung cancer?
In fact, lung cancer is a generic term for different malignant tumours in the lungs and respiratory system. The lung cancer that is colloquially often equated with lung cancer and addressed the following here is the by far most common form (90%). The blood to metastases, so daughter tumours of other types of cancer in the lung be flushed and to settle there. Malignant tumors of the lung and pleura are rare.
Depending on how the tissue will appear under the microscope, small cell (25%) and non-small cell lung cancer are distinguished. The latter is further subdivided into various forms, including the Squamous Cell Carcinoma, which goes from deck tissue and most commonly occurs with about 45%, and the adenocarcinoma, which does not depend in contrast to all other forms of smoking.
The small cell lung cancer spreads daughter tumors very early and therefore has a poorer prognosis. For prognosis and therapy also the tumor stage is important in addition to the microscopic findings of the cell, so the cancer is how big and how far it has spread in diagnosis on surrounding structures and in the body.
What are the causes of lung cancer?
The lung cancer arises primarily as a result of tobacco smoking. There are about 4 in the cigarette smoke.000 substances, 40 are carcinogenic of which, as well as standardised harms a responsible for the cancerous gene on chromosome 9 P 53. But not only active smoking is unhealthy, even exposure to secondhand smoke increases the risk of cancer. A non-smoker spends an evening surrounded by smokers in an enclosed space, such as a pub, the body will be charged as when he had smoked 4-9 cigarettes.
The risk increases with the number of cigarettes, the depth of inhalation, the duration of smoking and age. Tar and nicotine concentration also play a role. It assumes that the risk of cancer is 30-fold increased 40 Pack years (i.e. for 40 years of a pack of cigarettes daily). But there is good news: smokers do it, to rid themselves of their nicotine addiction the probability of getting lung cancer, approaches to and after again in non-smokers.
Toxic substances in the air as a cause of lung cancer
In addition to smoking, other toxins in the air we breathe can trigger lung cancer, especially if you are exposed to them over a long period. These include asbestos, arsenic, chromium, cadmium, nickel, polycyclic aromatic hydrocarbons, mustard gas, uranium, radon etc. So are E.g. Blast furnace workers, gas company workers, roofers and asphalt facilities at risk, especially if they violate the provisions of the occupational safety and health. The combination of these pollutants with active smoking is particularly dangerous.
Why is however in some smokers developed cancer, while others remain untouched despite decades of long nicotine addiction, is not yet clear. A clear genetic cause could be found so far nor as a diet-related. However, the scientists assume that relationships exist.
Lung Cancer: Symptoms and signs
What are lung cancer the symptoms of? Tricky is that lung cancer causes no symptoms, usually very long. Often, lung cancer is therefore either discovered coincidentally during an X-ray examination or only when it is already advanced and therefore poorly curable. Unlike some other types of cancer, also currently no screening is offered which would suitable as a screening for the early detection. When symptoms occur, they are at least in the beginning mostly not of other lung diseases to differentiate. Following symptoms should give rise to a visit to the doctor, especially when combined or prolonged occur:
- new-onset, which worsens or changing chronic dry cough
- Coughing up blood
- Breathing to the shortness of breath
- Lung sounds while breathing, chest pain
- Lung diseases such as bronchitis, that do not heal
- Hoarseness, swallowing
- Fever, night sweats
- Fatigue, power folding
- Loss of appetite, unintentional weight loss
More problems can occur when spreading lung cancer and metastases to other organs to settle. Frequently spinal cord, brain, adrenal glands and liver are affected, which can lead to back pain, headaches, dizziness, changes in behaviour, abdominal pain or nausea.
How is the diagnosis made?
By means of studies, not just the tumor is found, but also his style and his stage determines, to decide on the treatment. First, the doctor will ask the medical history, including smoking habits and occupational hazard. After the physical examination x-rays of the lungs, as well as various blood tests will join. To evaluate the tumor tissue, possibly a reflection of lung is performed at also cell - and tissue samples can be found.
With a computed tomography of the chest, Oberbauchs and brain cancer incidence can determine and track down the daughter tumours. Allows a skeletal scintigraphy in bone wastage is targeted to Absieden lungs, may join a bone marrow biopsy. There are a series of further tests which are used depending on the case and before a planned surgery.
What is the treatment?
The treatment depends on type and spread of the tumor. As far as possible attempts to achieve a cure. This however only works if all tumour metastases and diseased lymph nodes can be removed. Only then can prevent a recurrence. Depending on the type of cancer, stage and condition of the patient, surgery, chemotherapy, radiation therapy, or a combination thereof be applied.
Operation: Right and left lung consist of two or three lobes, which are composed of a total of ten or nine segments of the lung. Depending on the size of the tumor is occasionally the entire left or right lung (Pneumektomie) removed a segment (partial lung resection) or a lobe (Lobectomy). With a lung function test previously determined whether the remaining respiratory activity is sufficient. Especially non-small cell shapes are suitable for surgery.
Chemotherapy: This cytostatics are given mostly in several cycles, cell toxins which attack especially cancer cells, but not sparing even the body's healthy cells. It is therefore often cause strong side effects. Particularly small cell carcinomas are out.
Radiation therapy: Cells be harmed by x-rays in certain dosage. Particularly small cell lung cancer is to reduce, they irradiated the skull, a the settlement of metastases can possibly prevent.
Recently, scientists have found some new approaches at the molecular level, where in the therapy, the cancer cells are specifically attacked. First research results offer hope that is consequently will in future also in lung cancer new treatment options.
How are history and prognosis?
Total lung cancer is currently rather unfavourable prognostic cancer types – 5 years after diagnosis on average only 13-14% of patients. The prognosis depends however type, size and spread of the tumor, and hence responsiveness to therapy, but also by the age and general condition of the patient.
The relatively best forecast has the squamous cell carcinoma at an early stage, the worst the small cell lung cancer. If left untreated it leads even within a few weeks to death. Regular checkups are important after completion of treatment, so that also a recurring tumor can be detected early and treated. And in any case, the person concerned should be consistently abandoned cigarettes.
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