Resident of the Republican Oncology Dispensary, surgical department No. 2, Podolyak Maxim Aleksandrovich
GBUZ Republican Oncology DispensaryPetrozavodsk
Lososinskoe highway, 11
DEFINITION
Epidemiology
Lung cancer ranks first in morbidity and mortality from malignant tumors in the world and in Russia.83.6% of cases occur in men.
Every year, about 1.2 million lung cancer patients die worldwide, more than 60,000 people die in Russia.
Lung cancer is very rarely diagnosed before age 40. The average age at which lung cancer is diagnosed is 60 years.
The highest prevalence is observed in people over 75 years of age.
The risk of developing lung cancer largely depends on the age at which smoking begins, the duration of smoking and the number of cigarettes smoked per day. The risk is significantly higher for those who begin to smoke regularly in adolescence (13-19 years of age).
Epidemiology
Cigarette smoking is associated with 87 to 91% of lung cancer in men and 57 to 86% of lung cancer in women.Due to the significant increase in the prevalence of smoking among women, a significant increase in incidence in this population is projected starting in 2010.
Passive smoking also increases the risk of lung cancer in people who have never smoked by 17-20%.
Relevance
In approximately 70% of cases, lung cancer is diagnosed when symptoms of the disease appear, when there are already mediastinal or distant metastases.For lung cancer diagnosed clinically, the five-year survival rate of patients is only 10-16%.
Relevance
Lung cancer is the most common malignant tumor in the world population, occupying a leading place in the structure of cancer incidence among the male population of the CIS countries, its share is 18-22%*.Peripheral cancer accounts for 20-30% of the total number of lung cancer cases, and non-small cell lung cancer accounts for up to 70-80%.
screening
Chest X-ray. Large-frame fluorography (the most widely used screening method) makes it possible to detect many cases of lung cancer in the early stages, but does not reduce morbidity and mortality. Not effective for screening purposes.Spiral CT scan. A low-dose helical computed tomography scan can detect lung cancer at an early stage when the tumor is very small. The operability of tumors detected in high-risk individuals using this method increases significantly.
Cytological examination of sputum is not used for screening purposes!!!
Clinical and anatomical classification
Central cancer:Endobronchial
Peribronchial
Ramified
Peripheral cancer
Round tumor
Pneumonia-like cancer
Pancoast cancer
Atypical forms associated with the characteristics of metastasis:
Mediastinal form
Miliary carcinomatosis
Classification by localization
Hilar (central) lung cancer emanating from the stem, lobar and initial part of the segmental bronchus
Peripheral(including apical), emanating from the peripheral part of the segmental bronchus and its smaller branches, as well as from the alveolar epithelium.
classification
Morphological (histological)
Squamous cell (epidermoid) cancer;highly differentiated
moderately differentiated
low differentiated
Adenocarcinoma:
highly differentiated (acinar, papillary)
moderately differentiated (glandular - solid)
poorly differentiated (solid cancer with mucus formation)
bronchioloalveolar cancer;
Carcinoid tumor (carcinoid)
Small cell
oat cell, spindle cell carcinoma
pleomorphic
Large cell
giant cell
clear cell
Clinic
Symptoms
Primary(cough, hemoptysis, shortness of breath, chest pain)Secondary(hoarseness, SVC syndrome)
Are common(increase in body temperature, loss of body weight, decreased performance)
Clinic
Pancoast cancerMediastinal form or Claude-Barnard-Horner syndrome
Carcinomatosis of the thoracic cavity
Pancoast tumor
Central cancer
Peripheral cancer
Milliary cancer
Survey
Central lung cancer
General clinical studyCytological examination of sputum (at least 3 samples)
FBS
Survey
Peripheral lung cancer
General clinical studyPolypositional X-ray examination of the GP
VATS - biopsy
Surgery
Scope of intervention
PulmonectomyLung resection
1) Anatomical
lobectomy and its variants segmentectomy2) Non-anatomical
wedge-shaped planarResection of the trachea and large bronchi
Endoscopic interventions (recanalization of the trachea of large bronchi)
Intervention option
Typical operationExtended surgery (mediastinal lymph node dissection)
Combined surgery (resection of adjacent organs)
Contraindications to radical surgery
unresectable - spread of the tumor to adjacent tissues and organs, in which it is technically impossible to radically remove the tumor.inappropriate due to the presence of distant metastases.
insufficiency of functions of the cardiovascular and respiratory systems, decompensated diseases of internal organs
Molecular Tumor Biology
EGFR (epidermal growth factor receptor)ALK
Prescription of targeted therapy (Dasatinib, Crizotinib)
Evaluation of epidermal growth factor receptor (EGFR) mutational status
In the case of metastatic non-small cell lung cancer, when an EGFR mutation is detected, the effectiveness of targeted therapy based on EGFR inhibitors increases significantly. Before prescribing drugs (gefitinib, erlotinib), molecular genetic diagnostics are performed to identify receptor mutations. In 2012-2013, the Molecular Genetic Diagnostics Program of the Russian Society of Chemotherapeutic Oncologists operated in Russia, within the framework of which mutation tests were performed for all patients free of charge
Since 1985, lung cancer has been the main cancer killer! According to IARC, in 2002, 1,350,000 new cases of lung cancer were registered in the world, i.e. 12.4% of all forms of cancer. The global incidence of lung cancer since 1985 has increased for men by 51% and for women - by 75%. In 2002, 1,180,000 patients with lung cancer died in the world, or 17.6% of all cancer deaths in both sexes. The ratio of deaths from lung cancer to newly registered cases is 0. 87 Epidemiology
Epidemiology Lung cancer ranks first in the structure of malignant tumors The incidence of lung cancer has doubled over the past 20 years (in Russia it is 34.1 per 100,000 population) Men suffer from lung cancer 6 times more often than women At the beginning of the 21st century, lung cancer remains one of the main causes of death for cancer patients in the world.
Epidemiology In the USA in 2005, 172,570 patients with LC were registered, which is 12.6% of all oncological diseases 163,510 patients will die, i.e. 29.1% of all cancerous cancers. 5-year survival rate over 25 years remains at 15%. Only 16% of patients are registered at an early stage. The incidence of cancer is highest in men in Eastern countries– 65.7 per 100,000, in Southern Europe – 56.9, in Western Europe – 50.9, in Northern Europe– 44.3 per 100,000 In 2000, the incidence of LC in Europe varies in men from 95.4 in Hungary to 21.4 in Sweden, in women from 27.7 in Denmark to 4.0 per 100,000 in Spain In the countries of Northern and Western Europe The incidence of LC in men has decreased due to their massive cessation of smoking. This is especially noticeable in the UK, Finland, and Norway. Sweden. Among women, Denmark is in first place in RL
Epidemiology In terms of mortality from cancer in men, the list is topped by Hungary and Poland, and in women by Denmark. According to 20 European registers in 1990 -1994. in the first year after the diagnosis of LC, 31.4% remained alive, after 5 years – 9.7% (men). In Russia, LC ranks first among all tumors in people of both sexes. In 2003, 58,812 patients were registered. In men, LC accounts for 22.8% of all newly detected cancers, in women – 4%. In terms of LC incidence rates in 2002 among European countries, Russia ranked 3rd among men and 17th among women
Etiology I. I. Genetic risk factors: 1. Primary multiplicity of tumors (previous treatment for malignant tumor). 2. Three or more cases of lung cancer in the family (close relatives). II. Modifying risk factors A. Exogenous: 1. Smoking. 2. Pollution of the environment with carcinogens. 3. Occupational hazards. 4. Ionizing radiation. B. Endogenous: 1. Age over 45 years. 2. Chronic pulmonary diseases(pneumonia, tuberculosis, bronchitis, localized pulmonary fibrosis, etc.).
Etiology. Smoking Only 15% of cancers are not related to the exposure of tobacco to the bronchial mucosa. Squamous cell and small cell cancers practically do not occur in non-smokers. The risk of cancer depends on the number of cigarettes smoked daily, duration of smoking, length of service, and type of cigarettes. The cumulative risk of death from LC in men who smoke is 22 times higher, in women - 12 times higher than in non-smokers The risk of death from LC is 30% higher in women living with men who smoke If a person quits smoking after 10 years of smoking, the risk of LC it decreases by 50% Smoking cigars or pipes - doubles the risk of developing LC 85% of LC in men and 47% of LC in women - consequences of smoking
Etiology. Other factors Asbestos exposure is from 1 to 5% of RL, in non-smoking workers the risk of RL is 3 times higher than in non-working smokers, and in smokers associated with asbestos the risk increases 90 times IARC among chemical substances those associated with RL are called radon, arsenic, chromium, nickel, beryllium. Chronic obstructive pulmonary diseases increase the risk of RL by 13% in non-smokers and by 16% in smokers
Pathogenesis Impact of risk factors on the bronchial epithelium disturbance of mucociliary clearance impact of carcinogens on the tissue of the respiratory tract desquamation of the epithelium pathological regeneration metaplasia dysplasia squamous cell carcinoma adenocarcinoma
Clinical and anatomical classification Central lung cancer (occurs in large bronchi - main, lobar, intermediate, segmental) Peripheral lung cancer (occurs in subsegmental bronchi and their branches or localized in the lung parenchyma)
Classification of lung cancer according to Savitsky A.I. (1957) 1. Central cancer: a) endobronchial (endophytic and exophytic) b) peribronchial nodular; c) peribronchial branched. 2. Peripheral cancer: a) round tumor; b) pneumonia-like; c) apex of the lung (Penkosta); 3. Atypical forms associated with the characteristics of metastasis: a) mediastinal; b) miliary carcinomatosis; ; c) brain; ; d) bone; ; d) hepatic.
Pathohistological classification of LC arises from multipotent stem cells of the bronchial epithelium I. Squamous cell carcinoma (occurs in the proximal segmental bronchi): a) highly differentiated cancer; b) moderately differentiated cancer (without keratinization); c) poorly differentiated cancer. II. Small cell cancer (occurs in the central large air-conducting bronchi): a) oat cell cancer; b) intermediate cell carcinoma. III. Adenocarcinoma (occurs in the peripheral bronchi): a) highly differentiated adenocarcinoma (acinar, papillary); b) moderately differentiated adenocarcinoma (glandular-solid); c) poorly differentiated adenocarcinoma (solid mucus-forming cancer); d) bronchioloalveolar adenocarcinoma (“adenomatosis”). IV. Large cell carcinoma: a) giant cell carcinoma; b) clear cell carcinoma. V. Mixed cancer
LC LC (due to different and common treatment approaches) Small cell Non-small cell - Oat cell - Adenocarcinoma - Spindle cell - Squamous cell - - Polygonal cell - Large cell
NSCLC Adenocarcinoma accounts for 40% of LC. Occurs in non-smoking women. Special view– bronchioloalveolar cancer, patients with it respond more effectively than others to therapy with targeted drugs – gefitinib, erlotinib. Squamous cell carcinoma occurs in 30% of patients. Localization – central zone of the lungs
SCLC Found in 15% of patients with LC, the tumor is of central or hilus origin in 95%, 5% - peripheral. 98% of patients with SCLC are smokers
Anatomical regions: 1. main bronchus (C 34.0) 2. upper lobe (C 34.1) 3. middle lobe (C 34.2) 4. lower lobe (C 34.3)
Lung cancer clinic Symptoms caused by intrathoracic tumor spread Symptoms caused by extrathoracic tumor spread Paraneoplastic syndromes (There are no specific symptoms for early LC, 15% of LC are generally asymptomatic)
Symptoms caused by intrathoracic tumor spread Central lung cancer: Cough (80 -90%) Hemoptysis (50%) Fever and shortness of breath (atelectasis and hypoventilation) Fever and productive cough (paracancrosis pneumonitis) Peripheral lung cancer: Chest pain (60 - 65%) Cough Shortness of breath (30 -40%) Clinic lung abscess(when the tumor disintegrates)
Symptoms caused by extrathoracic spread of the tumor Liver damage Adrenal damage Bone damage Extrathoracic lymph node damage (para-aortic, supraclavicular, anterior cervical) Intracranial metastases
Principles for diagnosing lung cancer Primary diagnostic methods (recommended for all patients): Complete clinical examination X-ray examination chest organs Bronchological examination (in case of central cancer) Transthoracic tumor puncture (in case of peripheral cancer) Pathomorphological confirmation of malignancy
Principles for diagnosing lung cancer Clarifying diagnostic methods (recommended for patients who need surgical or radiation treatment): Computed tomography of the chest (method accuracy is 70% or more) and adrenal glands Ultrasound examination of the abdominal cavity and chest Scanning of skeletal bones X-ray of skeletal bones Computer or magnetic resonance imaging of the brain Functional study lungs and heart Mediastinoscopy, mediastinotomy, thoracoscopy, thoracotomy
Algorithm for examining a patient with lung cancer Lung cancer Standard chest X-ray Suspicion T 4 (invasion of mediastinal organs) All others Definitely T 4, N 3, M 1 Biopsy to confirm the stage (N 3, M 1) Standard CT Suspicion of metastases in the adrenal glands. N 2 or N 3 N 0 or N 1 Biopsy. Mediastinoscopy, transbronchial puncture biopsy Surgery. Contrast CT Definite T 4 Not determined T 4 Transbronchial puncture biopsy, mediastinoscopy, surgery
Treatment of lung cancer Small cell lung cancer Chemotherapy Non-small cell lung cancer Surgical treatment Radiation treatment Chemotherapy Combination treatment
Scope of surgery: segmentectomy, upper lobectomy with circular resection of the bronchi, upper, lower (right lung) bilobectomy, pneumonectomy
Options for surgical intervention: typical (standard) operation extended operation: - extended for fundamental reasons - forced extended operation combined operations extended-combined operations
Radiation therapy according to a radical program (total focal dose 60 -79 Gy) is indicated for patients with stage II - IIIIII A NSCLC who refused surgery or for whom surgical treatment is contraindicated (age, general condition, concomitant pathology)
Radiation therapy according to a palliative program (total focal dose no more than 40 Gy) is carried out for locally unresectable NSCLC in order to alleviate the painful clinical manifestations of the tumor. If there is pronounced regression of the tumor during radiation therapy and the patient’s general condition is satisfactory, the treatment plan can be changed and radiation therapy can be carried out according to a radical program.
Contraindications to radiation therapy are: destruction in the primary tumor or atelectasis with the formation of decay cavities; excessive bleeding; malignant effusion in the pleural cavity; recent myocardial infarction; active pulmonary tuberculosis; severe general condition of the patient
Irradiation regimens for EBRT: 5 Gy every other day, 3 times a week, SOD 25 -30 Gy; 7 -10 Gy once a week SOD 28 -40 Gy. Gy Remote irradiation is carried out in various modes up to an SOD of 40 -60 Gy. The interval between the components of the combined radiation treatment the average is 10 -20 days.
Radiation therapy according to the radical program: classical fractionation of SOD - 70 Gy x 35 days. dynamic fractionation of SOD - 70 Gy x 30 days. superfractionation of SOD - 46.8 Gy x 13 days. combined radiation therapy SOD - 60-80 Gy x 34 days Radiation therapy according to the palliative program: classical fractionation - 40 Gy x 20 days dynamic fractionation - 40 Gy x 17 days enlarged fractionation - 40 Gy x 10 days
Preoperative radiation therapy: classical fractionation - 30 Gy x 15 days dynamic fractionation - 30 Gy x 12 days large fractionation - 20 Gy x 5 days combined radiation therapy - 30 -40 Gy x 17 days Postoperative radiation therapy (after radical surgery): classical fractionation — 46 Gy x 23 days dynamic fractionation — 30 Gy x 12 days superfractionation — 46.8 Gy x 13 days
Chemotherapy for lung cancer Drugs: Vinorelbine Gemcitabine Cisplatin Carboplatin Paclitaxel Etoposide Cyclophosphamide Doxorubicin Mitomycin Ifosfamide vinblastine
Currently, the standard second-line chemotherapy for NSCLC stages IIIIII - IVIV are the combinations: Taxol + carboplatin Taxol + cisplatin Taxotere + cisplatin Navelbine + cisplatin Gemzar + cisplatin The use of these regimens allows an overall effect to be obtained in 40 -60% of patients, with a one-year survival rate of 31 - 50% of patients.
The goals of neoadjuvant chemotherapy are to reduce the size of the primary tumor, to affect micrometastases, to increase the ablasticity of the operation and resectability of the tumor.
Features of neoadjuvant chemotherapy 1. 1. Courses of treatment should be short, with short intervals. It is optimal to carry out 2 courses, but no more than 3 -4 2. 2. Treatment regimens should not have significant toxicity so as not to interfere with the implementation surgery 3. 3. The effectiveness/toxicity ratio of the treatment regimens used should be optimal.
Targeted therapy for NSCLC Targeted drugs act on: — Inhibition of enzymes involved in DNA and RNA synthesis — Transmission pathways and signal transduction mechanisms — Angiogenesis — Gene expression — Apoptosis
Targeted therapy for NSCLC The target of the drugs is the epidermal growth factor receptor. It is expressed in NSCLC (squamous in 84%, glandular in 68%) and is involved in the signaling cascade leading to cell proliferation angiogenesis, invasion, metastasis, arrest of apoptosis. Targeted drugs in combination with chemotherapy provide an objective positive effect compared to chemotherapy. Drugs: alimta, iressa, erlotinib, panitumubab
for resectable tumors (T 1 -2 NN 1 1 M 0), surgery followed by postoperative combination chemotherapy (4 courses) is possible; the feasibility of using induction chemotherapy and chemoradiation therapy followed by surgery continues to be studied, but convincing evidence of the advantages of this approach has not yet been obtained
for unresectable tumors (localized form), combination chemotherapy (4-6 cycles) in combination with irradiation of the tumor area of the lung and mediastinum is indicated. In case of achieving complete clinical remission, preventive irradiation of the brain (25-30 Gy). in the presence of distant metastases (common form of SCLC) - combination chemotherapy is indicated, radiation therapy is carried out according to special indications(metastases to the brain, bones, adrenal glands)
Currently, the possibility of curing about 30% of patients with SCLC in the early stages of the disease and 5-10% of patients with unresectable tumors has been convincingly proven. The fact that in recent years a whole group of new antitumor drugs active in SCLC has appeared allows us to hope for further improvement of therapeutic regimens and, accordingly, improved treatment outcomes
Occult lung cancer (Tx. N 0 M 0)) – – follow-up Stage 0 (Tis. N 0 M 0):): resection (segmentectomy or wedge resection) with maximum preservation of lung tissue endobronchial radiation therapy (tumors less than 1 cm)
Stage II B (B (T 1 N 0 M 0 , T 2 N 0 M 0):): Lobectomy Alternative: radical radiotherapy (at least 60 Gy) endobronchial radiotherapy
Stage IIII A, B (T 1 N 1 M 0, T 2 N 1 M 0, T 3 N 0 M 0):: lobectomy, pneumonectomy Alternative: radical radiation therapy
Stage IIIIII A (TT 33 NN 11 MM 00, T, T 1 -31 -3 NN 22 MM 0): neoadjuvant chemotherapy (including platinum drugs) + surgical treatment radiation therapy + surgical treatment chemoradiotherapy + surgical treatment + radiation therapy Alternative : radical radiation therapy chemoradiotherapy chemotherapy in an independent version
Stage III B (T-any N 3 M 0, T 4 N - any M 0 M 0):): In connection with possible different surgical tactics, they distinguish: T 4 a - germination of the trachea, carina, superior vena cava, left atrium ( potentially resectable lesions) T 4 b – diffuse mediastinal lesion, myocardial lesion, invasion of the vertebra, esophagus, malignant pleural effusion (surgery is not indicated)
Stage IVIV (T any NN any M 1): chemoradiotherapy palliative polychemotherapy symptomatic treatment
Prognosis for lung cancer 5-year survival rate II stage – 65% II c stage – 40% IIIIII A stage – 19% IIIIII B B cc stage – 5% IVIV stage – 2%
Screening for LC LC is diagnosed in the majority at late stages, only diagnosis in stage II allows 50-80% of patients to survive 5 years. Annual or once every 4 months chest x-ray Spiral computed tomography - detected from 0.44% to 2.7% of LC, with 74 -78% in stage II. The value of PET and fluorescence bronchoscopy is being studied
Prevention of lung cancer Primary, or hygienic, prevention is a system of medical and government measures aimed at stopping or sharply reducing the impact on the body of substances and factors that are currently recognized as carcinogenic (the fight against inhaled air pollution, smoking). Secondary, or clinical, prevention is a specially organized system for identifying and treating precancerous diseases (annual fluorography, observation and treatment by specialists).
Prevention of lung cancer fight against smoking reduction of tar content in cigarettes to the limits established by IARC fight for purity atmospheric air elimination or maximum reduction of the impact of occupational hazards in production; improvement of the health of persons with chronic diseases bronchi and lungs balanced diet with regular consumption of foods rich in vitamin A and carotenoids, screening in high-risk groups for lung cancer using large-frame fluorography
“At the beginning, the disease is difficult to recognize, but easy to cure, but if it is advanced, then it is easy to recognize, but difficult to cure. » N. Macchiaveli, 1513
Summary of the theory of cancer Suppressor gene (with mutation - loss of control) control Proto-oncogene (constantly mutates, which ensures adaptation) Reproduction of tumor cells Neoangiogenesis and metastasis Immunological paralysis The body dies The body survives, with help (treatment) Surgical Radiation Chemotherapy
Thus, cancer is a polyetiological disease, where numerous environmental factors are superimposed on a genetically determined predisposition, resulting in malignant neoplasms. Modern epidemiologists claim that up to 90% of tumors are caused by external reasons: 1. 1. For 1 esophageal cancer patient in Nigeria, there are 300 patients in Iran 2. 2. For 1 penile cancer patient in Israel, there are 300 patients in Uganda 3. 3. For 1 Indian skin cancer patient, there are 200 patients in Australia
Primary prevention cancer Dietary recommendations: (35%) Consumption of fresh vegetables, fruits and coarse fiber Limiting the intake of salt and preservatives Limiting alcohol Avoiding food additives A balanced diet to maintain normal body weight Limiting fat to 30% of total energy value food
Secondary cancer prevention Diagnosis and treatment of precancerous diseases, as well as early diagnosis cancer Screening programs operating in the world: 1. Rectum - hemocult test 2. Stomach (Japan) - fluorography 3. Lungs - fluorography 4. Breast - self-examination (according to WHO can reduce mortality by 20%), mammography (4 times more informative than palpation, reveals tumors up to 3-4 mm)
Screening is the detection of tumors among a practically healthy population (“screening”). Promising, but expensive, requiring significant financial expenditures, which is why it is often inaccessible to most states. General requirements for screening tumors of any location: Inexpensive Safe Easy to carry out Acceptable for subjects and testers Highly sensitive (few false negative responses) Specific (few false positive responses)
Screening by diagnosing precancer and then treating it has the potential to reduce incidence (and neglect, of course). And a decrease in morbidity leads to a decrease in mortality. Screening is carried out: In high-risk groups In formally healthy
Targeted therapy As a result of the achievements of molecular oncology, which entered the 21st century with fairly clear ideas about the pathogenesis of tumors, very promising, so-called targeted therapy of tumors has emerged and is actively developing. The previously existing empirical approach (often a random selection of drugs) is being replaced by a scientifically based, molecularly targeted search for specific anticancer drugs aimed at activating or inactivating the biochemical components of tumor transformation. These are targeted drugs. Their action is aimed at: Inhibition of enzymes involved in the synthesis of RNA and DNA Transmission pathways and mechanisms of signal transduction Angiogenesis Gene expression Apoptosis Targeted drugs in combination with chemotherapy give an objective positive effect, and the search for new agents inspires great optimism. Many similar drugs are already known, acting on various stages of pathogenesis. These are already actively used Herceptin, MabThera, Gleevec, Alimta, Iressa, monoclonal antibodies - Avastin, Sutent.
Photodynamic therapy PDT is a promising technique for the treatment of malignant and other neoplasms. Its essence is that a photosensitizer (PS) is introduced into the body, followed by irradiation of the tissue with light in the visible spectral range (400 -700 nm). In this case, excitation of PS molecules and molecular energy transfers occurs, which leads to the release of singlet oxygen and other highly reactive cytotoxic substances that cause cell death. Typically, PSs are taken up by malignant or dysplastic cells. When these conditions are combined (the tropism of the PS to malignant tissue and the selective delivery of light to the tumor), the effectiveness of antitumor therapy is ensured with minimal damage to healthy tissues
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 encounter this disease in their life. Lung cancer most often affects older people. Approximately 70% of all cancer cases occur in people over 65 years of age. People under 45 years of age rarely suffer from this disease; their share of the total mass of cancer patients is only 3%. Lung cancer is one of the leading causes of death on earth. According to statistics, every 14th person has encountered or will encounter this disease in their life. Lung cancer most often affects older people. Approximately 70% of all cancer cases occur in people over 65 years of age. People under 45 years of age rarely suffer from this disease; their share of the total mass of cancer patients is only 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: 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:
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. - 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 cancer cases. This type of cancer most often develops in the central part of the chest or bronchial tubes. - Squamous cell carcinoma. This cancer accounts for about 20% of all lung cancer cases. This type of cancer most often develops in the central part of the chest or bronchial tubes. -Undifferentiated cancer, the most rare type of cancer. -Undifferentiated cancer, the most rare type of cancer.
What are the signs and symptoms of lung cancer? Symptoms of lung cancer depend on the location of the cancer and the size of the lesion in the lungs. In addition, sometimes lung cancer develops asymptomatically. In the photo, lung cancer looks like a coin stuck in the lungs. As the cancerous tissue grows, patients experience breathing problems, chest pain, and coughing up blood. If cancer cells have invaded the nerves, it can cause pain in the shoulder that radiates into the arm. When the vocal cords are damaged, hoarseness occurs. Damage to the esophagus can lead to difficulty swallowing. The spread of metastases to the bones causes excruciating pain in them. Metastases in the brain usually cause decreased vision, headaches, and loss of sensation in certain parts of the body. Another sign of cancer is the production of hormone-like substances by tumor cells, which increase calcium levels in the body. In addition to the symptoms listed above, with lung cancer, as with other types of cancer, the patient loses weight, feels weak and constantly tired. Depression and sudden mood swings are also quite common. Symptoms of lung cancer depend on the location of the cancer and the size of the lesion in the lungs. In addition, sometimes lung cancer develops asymptomatically. In the photo, lung cancer looks like a coin stuck in the lungs. As the cancerous tissue grows, patients experience breathing problems, chest pain, and coughing up blood. If cancer cells have invaded the nerves, it can cause pain in the shoulder that radiates into the arm. When the vocal cords are damaged, hoarseness occurs. Damage to the esophagus can lead to difficulty swallowing. The spread of metastases to the bones causes excruciating pain in them. Metastases in the brain usually cause decreased vision, headaches, and loss of sensation in certain parts of the body. Another sign of cancer is the production of hormone-like substances by tumor cells, which increase calcium levels in the body. In addition to the symptoms listed above, with lung cancer, as with other types of cancer, the patient loses weight, feels weak and constantly tired. Depression and sudden mood swings are also quite common.
How is lung cancer diagnosed? Chest X-ray. This is the first thing done if lung cancer is suspected. In this case, a photo is taken not only from the front, but also from the side. X-rays can help identify problem areas in the lungs, but they cannot accurately show whether it is cancer or something else. A chest x-ray is a fairly safe procedure as the patient is exposed to a small amount of radiation. Chest X-ray. This is the first thing done if lung cancer is suspected. In this case, a photo is taken not only from the front, but also from the side. X-rays can help identify problem areas in the lungs, but they cannot accurately show whether it is cancer or something else. A chest x-ray is a fairly safe procedure as the patient is exposed to a small amount of radiation.
Computed tomography A CT scanner takes pictures of not only the chest, but also the abdomen and brain. All this is done to determine whether there are metastases in other organs. The CT scanner is more sensitive to pulmonary nodules. Sometimes, to more accurately detect problem areas, contrast agents are injected into the patient’s blood. The CT scan itself usually goes through without any side effects, but the injection of contrast agents sometimes causes itching, rashes and hives. Just like a chest x-ray, computed tomography only finds local problems, but does not allow you to accurately say whether it is cancer or something else. Additional tests are required to confirm a cancer diagnosis. Using a CT scanner, images are taken not only of the chest, but also of the abdomen and brain. All this is done to determine whether there are metastases in other organs. The CT scanner is more sensitive to pulmonary nodules. Sometimes, to more accurately detect problem areas, contrast agents are injected into the patient’s blood. The CT scan itself usually goes through without any side effects, but the injection of contrast agents sometimes causes itching, rashes and hives. Just like a chest x-ray, computed tomography only finds local problems, but does not allow you to accurately say whether it is cancer or something else. Additional tests are required to confirm a cancer diagnosis.
Magnetic resonance imaging. This type of study is used when more accurate location data is needed cancerous tumor. Using this method, it is possible to obtain images of very high quality, which makes it possible to determine the slightest changes in tissues. Magnetic resonance imaging uses magnetism and radio waves and therefore 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, as there is a risk of their displacement under the influence of magnetism. This type of study is used when more accurate data about the location of the cancerous tumor is needed. Using this method, it is possible to obtain images of very high quality, which makes it possible to determine the slightest changes in tissues. Magnetic resonance imaging uses magnetism and radio waves and therefore 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, as there is a risk of their displacement under the influence of magnetism.
Cytological examination of sputum The diagnosis of lung cancer should always be confirmed by cytological examination. The sputum is examined under a microscope. This method the safest, simplest and inexpensive, however, 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 similar to cancer cells. The diagnosis of lung cancer should always be confirmed by cytological examination. The sputum is examined under a microscope. This method is the safest, simplest and inexpensive, however, 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 similar to cancer cells. Sputum preparation
Bronchoscopy The essence of the method is water in Airways thin fiber optic probe. The probe is inserted through the nose or mouth. The method allows you to take tissue to test for the presence of cancer cells. Bronchoscopy gives good results when the tumor is located in central regions lungs. The procedure is very painful and is performed under anesthesia. Bronchoscopy is considered relatively safe method research. After bronchoscopy, coughing with blood is usually observed for 1-2 days. More serious complications such as heavy bleeding, cardiac arrhythmia and decreased oxygen levels are rare. After the procedure, side effects caused by the use of anesthesia are also possible. The essence of the method is to insert water into the respiratory tract of a thin fiber-optic probe. The probe is inserted through the nose or mouth. The method allows you to take tissue to test for the presence of cancer cells. Bronchoscopy gives good results when the tumor is located 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 with blood is usually observed for 1-2 days. More serious complications such as severe bleeding, cardiac arrhythmia, and decreased oxygen levels are rare. After the procedure, side effects caused by the use of anesthesia are also possible.
Biopsy This method used when it is impossible to reach the affected area of the lungs using bronchoscopy. The procedure is performed under the control of a computed tomograph 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 insert a needle through the chest and suck out liver tissue, which is subsequently examined under a microscope. The biopsy is performed under local anesthesia. A biopsy can accurately determine lung cancer, but only if it is possible to accurately take cells from the affected area. This method is used when it is impossible to reach the affected area of the lungs using bronchoscopy. The procedure is performed under the control of a computed tomograph 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 insert a needle through the chest and suck out liver tissue, which is subsequently examined under a microscope. The biopsy is performed under local anesthesia. A biopsy can accurately determine lung cancer, but only if it is possible to accurately take cells from the affected area.
Surgical removal of tissue Surgical removal of tissue Pleurocentosis (puncture biopsy) The essence of the method is to take fluid from the pleural cavity for analysis. Sometimes cancer cells accumulate there. This method is also carried out using a needle and local anesthesia. If none of the above methods can be applied, then in this case they resort to surgery. There are two types of surgery: mediastinoscopy and thoracoscopy. For mediastinoscopy, a mirror with a built-in LED is used. Using this method, a biopsy of the lymph nodes is taken and the organs and tissues are examined. During thoracoscopy, the chest is opened and tissue is removed for examination.
Blood tests. Routine blood tests cannot alone 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. Routine blood tests cannot alone 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.
What are the stages of lung cancer? Stages of cancer: Stages of cancer: stage 1. One is affected by cancer lung segment. The size of the affected area is no more than 3 cm. Stage 1. One segment of the lung is affected by cancer. The size of the affected area is no more than 3 cm. Stage 2. The spread of cancer is limited chest. The size of the affected area is no more than 6 cm. Stage 2. The spread of cancer is limited to the chest. The size of the affected area is no 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. Extensive damage to the lymph nodes is observed. Stage 3. The size of the affected area is more than 6 cm. The spread of cancer is limited to the chest. Extensive damage to the lymph nodes is observed. Stage 4. Metastases have spread to other organs. Stage 4. Metastases have spread to other organs. Small cell cancer is also sometimes divided into only two stages. Small cell cancer is also sometimes divided into only two stages. Localized tumor process. The spread of cancer is limited to the chest. Localized tumor process. The spread of cancer is limited to the chest. A common form of the tumor process. Metastases have spread to other organs. A common form of the tumor process. Metastases have spread to other organs.
How is lung cancer treated? Treatment for lung cancer may include surgical removal cancer, chemotherapy and radiation. As a rule, all three types of treatment are combined. The decision about which treatment to use depends on the location and size of the cancer, as well as general condition sick. Treatment for lung cancer may include surgical removal of the cancer, chemotherapy, and radiation. As a rule, all three types of treatment are combined. The decision about which treatment to use depends on the location and size of the cancer, as well as the patient's general condition. As with the treatment of other types of cancer, treatment is aimed at either complete removal cancerous areas or in cases where this is not possible to relieve pain and suffering. As with other types of cancer, treatment is aimed either at removing the cancerous areas completely or, in cases where this is not possible, at relieving pain and suffering.
Surgery. Surgery is mainly used only during the first or second stage of cancer. Surgery is acceptable in approximately 10-35% of cases. Unfortunately, surgical intervention doesn't always give positive result, very often cancer cells have already spread to other organs. After surgery, approximately 25-45% of people live more than 5 years. Surgery is not possible if the affected tissue is located 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. Surgery is mainly used only during the first or second stage of cancer. Surgery is acceptable in approximately 10-35% of cases. Unfortunately, surgery does not always give a positive result; very often cancer cells have already spread to other organs. After surgery, approximately 25-45% of people live more than 5 years. Surgery is not possible if the affected tissue is located 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 way, part of a lung lobe, one lobe of a lung, or an entire lung can be removed. Along with the removal of lung tissue, the affected lymph nodes are removed. The type of surgery depends on the size and location of the tumor. This way, part of a lung lobe, one lobe of a lung, or an entire lung can be removed. Along with the removal of lung tissue, the affected lymph nodes are removed. After lung surgery, patients require care for several weeks or months. People who have surgery typically experience difficulty breathing, shortness of breath, pain, and weakness. In addition, complications due to bleeding are possible after surgery. After lung surgery, patients require care for several weeks or months. People who have surgery typically experience difficulty breathing, shortness of breath, pain, and weakness. In addition, complications due to bleeding are possible after surgery.
Radiation therapy The essence of this method is the use of radiation to destroy cancer cells. Radiation therapy is used when a person refuses surgery, if the tumor has spread to the lymph nodes or 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 diseases other than cancer usually do not receive radiation therapy because radiation can reduce lung function. Radiation therapy does not have the risks of major surgery, but can have unpleasant side effects, including fatigue, lack of energy, decreased white blood cell counts (a person is more susceptible to infection), and low level platelets in the blood (blood clotting is impaired). The essence of this method is to use radiation to destroy cancer cells. Radiation therapy is used when a person refuses surgery, if the tumor has spread to the lymph nodes or 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 diseases other than cancer usually do not receive 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, low white blood cell counts (a person is more susceptible to infection) and low blood platelet levels (blood clotting is impaired). In addition, there may be problems from digestive organs exposed to radiation. In addition, there may be problems with the digestive organs exposed to radiation.
Chemotherapy. This method, like radiation therapy, is applicable for any type of cancer. Chemotherapy refers to treatment that stops the growth of cancer cells, killing them and preventing them from dividing. This method, like radiation therapy, is applicable for any type of cancer. Chemotherapy refers to treatment that stops the growth of cancer cells, killing them and preventing them from dividing. Chemotherapy is the main treatment method for small cell lung cancer, as it affects all organs. Without chemotherapy, only half of people with small cell cancer live more than 4 months. Chemotherapy is the main treatment method for small cell lung cancer, as it affects all organs. Without chemotherapy, only half of people with small cell cancer live more than 4 months. Chemotherapy is usually given in an outpatient setting. 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. Chemotherapy is usually given in an outpatient setting. 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.
What are the causes of lung cancer? Cigarettes. The main reason Lung cancer is smoking. People who smoke are 25 times more likely to develop lung cancer than non-smokers. People who smoke 1 or more packs of cigarettes per day for more than 30 years are especially likely to develop lung cancer. Tobacco smoke contains more than 4 thousand chemical components, many of which are carcinogenic. Cigar smoking is also a cause of lung cancer. People who quit smoking have a reduced risk of cancer because, over time, cells damaged by smoking are replaced by healthy cells. However, the restoration of lung cells is a rather long process. Typically, their complete recovery in former smokers occurs within 15 years. Cigarettes. The main cause of lung cancer is smoking. People who smoke are 25 times more likely to develop lung cancer than non-smokers. People who smoke 1 or more packs of cigarettes per day for more than 30 years are especially likely to develop lung cancer. Tobacco smoke contains more than 4 thousand chemical components, many of which are carcinogenic. Cigar smoking is also a cause of lung cancer. People who quit smoking have a reduced risk of cancer because, over time, cells damaged by smoking are replaced by healthy cells. However, the restoration of lung cells is a rather long process. Typically, their complete recovery in former smokers occurs within 15 years.
Passive smoking. Studies show that people who do not smoke themselves, but live or work with people who smoke, are 24% more likely to develop lung cancer. Studies show that people who do not smoke themselves, but live or work with people who smoke, are 24% more likely to develop lung cancer.
Air pollution. Air pollution from exhaust gases from industrial enterprises increases the risk of lung cancer. Approximately 1% of all cancers occur for this reason. Experts believe that long-term exposure to air pollution carries risks similar to second-hand smoke. Air pollution from exhaust gases from industrial enterprises increases the risk of lung cancer. Approximately 1% of all cancers occur for this reason. Experts believe that long-term exposure to air pollution carries risks similar to second-hand smoke.
Other causes include: Asbestos fibers. Asbestos fibers are not removed from the lung tissue throughout life. In the past, asbestos was widely used as an insulating material. Today its use is limited and banned in many countries. The risk of developing lung cancer due to asbestos fibers is especially high in people who smoke; more than half of these people develop lung cancer. Asbestos fibers. Asbestos fibers are not removed from the lung tissue throughout life. In the past, asbestos was widely used as an insulating material. Today its use is limited and banned in many countries. The risk of developing lung cancer due to asbestos fibers is especially high in people who smoke; more than half of these people develop lung cancer. Radon gas. Radon is a chemically inert gas that is a natural product of the decay of uranium. Approximately 12% of all lung cancer deaths are attributed to this gas. Radon gas easily passes through the soil and enters homes through cracks in the foundation, pipes, drains and other openings. According to some experts, in approximately every 15 residential buildings the level of radon exceeds the maximum permissible standards. Radon is an invisible gas, but can be detected using simple instruments. Radon gas. Radon is a chemically inert gas that is a natural product of the decay of uranium. Approximately 12% of all lung cancer deaths are attributed to this gas. Radon gas easily passes through the soil and enters homes through cracks in the foundation, pipes, drains and other openings. According to some experts, in approximately every 15 residential buildings the level of radon exceeds the maximum permissible standards. Radon is an invisible gas, but can be detected using simple instruments. Hereditary predisposition. Hereditary predisposition is also one of the causes of lung cancer. People whose parents or relatives of their parents died of lung cancer have a high chance of getting this disease. Hereditary predisposition. Hereditary predisposition is also one of the causes of lung cancer. People whose parents or relatives of their parents died of lung cancer have a high chance of getting this disease. Lung diseases. Any lung diseases (pneumonia, pulmonary tuberculosis, etc.) increase the likelihood of lung cancer. The more severe the illness, the higher the risk of developing lung cancer. Lung diseases. Any lung diseases (pneumonia, pulmonary tuberculosis, etc.) increase the likelihood of lung cancer. The more severe the illness, the higher the risk of developing lung cancer.
“The 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. Origin of species... On the incompleteness of the geological record. Instinct. On the denudation of granite regions.
“Trees and shrubs of grass” - Trees and Shrubs of Grass. 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 herbs? 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 fuse, 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 population numbers. 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 computer science. Amount of annual catch. Knowledge about population dynamics. Information models of population development.
“Bird Lesson” - Female birds, like reptiles, have one ovary. Bustard mating. Ritual behavior. Magpie Bullfinch Swallow Crow Jackdaw Nightingale Sparrow Grouse. Laying eggs. Find a match. Cranes - mating dances. On the outside, a bird's egg is protected by a leathery shell. Showing birds. Note the signs of high organization and similarities with reptiles.
“Crop growing” - There are also grain growers, vegetable growers, gardeners and cotton growers. The world. What's happened Agriculture. Plant growing. Take any cultivated plant and describe it. For example, so that there is always bread on our table, plant growers grow grain crops, wheat, rye and others.
Epidemiology of lung cancer (Ukraine, 2010) Incidence - 36 per 100 thousand (male - 63.5; female - 12.5) Number of registered cases - Mortality - 28.4 per 100 thousand (male - 51.7 ; female - 8.5) Mortality throughout the year - 64% Coverage with special treatment - 42% Morphologically verified - 58% Identified during medical examinations - 22.8%
Etiology of lung cancer Smoking (active and passive). Tobacco smoke aerosol contains over 3800 chemical compounds, of which over 40 are carcinogens: nicotine, benzanthracene, nitrosamines, radioactive elements (strontium, polonium, titanium, lead, potassium); Professional factors (metallurgical, mining, gas, textile, leather, cardboard industries). Asbestos, arsenic, chromium, nickel, cobalt salts, benzopyrene, mountain gas, coal sawn, etc.; Air pollution by chemical and radioactive carcinogens; Endogenous factors – chronic lung diseases, age over 45 years
Risk factors for lung cancer Smoking persons over 45 years of age; Patients with chronic diseases of the bronchopulmonary system; Persons in contact with asbestos, salts of non-ferrous and heavy metals, sources of radioactive radiation; Persons with a family history
Precancerous diseases (frequency of malignancy %) chronic recurrent bronchitis chronic abscesses bronchiectasis cavernous cysts localized pulmonary fibrosis chronic interstitial pneumonia
3 cm or a tumor that spreads to the main bronchus at dis" title=" Classification of lung cancer by stages T N M T 0 – tumor is not determined T is – pre-invasive cancer (cancer in situ) T 1 – tumor up to 3 in size cm in greatest dimension T 2 – tumor > 3 cm in size or a tumor extending to the main bronchus at a distance" class="link_thumb"> 9 !} Classification of lung cancer by stages T N M T 0 – tumor is not determined T is – pre-invasive cancer (cancer in situ) T 1 – tumor measuring up to 3 cm in the greatest dimension T 2 – tumor measuring > 3 cm or a tumor extending to the main bronchus at a distance of 2 cm or more from the carina, or the presence of atelectasis T 3 - tumor of any size with infiltration chest wall, diaphragm, pericardium, pleura, main bronchus at a distance of less than 2 cm from the carina, or total atelectasis of the lung T 4 - tumor of any size with infiltration of the mediastinum or large great vessels, or trachea, or esophagus, or carina, or exudative pleurisy N 0 - no metastases in regional lymph nodes N 1 - metastases in the peribronchial and/or lymph nodes of the lung root on the affected side N 2 - metastases in the bifurcation lymph nodes or mediastinal lymph nodes on the affected side N 3 - metastases in the mediastinal or pulmonary root lymph nodes on the opposite side or in supraclavicular lymph nodes M 0 – no distant metastases M 1 – distant metastases present 3 cm or a tumor extending to the main bronchus at a distance of > 3 cm or a tumor extending to the main bronchus at a distance of 2 cm or more from the carina, or the presence of atelectasis T 3 - a tumor of any size with infiltration of the chest wall, diaphragm, pericardium, pleura , main bronchus at a distance of less than 2 cm from the carina, or total atelectasis of the lung T 4 - tumor of any size with infiltration of the mediastinum or great great vessels, or trachea, or esophagus, or carina, or exudative pleurisy N 0 - no metastases in regional lymph nodes N 1 - metastases in the peribronchial and/or lymph nodes of the lung root on the affected side N 2 - metastases in the bifurcation lymph nodes or mediastinal lymph nodes on the affected side N 3 - metastases in the mediastinal or pulmonary root lymph nodes on the opposite side or in the supraclavicular lymph nodes M 0 - no distant metastases M 1 - there are distant metastases "> 3 cm or a tumor that spreads to the main bronchus at a distance" title=" Classification of lung cancer by stages T N M T 0 - the tumor is not determined T is - pre-invasive cancer (cancer in situ) T 1 – tumor measuring up to 3 cm in greatest dimension T 2 – tumor measuring > 3 cm or a tumor extending to the main bronchus at a distance"> title="Classification of lung cancer by stages T N M T 0 – tumor is not determined T is – pre-invasive cancer (cancer in situ) T 1 – tumor measuring up to 3 cm in the greatest dimension T 2 – tumor measuring > 3 cm or a tumor extending to the main bronchus on the race"> !}
Clinical and radiological forms of LC 1. Central (endobronchial, peribronchial, mixed) 2. Peripheral (globular, pneumonia-like, Penkosta cancer) 3. Atypical forms (mediastinal, miliary, cerebral, hepatic, bone, Penkosta cancer)
Methods for diagnosing lung cancer Patient complaints and anamnesis Physical examination (external examination, palpation, percussion, auscultation) Radiation diagnostics(radiography, CT, MRI, PET) Endoscopic diagnostics (bronchoscopy, mediastinoscopy, thoracoscopy) Biopsy and morphological diagnosis
Endoscopic RL syndromes Syndrome of direct anatomical changes - plus tissue - destruction of the mucosa - cone-shaped narrowing of the lumen - narrowing of the bronchus in a limited area Syndrome of indirect anatomical changes - infiltration without destruction of the mucosa - unclear pattern of bronchial rings - displacement of the walls or mouth of the bronchus - wall rigidity during instrumental palpation – bulging of the wall – absence of passive displacement of the bronchus Syndrome of functional changes – immobility of the bronchus wall during breathing – absence of transmitting pulsation from the heart and great vessels – presence of hemorrhagic discharge from the bronchus
Treatment of lung cancer SMALL CELL Surgical treatment is not subject to; Sensitive to chemoradiotherapy NON-SMALL CELL The main method of treatment is surgery; Chemotherapy and radiation therapy are used in combination with surgery or in inoperable cases
Prevention of lung cancer; Smoking cessation; Protection of workers in hazardous industries from the influence of occupational factors; Purification of the air environment by eliminating harmful industries and production processes (closed production cycles, etc.); Installation of catalysts on all vehicles, transition to electric vehicles
