Lung cancer – Diagnosis and treatment

Lung cancer –
Diagnosis and treatment

Lung cancer: What is it?

Cancer generally refers to malignant neoplasms caused by the degeneration of the body's own cells. Cancer cells are characterised by an altered cell structure, growing into surrounding tissue and the capacity to metastasise (metastases).

Lung cancer is one of the most common types of cancer and it affects men about three times more than women. As lung cancer concerns the bronchial cells inside the lungs, it is also described as bronchial carcinoma.

Essentially there are two forms of lung cancer: the so-called small-cell and non-small-cell carcinomas. The difference relates to the appearance of the tumour cells, but also the biological behaviour of the tumours and this is of importance with regard to the therapy.

Lung cancer: Development

Lung cancer is one of the few types of cancer, where the main risk factors are well known. The main risk factor for the disease is tobacco smoke, essentially the smoking of cigarettes. In comparison to non-smokers, people who smoke are 30 times as likely to develop lung cancer. In the case of men, up to 90 % of current lung cancer cases can be attributed to smoking, for women up to 60 %.

Lung cancer: Symptoms

Detecting lung cancer is difficult: It rarely causes complaints in the early stages. There is no targeted early detection examination. The symptoms which should be clarified with a physician by all means, especially for people who smoke, include a new, persistent cough, a worsening chronic cough and sputum with or without blood content. Shortness of breath, bouts of fever, general fatigue and weight loss are in most cases signs of advanced lung cancer.

Lung cancer: Diagnosis

If the lungs in the x-ray image show suspected alterations, further examinations are required. Only a tissue sample can ultimately confirm the lung cancer diagnosis. This is collected by means of an endoscopy of the respiratory tract, a bronchoscopy, whereby a tube is inserted into the bronchial tubes via the windpipe, so that it is possible to take a sample from the suspected locations. This examination is normally carried out under anaesthetic. If there are cancer cells in the tissue samples, the question then arises how the tumour has spread and whether metastases have already developed in other organs. Further examinations are required for clarification, including computer tomography of the chest region and the abdomen with a contrast agent and, if necessary, a skeletal scintigraphy, which indicates bone metastases. A computer tomography or magnetic resonance tomography of the brain may also be appropriate. Furthermore, it is important to check the function of the heart and lungs with regard to the tolerability of treatment.

Lung cancer: Therapy

Lung cancer treatment is based on the extent of the spread and the type of carcinoma. In the case of non-small-cell lung carcinomas, there are essentially three treatment options - surgery, radiation and chemotherapy. In addition, new strategies which directly intervene in the growth control of tumour cells could prove effective, e.g. blocking growth signals. Which method is used alone or in combination depends on the stage of the disease. If the tumour has already developed metastases, a lasting cure cannot be expected. The treatment is aimed at bringing the lung cancer under control, alleviating symptoms and maintaining quality of life as long as possible.

The small-cell lung carcinoma often develops the tiniest metastases in the early stages. As it is also more sensitive to chemotherapy, chemotherapy comes first in the treatment of small-cell carcinomas. Only very small tumours are primarily operated, followed by chemotherapy and also radiation therapy in case of affected lymph nodes. In all other cases of localised diseases, the treatment is chemotherapy followed by radiation therapy or a combined chemo-radiation therapy with the aim of complete tumour regression. This is possible for up to half of patients. However, the disease often relapses in the further course, which is then much more difficult to treat.

You can obtain more detailed information on the detection and treatment of lung cancer from our telephone info-line or by email. All contact details can be found on our Contact page.