Arete among men 30's and 40's of XX century is reflected in the incidence of lung cancer, which was the highest in the 50's, 60 - and 70-ies. Incidence among women (for whom smoking was generally uncommon until the Second World War and postwar period) is still increasing in older age groups. Although now there is a slight reduction in the incidence of lung cancer among men, he is still the most common type of cancer among them, and among women - the second in frequency after breast cancer. It is tase that in some areas of lung cancer occursmorefrequently now than breast cancer. And since the number of women smokers, especially young, growing, raising among them lung cancer appears to continue. In general, the proportion of cancer of this localization accounts for about 1 / 4 of all deaths from cancer.
It is well established that the longer a person smokes and themoreit consumes cigarettes, the higher the risk of lung cancer. Smoking cigarettes with low tar and filter slightly reduces the risk because it is believed that this resin contains carcinogens (although some smokers to compensate for the weakness of cigarettes domorepuffs). Other forms of tobacco such as smoking cigars and pipes are associated with a much lower risk compared to cigarettes.
with an increased likelihood of lung cancer associated passive smoking - inhaling cigarette smoke around them. Non-smokers who live with smokers or work in smoky places (pubs, clubs, restaurants) are at slightly increased risk of lung cancer, although it is still much lower than if they smoked themselves. Nevertheless, many organizations regard it as a risk factor that led to the ban in many countries, smoking in various public places, offices, public transportation, etc.
known as a number of other carcinogens that cause lung cancer. With the high risk associated development of asbestos and uranium. Radon, which usually occurs in the form of natural gas may, in some geographical areas to achieve high levels, so it is associated with risk of lung cancer.
Prevention
single most effective way to reduce the risk of lung cancer is smoking cessation. 10-15 years after giving up the habit risk of former smokers is at risk of ill people who never smoked.
There is some evidence that vitamin A (beta carotene), contained in green and yellow vegetables may have a protective effect against lung cancer.
Manifestations
The most common manifestation of lung cancer include: a cough that persists even after antibiotic treatment, isolation of blood when you cough, shortness of breath, chest pain, common symptoms of weakness and weight loss . Studies
After a general inspection of the first study usually chest X-ray. It does not allow an accurate diagnosis of lung cancer, but can detect suspicious blackout in the lungs, which would require further research.
sputum cytology, providing the study samples of mucus under the microscope, may be sufficient for such a diagnosis and identify the type of cancer. Otherwise, spend bronchoscopy. In this procedure a thin flexible tube inserted through the throat into the lung airways. With the bronchoscope doctor examines the plot for anomalies and takes samples of cells for research in the laboratory. Bronchoscopy is usually performed under local anesthesia.
If there is a question of surgery, the doctor may need to survey the local lymph nodes in the chest, why spend mediastinoscopy. This procedure is performed under general anesthesia, it provides for the introduction of a small tube into the chest through an incision at the base of the neck. To study the sampled material from the cells and lymph nodes.
to identify possible metastases may be followed by other studies such as computed tomography of the chest and abdomen, ultrasound of the liver and bone scans.
types of lung cancer
There are 4 main types of lung cancer: squamous cell carcinoma - the most common type, accounting for about 50% of all cases. It affects mainly the cells lining the airways; adenocarcinoma, which is approximately 20% of patients with lung cancer develops from cells that form mucus, large-cancer got its name from the large, having round shape of cancer cells. It accounts for about 10% of cases of lung cancer.
These three types of cancer known as non-small cell carcinomas, "because they differ in terms of development of the cancer process and treatment of the fourth type, namely, small cell, or ovsyanokletochnogo, cancer, called so because of the characteristic cell shape, resembling the grain oats. This type of cancer occurs in about 20% of cases of lung cancer.
Treatment
choice of treatment depends on the type of lung cancer. When non-small cell carcinoma, diagnosed at an early stage, less than the small cell, observed the germination of cancer cells to other parts of the body. Therefore, if the study found no evidence of such vigor, the preferred method for first-line treatment is surgical intervention.
However, small cell lung cancer at the time of diagnosis usually spreads to other parts of the body, and the likelihood of effective operations is reduced. Meanwhile, these diseases are very sensitive to chemotherapy and radiotherapy.
non small cell lung cancer
In cases of this cancer should first establish the possibility of surgery. If the tumor is located in the lung and is not affected lymph glands, and if the patient is able to have surgery, surgical removal of part or all of the affected lung gives a satisfactory chance of cure. However, this category can be attributed only about 25% of individuals with this type of cancer. Other patients surgery is not shown because they have already been spread of cancerous lesions or unaffected by light is in good enough condition to take the entire load after the operation either as patients themselves inoperable.
patients who are unable to have surgery, but whose tumor is small and there are no metastases, radical radiotherapy, the tumor can sometimes provide treatment or,morelikely, lead to a reduction of the tumor and thus relieve the symptoms. Whether such treatment prolongs the lives of as yet unknown. To radiotherapy often begin only after the symptoms have become hard to bear, since this treatment gives a very good palliative effect.
been shown that chemotherapy can provide a certain percentage of patients with reduction in cancer lesions and to a certain degree of prolongation of life. Its purpose - curbing symptoms and improve quality of life.
Until recently, chemotherapy was performed before surgery and radiotherapy (neoadjuvant chemotherapy). There is now some evidence that it may slightly increase survival rates. Currently, research continues to find ways to use this combination of treatment methods with a maximum benefit.
small cell lung cancer
to treat this type of cancer for surgery resort is very rare, because even before the diagnosis of cancer cells usually spread to other parts of the body.
method of choice usually is chemotherapy. As shown, it can lead to longer life and a very small percentage of patients - to cure. Usually there is a combination of dasgs, with side effects that are easily controlled, but almost always one of these effects is hair loss.
Radiotherapy undertaken after chemotherapy, also plays an important role, since this type of cancer is highly sensitive to treatment by this method. It is particularly useful if the cancer process is limited to the thorax. It also provides palliative effect, reducing the size of the tumor, which causes various symptoms such as pain.
Forecast
Healing primarily surgically, can be achieved only in a very small percentage of patients. Cure about 25% of persons who can postpone surgical lung resection. You can, apparently, to heal a small number of persons suffering from small cell carcinoma. Most of the deaths of the disease occurs within 1 year - 2 years after diagnosis. However, many lives can be extended by appropriate treatment of surgery, radiotherapy and chemotherapy techniques, and observed their symptoms can be controlled, providing a satisfactory quality of life.
is now under a lot of work to improve the treatment of lung cancer, but it is clear that the most important role in the fight against cancer of this localization are health education campaigns aimed at is to prevent the formation of the habit of smoking and help people to abandon it.
Rare lung cancer
Mesothelioma is not in the literal sense of lung cancer, because strikes the pleura (lining the lungs shell). Already at least 60 years ago it was known that this disease is largely caused by exposure to asbestos. Meanwhile, there is a fairly large group of people with mesothelioma, which obviously will never expose it. However, the process of developing this disease is very long (usually 30-40 years), and it is often difficult to establish with certainty as to whether this or that person exposed to asbestos, especially if one considers that this material is used in different ways due to its fire resistant properties, for example, the constasction of buildings, manufacture of brake linings and ironing boards.
also known that exposure to asbestos increases the risk of other types of lung cancer, especially in smokers.
mesothelioma causes thickening of the lining of the lung and the formation of a liquid. The result is shortness of breath, serving in many cases the first symptom. Diagnosis is by biopsy (or puncture, performed under local anesthesia, or open, carried out under general anesthesia), but it is sometimes difficult to come to a definite conclusion, even after examining the cells under a microscope.
If mesothelioma detected at an early stage, in very rare cases, it is possible to remove the lining of the lungs surgically and thus eliminate the defeat. Usually, however, impossible to cure, although such an operation performed to reduce breathlessness. In order to reduce cancerous lesions and containment of its development can also resort to the chemotherapy and radiotherapy, but their role is poorly understood.
Bronchoalveolar carcinoma (alveolar cell carcinoma) This disease is a type of adenocarcinoma of the lung, which often manifests multiple foci of cancer in both lungs. X-ray examination it is sometimes confused with pneumonia. Due to the large number of lesions surgical and radiotherapy treatments are not practiced. Chemotherapy can temporarily give effect in controlling the cancer process.
carcinoid tumors These tumors may arise as a primary lung cancer. In such cases, they are very similar to themorecommon carcinoid tumors of the gastrointestinal tract.