How to recognize lung cancer?

Introduction

Lung cancer is roughly divided into two different types. The distinction is made at the histological (cellular) level: there are small-cell and non-small-cell bronchial carcinomas (lung cancer). The group of non-small-cell tumors, for example, consists of 30 % so-called squamous cell carcinomas, 30 % adenocarcinomas and many other subtypes.

Lung cancer ranks first among the most deadly cancers in men. Among women, bronchial carcinoma ranks second behind breast cancer, with smoking still the biggest risk factor. Due to the gender-specific change in the group of smokers, more and more women are also affected by lung cancer.

The diagnosis of lung cancer is often complicated. A malignant tumor is usually discovered late, when clinical signs are already present. In many cases, the symptoms are non-specific, i.e. they may indicate several diseases, but usually worsen considerably in the course of the disease.

So-called paraneoplastic syndromes can occur, especially in the context of small cell bronchial carcinomas. These are accompanying diseases caused by the release of tumor toxins or hormone-like substances by the cancer. The symptoms are manifold and can lead the treating physician on the wrong track.

As a result, the diagnosis is delayed and the chances of recovery gradually deteriorate. Imaging techniques probably play the biggest role in the diagnosis of lung cancer. In X-rays, the tumor foci can usually be seen as shadows.

However, the cancer must be large enough to be seen. In some cases, a tumor can be visualized on X-rays before the first symptoms appear. For further diagnostics, computed tomography (CT) is the method of choice.

The CT determines the exact size and location of the tumor tissue. Otherwise, ultrasound and scintigraphy are used to search for metastases. Laboratory values play a rather minor role in the detection of lung cancer.

Since no conventional blood values are characteristically altered in bronchial carcinoma, so-called tumor markers must be used. The markers under investigation are assigned to certain tumor forms, but also occur in other types of cancer or disease. For example, the neuron-specific enolase (NSE) may be elevated in small cell lung cancer, the carcinoembryonic antigen (CEA) in adenocarcinoma and the cytokeratin fragment 21-1 (CYFRA 21-1) in squamous cell carcinoma.