Symptoms
Lung cancer may initially be asymptomatic. It is often discovered only when it is no longer curable. Possible typical symptoms include a chronic cough, coughing up blood, difficulty breathing, recurrent colds, chest pain, and weakness, fatigue, lack of appetite, and weight loss. If spread further, additional symptoms include hoarseness, noises when breathing, and difficulty swallowing. Offshoots often form in the bones, liver, adrenal glands, other lung, lymph nodes, and spinal cord. In many countries, well over 3000 people are diagnosed with lung cancer each year, and over 200,000 in the United States. For several years, cancer has been steadily increasing in women because women are now as likely to smoke as men.
Causes
Lung cancer forms from lung or bronchial tissue and is more common in older age. Smoking is by far the most important risk factor for development, and secondhand smoke also poses a risk. Other carcinogens that can cause lung cancer include asbestos, radon (see there), radioactive dust, arsenic, chromium, nickel, vinyl chloride, and ionizing radiation. Air pollution, chronic lung disease, and heredity can also promote its development. A distinction is made between: 1. Non-small cell bronchial carcinoma (80%):
- Squamous cell carcinomas
- Adenocarcinomas
- Large cell carcinomas
2. small cell bronchial carcinomas (20%) Small cell bronchial carcinomas are considered particularly aggressive and metastasize rapidly. In addition to malignant ones, benign lung tumors may develop that do not form offshoots.
Diagnosis
Diagnosis is made in specialist care using imaging techniques (X-ray, computed tomography, PET), laboratory methods, and bronchoscopy (lung endoscopy) with tissue sampling, among others.
Prevention
For prevention, it is recommended to avoid the substances that cause cancer:
- Do not smoke and smoke passively. Give up the throat.
- Check the living quarters for high radon concentrations.
- Safety in the workplace.
- Eat healthy and get enough exercise.
Drug treatment
Treatment is based on the type of lung cancer, stage, spread, and lung function. A distinction is made between curative and palliative treatment for incurable cancer. The carcinomas may be surgically removed or treated with chemotherapy and radiation. Drugs used include: Monoclonal antibodies:
- Bevacizumab (Avastin).
- Durvalumab (Imfinzi) – cancer immunotherapy.
- Necitumumab (Portrazza)
- Nivolumab (Opdivo) – cancer immunotherapy.
Kinase inhibitor (EGFR):
- Afatinib (Gilotrif)
- Dacomitinib (Vizimpro)
- Erlotinib (Tarceva)
- Gefitinib (Iressa)
- Osimertinib (Tagrisso)
ALK inhibitors:
- Alectinib (Alecensa).
- Crizotinib (Xalkori)
- Ceritinib (Zykadia)
- Lorlatinib (Lorviqua)
Multikinase inhibitor:
- Nintedanib (Vargatef)
Cytostatic drugs (selection):
- Carboplatin (Paraplatin)
- Cisplatin (Platinol)
- Cyclophosphamide (Endoxan)
- Docetaxel (Taxotere)
- Epirubicin (Farmorubicin)
- Etoposide (Vepeside)
- Gemcitabine (Gemzar)
- Irinotecan (Campto)
- Lomustine (Ceenu)
- Paclitaxel (Taxol)
- Pemetrexed (Alimta)
- Vinblastine (Velbe)
- Vincristine (Oncovin)
- Vindesine (Eldisine)
- Vinorelbine (Navelbine)
Generic drugs are available in some cases. Not all agents are approved for this indication in many countries. Cytostatic drugs are often combined with antiemetics to treat nausea resulting from treatment. Finally, the accompanying symptoms are also treated (eg, pain, respiratory function) and complementary and supplementary methods are available, such as anthroposophic mistletoe therapy and psychotherapy.
