Lung tumors can be malignant (malignant) and benign (benign).

Lung cancer is a malignant tumor. It is not a contagious disease and cannot be transmitted from person to person.

Malignant tumors consist of pathologically altered cells that have the ability to spread beyond the site of their origin. If the tumor is not treated in time, it can attack and destroy the surrounding tissue. Sometimes the cells spread from the site of the primary tumor via blood or lymph vessels, thus reaching other tissues and organs, where they create a new tumor, which is called a metastasis, through their further division.

Among the most common risk factors in the development of lung cancer are smoking, the environment (air pollution) and genetic predisposition (hereditary tendency).

The most important and most common symptoms of lung cancer are: persistent cough, coughing up bloody sputum, chest pain when coughing or deep breathing, difficulty breathing, pneumonia that does not go away after treatment or pneumonia that is repeated in the same place, as well as loss of appetite and physical weight.

These symptoms can be caused by other diseases, which have nothing to do with cancer, but if any of them appear, you should consult a doctor.

The diagnosis of lung cancer is made based on the results of diagnostic procedures:

• radiograph of the lungs
• cytopathological examination of sputum
• Bronchoscopy is a basic and indispensable diagnostic method for examining and checking the state of the airways and taking cell samples. The examination takes only a few minutes. It is performed under local anesthesia, and the local anesthetic is applied to the back of the oral cavity in the form of a spray. Bronchoscopy is also performed under general anesthesia, when a rigid (rigid) bronchoscope is used, and then it is necessary for the patient to stay in the hospital for several days.
• A CT scan is a painless and harmless examination method that determines the exact location and size of a tumor or the extent of a disease.
• Mediastinoscopy is a surgical method by which the surgeon, through a small incision in the skin of the neck and through a tube that enters the chest, performs an examination of the area of ​​the middle chest (mediastinum) and the lymph nodes near the lungs. Mediastinoscopy is performed under general anesthesia, with a shorter stay of the patient in the hospital.
• VATS (video-assisted thoracoscopy) is also a surgical method, which involves making a small incision in the skin of the chest wall and inserting an optical instrument into the inside of the chest to directly see the lungs with lung tissue and to take appropriate samples from suspicious areas.
• Lung biopsy (puncture) is usually performed in the radiology department, most often during a CT scan. A local anesthetic is given to numb the specific region. A thin needle is inserted through the skin into the lungs, which is monitored by X-ray. In doing so, a sample of cells is taken and examined under a microscope.

All tissue samples obtained by diagnostic methods (bronchoscopy, transthoracic puncture or tumor biopsy, biopsy or puncture of peripheral lymph glands, mediastinoscopy, pleuroscopy with lung tissue biopsy, video-assisted thoracotomy) are subjected to appropriate cytological, pathohistological and immunohistochemical examinations, in order to determine the diagnosis, degree of malignancy (malignancy) and stage of spread of the disease.

• Bone scintigraphy is a radioisotope diagnostic method that shows any abnormal areas of bone. It is always done when there is a clinical suspicion of bone metastases.

Treatment of lung cancer

Treatment of lung cancer depends on its type (tumor type), size and location, degree of expansion (whether it has spread beyond the lungs), general health condition of the patient and associated diseases (heart disease, kidney disease, diabetes, bronchitis, bronchial asthma, etc. ).

Lung cancer is treated surgically (operation), radio-therapy (radiation) and chemotherapy (cytostatics). These methods can be performed separately or together, and surgical treatment can sometimes be combined with radiation therapy or chemotherapy.

Surgical treatment of lung cancer (surgery)

Surgical treatment of lung cancer (operation) is applied when the disease has not spread beyond that organ and can thus be removed from the body, and the remaining part of the lung enables the patient to live a normal life. The speed of recovery after surgery is individual: some people recover faster, others slower. It usually takes several weeks for a patient to fully recover from lung cancer surgery. Every major operation, regardless of how successful and necessary it is, is followed in the postoperative course by corresponding difficulties and problems.

Drains come out of the wound and are usually removed two to seven days after the operation. Intravenous infusion is given for several days to maintain fluid balance in the body, until the patient is able to eat and drink normally again. Regular X-rays are used to monitor and control whether the lungs are functioning properly. The presence of pain and discomfort is a normal phenomenon, it can last for several weeks after the operation. The patient is usually discharged home seven to 14 days after the operation, depending on his condition.

Radiotherapy (air therapy)

Radiation therapy destroys cancer cells, while at the same time causing minor damage to normal cells. The number of treatments and the duration of therapy depend on the type and size of the tumor and are determined by the radiotherapist. Radiation therapy is used when, due to the advanced stage of the disease, it is not possible to access operative treatment or in cases where it is a tumor involving the trachea and large airways. Sometimes radiation therapy is also applied after surgery, but only when the tumor affects the lymph glands of the middle chest.
There are two types of radiation therapy.

External (transcutaneous) radiation

External (transcutaneous) radiation involves directing it from the external environment into the lungs.

Before the radiation begins, markings are drawn on the skin, and they enable the radiological technician who conducts the radiation therapy to precisely direct the rays to a certain place. The markings must remain visible during the entire treatment. Sometimes permanent small marks are left on the skin, which will be helpful to the radiotherapist in further treatments. At the beginning of radiation therapy, the patient is given exact instructions on how to take care of the skin of the area to be irradiated. Namely, it becomes red, dry, sensitive, with the presence of itching in those places, it has dark pigmentation for a long time after radiation.

The treatment lasts only a few minutes. Air therapy is not painful, but the patient must remain completely still during this time.

During external radiation therapy, the patient does not become radioactive, therefore it is completely safe to be with other people and children.

Internal radiation (brachytherapy)

Internal radiation (brachytherapy) is used if the tumor blocks one of the large airways and thus causes airlessness (atelectasis) of the lungs. Internal radiation is a simple way to open the airway. A probe in the form of a thin tube, to which the radiation source is later connected, is temporarily placed in a certain place in the airways using a bronchoscope. It is removed immediately after the treatment. A treatment or two spaced one week apart is usually required. After internal radiation, the patient is slightly radioactive for several days, so some precautions must be taken.

The most common side effects of radiation therapy are:

• nausea and vomiting (can be relieved with medicines called antiemetics);
• chest pains;
• loss of appetite (meals can be replaced with high-calorie drinks);
• difficult or painful swallowing (lasts for several days, and occurs as a result of irradiation of the esophagus, so in such cases, taking cold milk or yogurt usually helps);
• fatigue and weakness (you should rest as much as possible);
• flu-like symptoms.

These side effects can be mild, but also very pronounced, which depends on the dose of radiation received and the length of the therapy.

Chemotherapy (cytostatic therapy)

Chemotherapy is the use of anticancer (cytotoxic) drugs to destroy cancer cells. It lasts for a few days, followed by a rest period of a few weeks to allow the body to recover. The number of chemotherapy cycles received depends on the type of cancer the patient has and the response to treatment. Chemotherapy can be given on an outpatient basis (day hospital), but sometimes requires the patient to stay in the hospital for several days.

Chemotherapy can cause unpleasant side effects. In most patients, they are mild and can be well controlled with drugs that kill cancer cells, but at the same time affect healthy cells in the body. Side effects of chemotherapy are:

• leukopenia  (decrease in the number of white blood cells), which occurs as a result of chemotherapy, which is why seven to 15 days after the application of cytostatics, the blood count must be checked;
• anemia  (anemia) occurs due to a disturbance in the number of normal blood cells, so the blood count is often checked during chemotherapy; in mild cases, it is treated by taking appropriate drugs, and in severe cases, a transfusion is given;
• nausea  and vomiting can be alleviated or eliminated with antiemetic drugs;
• hair loss , although a temporary phenomenon, has a very unfavorable effect on the patient’s mental state (hair usually grows back three to six months after therapy, and during that period wigs or various hats and caps can be worn);
• loss of appetite  during chemotherapy is a common occurrence. In that case, the meal should be replaced with high-calorie drinks or cooked soft or pureed food;
• sensitivity of the oral cavity , ulceration and bleeding, if they occur, can be alleviated or removed by rinsing the mouth with disinfectants;
• susceptibility to infections  is also common; if an elevated body temperature appears (over 38 ºС), you should contact your doctor or the staff giving chemotherapy;
• fatigue and weakness  are individual phenomena as some feel they can lead a normal life during treatment, but many feel very tired and have to slow down or postpone their physical activities.

Laser therapy and stents

Sometimes lung cancer creates a feeling of difficulty breathing and suffocation, most often due to blockage of the trachea (trachea) and large airways by tumor growth. If the tumor can be removed, it is most often carried out by laser therapy, its burning and removal.

Laser therapy does not remove the tumor completely, but it eliminates symptoms such as difficulty breathing and suffocation. It is usually performed under general anesthesia, via bronchoscopy, and usually has no major side effects.

Sometimes the narrowing and closing of the airway is caused by pressure from the outside, so a small device called a stent is used to eliminate this phenomenon. It is placed inside the airway to keep it open, stays in it permanently and does not cause any major difficulties.

Symptomatic therapy

It implies the treatment of symptoms, ie. subjective complaints of the patient, which are caused both by the underlying disease and by the application of appropriate antitumor therapy. The goal of the therapy is to eliminate or alleviate complaints so that the quality of daily life of the sufferer is as good as possible. Of all the drugs that are used, the biggest role is played by those against pain, the so-called. analgesics, which are given according to a specific procedure. They are introduced from weaker to stronger, if necessary they are combined and given at such intervals as to prevent the occurrence of pain.

Doctor’s advice

After you leave the hospital, your doctor will schedule appointments to monitor your condition. At these examinations, it is important to tell the doctor if you have any new ailments and problems related to the disease.

The most important thing is to pay attention to the nature and intensity of the pain, difficulty breathing and coughing, and especially whether there are traces of blood in the sputum.

Examinations are performed every two to three months by a competent pulmonologist-oncologist who determines the type and length of antitumor treatment. A new lung scan, blood count, ECG and abdominal ultrasound must be brought to the examination, while other examinations (CT of the chest, CT of the brain, bone scintigraphy) are performed as needed, and at the request of the pulmonologist. It is also mandatory to bring previous findings, specialist opinions and a discharge certificate from the hospital. When you receive the specialist doctor’s report after the examination, you should contact your attending physician who will administer the prescribed therapy.

In most cancer patients, eating is difficult due to loss of appetite and side effects of cytostatic and radiation therapy such as nausea, vomiting and loss of sense of taste. Therefore, the diet must be adapted to the condition of the patient. In any case, a good diet includes the intake of necessary proteins, calories and vitamins (especially C and A), which prevents weight loss and promotes recovery. Therefore, macrobiotic and vegetarian diets are generally not recommended for cancer patients. In any case, it is best to seek medical advice before taking substances that are today advertised as protective agents (vitamins, antioxidants, immune boosters, aloe, etc.).