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Lung Cancer Symptoms Causes Treatment

What is Lung Cancer?

Lung cancer usually arises from the cells of the lower respiratory tract (bronchi). Therefore, it is also called bronchial carcinoma. Doctors distinguish between a small cell and a non-small cell form in lung cancer. Small cell bronchial carcinomas grow rapidly and often form metastases, i.e. daughter tumors in other organs. However, this form only occurs in 20 percent of the cases. Around eight out of ten patients have non-small cell bronchial carcinoma.

Lung cancer is the second most common cancer among men in Germany and the third most common among women. According to the Center for Cancer Registry Data, around 53,000 people fell ill in 2012 ; men are affected more often than women. However, fewer and fewer men have contracted lung cancer since the 1980s, while the number of women is increasing. Experts attribute this to the fact that more women smoke today than in the past.

Causes and risk factors:

Smoking is the main risk factor:

Tobacco smoke is the largest avoidable risk factor for cancer. Tobacco contains over 4800 substances, of which approximately 90 have been shown to either cause cancer or are suspected of causing cancer. It is estimated that up to nine out of ten lung cancer cases can be attributed to smoking. The longer and the more a person smokes, the greater the risk of developing lung cancer. Those who started smoking as a teenager are particularly at risk.
Important: passive smoking also increases the risk of lung cancer. Passive smokers inhale the so-called side stream smoke. Although it contains less tar and nicotine, it does contain higher concentrations of carcinogenic substances.
Environmental factors: for example radon and fine dust
After smoking, the radioactive noble gas radon is the second most important cause of lung cancer, according to the Federal Office for Radiation Protection. It occurs naturally in the soil, the concentration varies from region to region. Especially in older buildings, the gas can penetrate the basement and the ground floor. Ventilation is the simplest measure to reduce the radon exposure in houses. Other important environmental risk factors are automotive exhaust fumes from diesel vehicles, fine dust and air pollution.

Dangerous pollutants in the workplace:

Especially workers in construction, mining and metal processing are sometimes exposed to fine dust, which has proven to be disease-promoting. Asbestos is particularly well known, a long-lasting fibrous material that has been used extensively in the construction industry as insulation and insulation material. Asbestos particles in the lungs lead to inflammatory remodeling and scarring of the lung tissue (asbestosis). Lung cancer can develop from this with a delay of up to 40 years. The use of asbestos has been completely banned in Germany since 1995, but there are still many contaminated sites.

Other carcinogenic dusts and vapors are: quartz dusts, arsenic, chromium and nickel compounds. Lung cancer patients who have been exposed to such dusts at their workplace should speak to their doctor about any recognition as an occupational disease.

Genetic influences:

Inheritable factors may play a role in the development of lung cancer. This is particularly suspected in people who develop this type of tumor at a young age. However, it is not known how relevant genetic influences are and in which patients they may actually favor lung cancer.


ung cancer rarely causes symptoms in the early stages. Signs of the disease (symptoms) often only appear when the disease has already progressed. Smaller tumors are therefore often only discovered by chance, for example if the lungs are X-rayed for other reasons. In addition, the complaints are usually not clearly attributable to lung cancer, but can also indicate other diseases.

If you have the following symptoms, it is important to see a doctor immediately to find out the cause:

• Cough that lasts longer than three weeks without any other known cause or worsening of a                     chronic cough
•  Prolonged expectoration with and without blood admixture
•  Unexplained febrile episodes
•  Shortness of breath
•  Chest pain
•  Fatigue, reduced performance and weight loss
•  Hoarseness and difficulty swallowing
•  Bone pain
•  Lymph node swelling above the collarbone

Such symptoms should raise suspicions of lung cancer, especially in high-risk patients. They include older smokers, patients with chronic bronchitis , people with previous cancer or those in whose families have already developed cancer, and people with the occupational pollution levels mentioned in the causes section.

Early detection not yet possible
Because of the diagnostic ambiguity and the late onset of these symptoms, physicians have been searching for years for a reliable method of early detection that could be used in people at high risk of illness. Because if you discovered cancer earlier, it would be better treated, if not cured. So far, however, there is no procedure that German experts consider suitable to apply to the entire population.

Diagnosis: how do doctors diagnose lung cancer?

If a patient shows symptoms that may indicate lung cancer, the doctor will initiate a series of tests. The aim is to confirm the suspicion or to dispel it. The doctor also looks for other possible causes of the symptoms.

Physical exam and medical history
During a first examination, the doctor gets an idea of ​​the patient's general health. He asks about symptoms and possible risk factors ( medical history ). At the same time, he receives the first signs of suspected lung cancer, such as when lymph nodes are typically swollen.

X-rays of the lungs
X-rays of the lungs are used to detect any tumors and their approximate location and size. Other lung diseases can also be identified.

Computed tomography / magnetic resonance imaging
A cross-sectional examination in the form of a computed tomography (CT) is done if the result of the X-ray examination was not clear or if it indicates lung cancer. If there is a tumor, the exact location and local spread can be determined with the method. CT can also be used to search for tumor deposits (metastases) in the head, chest and abdomen.

Magnetic resonance imaging (MRI) is another method for diagnosing metastases. In certain tissues or organs such as the brain, magnetic resonance imaging is more suitable for the exclusion or detection of metastases than computed tomography.


Bronchoscopy is the most important diagnostic measure. A flexible tube or, more rarely, a rigid tube (bronchoscope) is inserted into the airways. The bronchoscope is equipped with a light guide, optics and pliers. This instrument allows the lower respiratory tract, the bronchi, to be viewed through the trachea and, if necessary, small tissue samples (biopsies) to be taken. These samples are then examined microscopically. In this way it can be determined whether the sample material contains cancer cells and - if so - what type of cancer it is.

If the suspicious area is in an area of ​​the lungs that is not directly accessible with the bronchoscope, the sample can be taken using a needle biopsy. This can be done either with external bronchoscopy through the skin or with an endoscope through the esophagus. A fine needle is inserted into the lung tissue under control by an imaging process ( ultrasound or computer tomography) and then a piece of tissue is punched out or cells are sucked in. This procedure is called needle biopsy or needle aspiration.

Methods to determine the spread of the tumor
Sonography (ultrasound examination): Sonography is particularly suitable for discovering daughter tumors in the abdomen. The liver in particular is examined in this way.

Bone or skeletal scintigraphy : 

Bone scintigraphy is especially used to discover metastases in the skeleton. For this purpose, a radioactive substance is injected into the bloodstream, which primarily accumulates in the places in the bone where the bone metabolism is increased - for example because the tumor has spread there (metastasis). The areas with enriched radioactivity can be seen with a special camera. The radioactive substances used are markers that disintegrate very quickly and no longer accumulate in the body.

Positron emission tomography ( PET ): PET can be used to display the metabolic activity in tissues using radioactive labeled sugar. The metabolism is usually higher in tumors than in healthy tissue. This allows you to be identified.


 Mediastinoscopy is an endoscopic examination (mirroring) of the medial space between the lungs (mediastinum) or the lymph nodes under general anesthesia. It is carried out when the findings of computer tomography, magnetic resonance imaging or positron emission tomography still leave questions unanswered and the doctor expects the examination result to provide information for planning the treatment.

Stages division:

If there is actually lung cancer, further questions must be answered. When planning treatment, it is important to find out whether it is a small-cell or non-small-cell carcinoma and the stage at which the disease has spread (staging).

The tumor type is determined using tissue samples. In lung cancer, the stages are classified according to the so-called TNM scheme. T denotes the size of the tumor, N (nodus = lymph node) the extent of the lymph node involvement and M the presence of distant metastases. Depending on the findings, the disease is finally divided into one of four stages (I-IV).

In stage I disease there is a localized tumor without lymph node involvement and without distant metastases. Stages II and III include tumors with greater spread and / or different degrees of lymph node involvement. Distant metastases are already present in stage IV.

Therapy: how is lung cancer treated?

Lung cancer therapy is based on surgery, chemotherapy and radiation therapy . In advanced stages, new treatment approaches such as targeted therapies are also available. Which of the aforementioned treatment approaches are used individually or in combination depends on the individual situation.
Patients with small cell carcinomas are usually at an advanced stage at the time of diagnosis. The tumor has often already affected large parts of the lung tissue and has often already metastasized in other parts of the body. A complete surgical removal of the cancerous tissue is no longer possible in these cases. However, small cell tumors respond better to chemotherapy than non-small cell carcinomas , so this procedure dominates treatment.

In the treatment of non-small cell carcinomas in stage I and II, surgery comes first. It offers an opportunity for long-term healing. In more advanced stages, chemotherapy and radiation therapy are used individually or in combination, possibly supplemented by surgery. If distant metastases have already occurred, the prospects of healing decrease significantly. The main aim of the treatment is to prevent or slow the progression of the disease, to alleviate the symptoms and to maintain the quality of life.


Lung surgery is a major operation. A wide range of tissue-conserving techniques are available to surgeons today: for example, lobectomy only removes the affected lung lobe; cuff resection - a variant of lobectomy - also includes part of the associated bronchus in addition to the flap. Finally, only part of a lung lobe is removed during segment resection. With these procedures, the surgeon tries to find a compromise between maintaining functional lung tissue and the tissue removal required for healing.

If necessary, chemotherapy and / or radiation therapy can precede or follow the operation. One then speaks of neoadjuvant or adjuvant chemotherapy or radiation therapy.


Chemotherapy uses substances that inhibit the division of cells and cause them to die (cytostatics). These chemotherapeutic agents mainly affect cells that divide strongly and have a lively metabolism. Cancer cells are therefore more affected than healthy cells.

Nevertheless, chemotherapy is not without side effects. These can differ from drug to drug. Typical side effects include, for example, a decrease in the number of certain blood cells, nausea, vomiting , gastrointestinal disorders, loss of appetite , fatigue (chronic fatigue) and hair loss . In addition, chemotherapy patients are more susceptible to infection. However, many of these disorders can be alleviated or even avoided with special measures or medication.

A combination of radiation and chemotherapy can be useful to achieve better treatment results. The two methods can either be carried out in succession - usually chemotherapy first, then radiation therapy - or simultaneously. The latter increases the chances of a cure, but also the side effects.

Radiotherapy (radiation):

Radiation therapy specifically delivers high-energy rays that damage the genetic material (DNA). If the damage exceeds a certain level, the cells lose their ability to divide and function and die.

In the simplest case, the radiation source is outside the body (external or percutaneous radiation). The radiation dose, penetration depth of the rays and the size of the area to be irradiated are determined by the doctor responsible so that cell destruction is limited to the tumor as far as possible.

Special active ingredients:

If the disease has progressed, newer treatment approaches can be used.

In addition to chemotherapy drugs, there are now new active ingredients that are aimed at targeting the tumor. This can succeed if the active ingredients block certain tumor-specific growth mechanisms. For example, substances are permitted that prevent the transmission of growth signals or other signaling pathways in the cancer cell (tyrosine kinase inhibitors, multicinase inhibitors), inhibit the formation of new blood vessels in the growing tumor (angiogenesis inhibitors) or block special switches in the immune system (immune checkpoint inhibitors). However, many of these new methods only work if the tumor has special features.

endoluminal brachytherapy:

In addition to the usual radiation therapy, there is the option of radiation therapy in the airways (endoluminal brachytherapy). This way the tumor is irradiated from the inside. In the case of lung cancer, this treatment is used, for example, to prevent the tumor from constricting the airways in advanced tumors and thus causing shortness of breath.

Symptom-oriented therapy:

Pain is one of the leading symptoms in advanced cancer. However, there are several ways to relieve pain.

Other common symptoms that can be treated more or less well are weakness, loss of appetite , vomiting and shortness of breath . In any case, patients should speak to their doctor about treatment options.

Complementary measures: nutrition and psychological support

In addition to standard medical therapy, there are numerous approaches that can have a favorable influence on the course of the disease: a wholesome diet, for example, strengthens the general state of health and prevents nutrient deficits from occurring. Cancer is an enormous psychological burden. Consultation with a psycho-oncologist or support from a specially trained psychologist can help to maintain or regain your mental balance.

Source. This info is taken from and other website through internet


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