What are the main types of lung cancer. How are lung nodules diagnosed and treated. What are the characteristics of non-small cell lung cancer. How is small cell lung cancer different from other types. What is mesothelioma and how is it treated. What are chest wall tumors and their types. How are rare lung cancers diagnosed and managed.

Lung Nodules: Detection and Diagnosis

Lung nodules are small masses of tissue that can be found in the lungs. These nodules may be benign, precancerous, or metastatic tumors that have spread from other parts of the body. The size of a nodule can be an indicator of its potential malignancy, with larger nodules generally being more likely to be cancerous.

How are lung nodules typically discovered?

Interestingly, lung nodules are often found incidentally when patients undergo imaging tests for unrelated symptoms or conditions. For example, a patient experiencing abdominal pain or recovering from an injury might have a chest X-ray or CT scan that reveals the presence of lung nodules.

Evaluating Lung Nodules

When a lung nodule is detected, several factors are considered to determine its nature:

• Size: Larger nodules have a higher likelihood of being cancerous
• Shape: Irregular or spiculated edges may indicate malignancy
• Growth rate: Rapidly growing nodules are more concerning
• Patient’s risk factors: Smoking history, age, and other health conditions

How are lung nodules monitored or treated?

The approach to lung nodules depends on their characteristics and the patient’s overall health. Options may include:

1. Watchful waiting with periodic imaging to monitor growth
2. Biopsy for definitive diagnosis
3. Surgical removal if cancer is suspected or confirmed

Non-Small Cell Lung Cancer: Subtypes and Treatment Approaches

Non-small cell lung cancer (NSCLC) is the most prevalent type of lung cancer, accounting for approximately 80-85% of all cases. It tends to grow and spread more slowly than small cell lung cancer, which can impact treatment strategies and prognosis.

What are the main subtypes of non-small cell lung cancer?

NSCLC is classified into three primary subtypes based on the type of cells involved:

• Adenocarcinoma: The most common type in the United States, typically originating in the outer sections of the lungs
• Squamous cell carcinoma: Often begins in the bronchi near the middle of the lungs
• Large cell carcinoma: Can start anywhere in the lungs and tends to grow quickly

Treatment Options for NSCLC

The treatment approach for non-small cell lung cancer depends on various factors, including the stage of the disease, the patient’s overall health, and specific genetic markers of the tumor. Common treatment modalities include:

1. Surgery: Removal of the tumor and surrounding tissue
2. Radiation therapy: Use of high-energy X-rays to destroy cancer cells
3. Chemotherapy: Systemic treatment with cancer-fighting drugs
4. Targeted therapy: Drugs that target specific genetic mutations in cancer cells
5. Immunotherapy: Treatments that boost the body’s immune system to fight cancer

How is neoadjuvant therapy used in NSCLC treatment?

Neoadjuvant therapy involves administering treatments such as chemotherapy or radiation before surgery. This approach aims to shrink tumors, making them easier to remove surgically, and to prevent the spread of cancer cells through the bloodstream. It can be particularly beneficial for patients with more advanced stages of NSCLC.

Small Cell Lung Cancer: A Rapidly Progressing Malignancy

Small cell lung cancer (SCLC) is a less common but more aggressive form of lung cancer. It is strongly associated with cigarette smoking, with almost all cases attributed to tobacco use. SCLC tends to grow and spread much more quickly than non-small cell lung cancer, which impacts treatment strategies and outcomes.

What are the types of small cell lung cancer?

Small cell lung cancer is typically classified into two types:

• Small cell carcinoma (oat cell cancer)
• Combined small cell carcinoma

Treatment Approaches for SCLC

Due to its rapid spread, the treatment of small cell lung cancer often involves systemic therapies that can target cancer cells throughout the body. The primary treatment modalities include:

1. Chemotherapy: The most common treatment for SCLC
2. Radiation therapy: Often used in combination with chemotherapy
3. Surgery: Less frequently used due to the rapid spread of SCLC
4. Immunotherapy: Emerging treatment option for some patients

How is prophylactic cranial irradiation used in SCLC treatment?

Prophylactic cranial irradiation (PCI) is a type of radiation therapy used to prevent or treat the spread of small cell lung cancer to the brain. It is often recommended for patients who have responded well to initial treatment, as SCLC has a high propensity to metastasize to the brain.

Mesothelioma: Asbestos-Related Lung Cancer

Mesothelioma is a rare and aggressive form of cancer that affects the mesothelium, the thin layer of tissue that covers many internal organs. In the context of lung cancer, mesothelioma typically affects the pleura, which is the lining of the lungs and chest cavity.

What causes mesothelioma?

The primary cause of mesothelioma is exposure to asbestos. Asbestos is a naturally occurring mineral that was widely used in construction, insulation, and various industries until its health risks became known. The development of mesothelioma typically occurs 30 to 50 years after asbestos exposure, making it challenging to diagnose early.

Diagnosis and Staging of Mesothelioma

Diagnosing mesothelioma often involves a combination of imaging studies, biopsies, and blood tests. Once diagnosed, the cancer is staged to determine its extent and guide treatment decisions. Staging considers factors such as:

• Tumor size and location
• Lymph node involvement
• Metastasis to other organs

What treatment options are available for mesothelioma?

Treatment for mesothelioma typically involves a multimodal approach, combining various therapies to target the cancer from different angles. Treatment options may include:

1. Surgery: To remove as much of the tumor as possible
2. Chemotherapy: To kill cancer cells throughout the body
3. Radiation therapy: To shrink tumors and alleviate symptoms
4. Immunotherapy: To boost the body’s natural defenses against cancer
5. Targeted therapy: To attack specific molecular targets in cancer cells

Innovative approaches, such as using chemotherapy before surgery (neoadjuvant chemotherapy) and developing drugs that specifically target mesothelioma cells, are currently being researched to improve treatment outcomes.

Chest Wall Tumors: Rare But Significant

Chest wall tumors are uncommon neoplasms that can arise from various tissues within the chest wall, including bone, cartilage, muscle, and nerves. These tumors can be either benign or malignant, each presenting unique challenges in diagnosis and treatment.

How are chest wall tumors classified?

Chest wall tumors are primarily categorized based on their origin:

• Primary tumors: Originating in the chest wall itself
• Metastatic tumors: Spreading to the chest wall from other parts of the body

Types of Chest Wall Tumors

There are several types of chest wall tumors, each with distinct characteristics:

1. Osteosarcoma: A malignant bone tumor
2. Chondrosarcoma: Cancer arising from cartilage
3. Ewing sarcoma: A rare cancer that primarily affects children and young adults
4. Soft tissue sarcomas: Malignant tumors of connective tissues
5. Desmoid tumors: Locally aggressive but non-metastasizing tumors

When do chest wall tumors require treatment?

The decision to treat chest wall tumors depends on several factors:

• Malignant tumors always require treatment to prevent spread and alleviate symptoms
• Benign tumors may be treated if they cause symptoms or impair function
• Location and size of the tumor can influence treatment decisions
• Potential for malignant transformation in some benign tumors

Rare Lung Cancers: Diagnostic Challenges and Treatment Approaches

While non-small cell and small cell lung cancers account for the majority of lung cancer cases, there are several rare types of lung cancer that present unique diagnostic and treatment challenges. These rare cancers often have distinct characteristics and may require specialized approaches to management.

What are some examples of rare lung cancers?

Examples of rare lung cancers include:

• Carcinoid tumors
• Sarcomatoid carcinomas
• Adenosquamous carcinomas
• Salivary gland-type tumors
• Unclassified carcinomas

Diagnostic Approaches for Rare Lung Cancers

Diagnosing rare lung cancers often requires a combination of imaging studies, biopsies, and advanced molecular testing. The diagnostic process may involve:

1. High-resolution CT scans
2. PET scans to assess metabolic activity
3. Bronchoscopy with biopsy
4. Immunohistochemistry to identify specific tumor markers
5. Genetic profiling to detect unique molecular signatures

How are treatment plans developed for rare lung cancers?

Treatment plans for rare lung cancers are typically developed through a multidisciplinary approach, considering factors such as:

• Specific tumor type and molecular characteristics
• Stage of the disease
• Patient’s overall health and preferences
• Available clinical trials for novel therapies

Treatment options may include surgery, radiation therapy, chemotherapy, targeted therapies, and immunotherapy, often used in combination to achieve the best possible outcomes.

Advances in Lung Cancer Research and Treatment

The field of lung cancer research is rapidly evolving, with new discoveries and treatment modalities emerging regularly. These advancements are improving outcomes for patients across all types of lung cancer, from common forms to rare variants.

What are some recent breakthroughs in lung cancer treatment?

Recent advances in lung cancer treatment include:

• Targeted therapies for specific genetic mutations
• Immunotherapy drugs that harness the body’s immune system
• Liquid biopsies for non-invasive cancer detection and monitoring
• Improved radiation therapy techniques with reduced side effects
• Minimally invasive surgical approaches

The Role of Precision Medicine in Lung Cancer

Precision medicine is revolutionizing the approach to lung cancer treatment by tailoring therapies to the specific genetic and molecular characteristics of each patient’s tumor. This approach involves:

1. Comprehensive genomic profiling of tumors
2. Identification of actionable genetic mutations
3. Selection of targeted therapies based on tumor biology
4. Monitoring treatment response with molecular markers
5. Adjusting treatment plans based on evolving tumor characteristics

How is artificial intelligence contributing to lung cancer management?

Artificial intelligence (AI) is playing an increasingly important role in lung cancer management, including:

• Improving early detection through AI-assisted image analysis
• Predicting treatment outcomes and potential side effects
• Identifying novel drug targets through analysis of large datasets
• Streamlining clinical trial matching for patients
• Enhancing personalized treatment planning

These technological advancements, combined with ongoing research efforts, are paving the way for more effective, personalized approaches to lung cancer diagnosis and treatment across all cancer types.

Lung Cancer Types | Johns Hopkins Medicine

What You Need to Know

• The most common types of lung cancer include lung nodules, non-small cell lung cancer, small cell lung cancer and mesothelioma.
• Rare lung cancers often don’t originate in the lung.
• Rare lung cancers vary according to size, recommended treatment options and rate of metastasis.

The most common types of lung cancer are those found right in the lungs. Other rarer types of cancer may also occur in the lungs and chest wall.

Lung Nodules

Lung nodules are small masses of tissue. They may be benign, precancerous or metastatic tumors that have spread from other parts of the body. Generally, a larger nodule is more likely to be cancerous than a smaller one.

Lung nodules are often found when a patient is being tested for unrelated symptoms, such as abdominal pain or an injury.

Non-Small Cell Lung Cancer

Non-small cell lung cancer is the most common type of lung cancer. It grows and spreads more slowly than small cell lung cancer. The three main kinds of non-small cell lung cancer are named for the type of cells in the tumor:

• Adenocarcinoma is the most common type of lung cancer in the United States and usually begins along the outer sections of the lungs. It is also the most common type of lung cancer in people who have never smoked.

• Large cell carcinomas are a group of cancers with large, abnormal-looking cells. These tumors may begin anywhere in the lungs and tend to grow quickly.

• Squamous cell carcinoma is also called epidermoid carcinoma. It often begins in the bronchi near the middle of the lungs.

For non-small cell lung cancers that have not spread beyond the lung, surgery is used to remove the cancer. Surgery may also be used in combination with radiation therapy and chemotherapy in cancers that are more advanced. These treatments can also be given prior to surgery to shrink tumors and prevent the spread of cancer cells through the blood stream. This is called neoadjuvant therapy.

Small Cell Lung Cancer

Almost all cases of small cell lung cancer are due to cigarette smoking. It is a fast-growing cancer that spreads much more quickly than other types of lung cancer. There are two different types of small cell lung cancer:

Surgery is most commonly used in non-small cell lung cancers and less frequently in small cell lung cancer, which tends to spread more quickly to other parts of the body. Chemotherapy is the most common treatment for small cell lung cancer, as these medicines circulate throughout the body killing lung cancer cells that may have spread outside of the lung. Radiation therapy is frequently used in combination with chemotherapy when the tumor is confined to the lung and other areas inside of the chest. Radiation therapy may also be used to prevent or treat the development of small cell lung cancer that has spread to the brain (metastasis). In radiation therapy, precisely targeted X-rays are used to destroy localized cancer cells. Radiation therapy can be used to prevent tumor recurrence after surgery, to treat tumors in patients who are not candidates for surgery or to treat tumors causing symptoms in other parts of the body.

Mesothelioma

Mesothelioma is a rare cancer of the chest lining, most often caused by asbestos exposure. It accounts for about 5 percent of all lung cancer cases. Mesothelioma develops over a long period time, from 30 to 50 years between exposure to asbestos and getting the cancer.

Most people who develop mesothelioma worked in places where they inhaled asbestos particles.

Once mesothelioma has been diagnosed, it is staged, which tells the patient and doctors how large the tumor is and where is has progressed beyond the initial site.

Chemotherapy, radiation and surgery can all be part of the treatment for mesothelioma. Combined approaches that utilize these therapies together — particularly using chemotherapy prior to surgery, as well as new drugs that specifically target mesothelioma cells — are currently being tested.

Lung cancer specialists at Johns Hopkins use surgery, radiation, chemotherapy or all three to treat mesothelioma.

Chest Wall Tumors

Chest wall tumors are rare. Like other cancers, tumors found in the chest wall may be malignant or benign. Malignant tumors must be treated. Benign tumors will be treated depending on where they are located and the symptoms they cause. If a tumor presses against a lung so that a patient can’t breathe, for example, then it must be treated.

Types of Chest Wall Tumors

Tumors found in the chest wall are also categorized by whether they are primary tumors (starting in the chest wall) or metastatic tumors (spread to the chest wall from cancer that started elsewhere, such as in the breast). All metastatic tumors are malignant. In children, most chest wall tumors are primary, while they are more often metastatic in adults. Primary tumors start in the bones or muscles located in the chest wall.

Sarcomas — tumors that start in bone or muscle tissue, or more rarely in other types of tissue — are the most common type of primary tumor found in the chest wall.

Metastasized Cancer

Some cancers in the lung are the result of pulmonary metastasis — cancer that began in another part of the body and spread to the lung through the lymphatic system or bloodstream. Almost any cancer can metastasize to the lung. Some cancers that often spread to the lung are:

• Bladder cancer

• Breast cancer

• Colon cancer

• Kidney cancer

• Neuroblastoma

• Prostate cancer

• Sarcoma

• Wilms’ tumor

Rare Cancer Types

Carcinoid Tumors

Carcinoid tumors are rare cancers that most often appear in the stomach or intestines. However, they sometimes start in the lung. Carcinoid tumors can be classified as either typical or atypical.

Carcinoid tumors are also sometimes categorized by where they start in the lung:

• Central carcinoids form in the bronchi, which are the large airways located near the center of the lungs. Most lung carcinoid tumors start there. These carcinoids are almost always typical carcinoids.

• Peripheral carcinoids develop in the smaller airways on the edges of the lungs and they too are almost always typical carcinoids.

Lung carcinoid tumors are most often treated by surgery. Chemotherapy and radiation therapy may be used as adjunct therapies or if surgery is not possible.

Mediastinal Tumors

Mediastinal tumors are rare tumors that develop in the mediastinum, the area of the chest that separates the lungs. It is surrounded by the breastbone in front and spine in the back.

They can be benign or cancerous, forming from any tissue that exists or passes through the chest cavity. Most mediastinal tumors in children are benign while many mediastinal tumors in adults are cancerous. Because they are located in the chest cavity where the heart and major arteries are or near the spinal cord in back, both benign and malignant tumors must be treated.

There are several types of mediastinal tumors:

Germ cell tumors: These cancers are very treatable and often curable. They develop from reproductive cells and are more often found in the reproductive systems of both men and women. When found outside the reproductive system, they may also be called extragonadal germ cell tumors. How these cells move from the reproductive system to the mediastinum is not currently known.

Lymphomas: These malignant tumors start in the lymphatic system and include Hodgkin’s lymphoma and non-Hodgkin’s lymphoma. The lymphatic system is a complex network of capillaries, thin vessels, valves, ducts, nodes and organs that helps to protect and maintain the fluid environment of the body by filtering and draining lymph. In rare case, lymphoma can originate in the lungs.

Teratomas: These malignant tumors are made of cysts that contain one or more layers of embryonic cells. The layers are called ectoderms, mesoderms and endoderms. A rare cancer, teratomas occur most often in young men in their twenties and thirties. The tumors are most often located in the chest area. By the time the cancer is diagnosed, they have often spread. A number of other cancers are often associated with these tumors, including:

• Acute myelogenous leukemia (AML)

• Embryonal rhabdomyosarcoma (ERMS)

• Malignant histiocytosis

• Myelodysplasia (MDS)

• Small cell undifferentiated carcinoma

Thymomas: Thymomas and thymic carcinoma are rare cancers in which cancerous cells form on the outside of the thymus, a small organ in the upper chest that makes white blood cells. Thymomas are rarely malignant, grow slowly and don’t often spread beyond the thymus. Thymoma is linked with myasthenia gravis and other autoimmune diseases (diseases that cause the immune system to attack healthy cells and tissue).

Thymic carcinomas grow more quickly and have usually spread by the time the cancer is diagnosed. People with thymoma often have autoimmune diseases as well.

Lung Cancer Screening | Q&A

Lonny Yarmus, clinical chief of the Division of Pulmonary and Critical Care Medicine, gives a brief overview on lung cancer screening, including likely candidates and whether or not screenings a recovered by insurance.

What Is Lung Cancer? | Types of Lung Cancer

• Normal structure and function of the lungs
• Types of lung cancer
• Other types of lung tumors

Lung cancer is a type of cancer that starts in the lungs. Cancer starts when cells in the body begin to grow out of control. To learn more about how cancers start and spread, see What Is Cancer?

Normal structure and function of the lungs

Your lungs are 2 sponge-like organs in your chest. Your right lung has 3 sections, called lobes. Your left lung has 2 lobes. The left lung is smaller because the heart takes up more room on that side of the body.

When you breathe in, air enters through your mouth or nose and goes into your lungs through the trachea (windpipe). The trachea divides into tubes called bronchi, which enter the lungs and divide into smaller bronchi. These divide to form smaller branches called bronchioles. At the end of the bronchioles are tiny air sacs known as alveoli.

The alveoli absorb oxygen into your blood from the inhaled air and remove carbon dioxide from the blood when you exhale. Taking in oxygen and getting rid of carbon dioxide are your lungs’ main functions.

Lung cancers typically start in the cells lining the bronchi and parts of the lung such as the bronchioles or alveoli.

A thin lining layer called the pleura surrounds the lungs. The pleura protects your lungs and helps them slide back and forth against the chest wall as they expand and contract during breathing.

Below the lungs, a thin, dome-shaped muscle called the diaphragm separates the chest from the abdomen. When you breathe, the diaphragm moves up and down, forcing air in and out of the lungs.

Types of lung cancer

There are 2 main types of lung cancer.

Non-small cell lung cancer (NSCLC)

About 80% to 85% of lung cancers are NSCLC. The main subtypes of NSCLC are adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. These subtypes, which start from different types of lung cells, are grouped together as NSCLC because their treatment and prognoses (outlook) are often similar.

Adenocarcinoma: Adenocarcinomas start in the cells that would normally secrete substances such as mucus.

This type of lung cancer occurs mainly in people who smoke or used to smoke, but it is also the most common type of lung cancer seen in people who don’t smoke. It is more common in women than in men, and it is more likely to occur in younger people than other types of lung cancer.

Adenocarcinoma is usually found in the outer parts of the lung and is more likely to be found before it has spread.

People with a type of adenocarcinoma called adenocarcinoma in situ (previously called bronchioloalveolar carcinoma) tend to have a better outlook than those with other types of lung cancer.

Squamous cell carcinoma: Squamous cell carcinomas start in squamous cells, which are flat cells that line the inside of the airways in the lungs. They are often linked to a history of smoking and tend to be found in the central part of the lungs, near a main airway (bronchus).

Large cell (undifferentiated) carcinoma: Large cell carcinoma can appear in any part of the lung. It tends to grow and spread quickly, which can make it harder to treat. A subtype of large cell carcinoma, known as large cell neuroendocrine carcinoma (LCNEC), is a fast-growing cancer that is very similar to small cell lung cancer.

Other subtypes: A few other subtypes of NSCLC, such as adenosquamous carcinoma and sarcomatoid carcinoma, are much less common.

Small cell lung cancer (SCLC)

About 10% to 15% of all lung cancers are SCLC. It is sometimes called oat cell cancer. 

This type of lung cancer tends to grow and spread faster than NSCLC. In most people with SCLC, the cancer has already spread beyond the lungs at the time it is diagnosed. Since this cancer grows quickly, it tends to respond well to chemotherapy and radiation therapy. Unfortunately, for most people the cancer will return at some point.

Other types of lung tumors

Along with the main types of lung cancer, other tumors can occur in the lungs.

Lung carcinoid tumors: Carcinoid tumors of the lung account for fewer than 5% of lung tumors. Most of these grow slowly. For more information about these tumors, see Lung Carcinoid Tumor.

Other lung tumors: Other types of lung cancer such as adenoid cystic carcinomas, lymphomas, and sarcomas, as well as benign lung tumors such as hamartomas are rare. These are treated differently from the more common lung cancers and are not discussed here.

Cancers that spread to the lungs: Cancers that start in other organs (such as the breast, pancreas, kidney, or skin) can sometimes spread (metastasize) to the lungs, but these are not lung cancers. For example, cancer that starts in the breast and spreads to the lungs is still breast cancer, not lung cancer. Treatment for metastatic cancer to the lungs is based on where it started (the primary cancer site).

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Araujo LH, Horn L, Merritt RE, Shilo K, Xu-Welliver M, Carbone DP. Ch. 69 – Cancer of the Lung: Non-small cell lung cancer and small cell lung cancer. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020. 

Chiang A, Detterbeck FC, Stewart T, Decker RH, Tanoue L. Chapter 48: Non-small cell lung cancer. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

Hann CL, Wu A, Rekhtman N, Rudin CM. Chapter 49: Small cell and Neuroendocrine Tumors of the Lung. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

National Cancer Institute. Physician Data Query (PDQ). Health Professional Version. Non-Small Cell Lung Cancer Treatment. 2019. Accessed at https://www.cancer.gov/types/lung/hp/non-small-cell-lung-treatment-pdq on June 12, 2019.

National Cancer Institute. Physician Data Query (PDQ). Health Professional Version. Small Cell Lung Cancer Treatment. 2019. Accessed at https://www.cancer.gov/types/lung/hp/small-cell-lung-treatment-pdq on June 12, 2019.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Small Cell Lung Cancer. V.4.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf on June 12, 2019.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Small Cell Lung Cancer. V.1.2019. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf on June 12, 2019.

Osmani L, Askin F, Gabrielson E, Li QK. Current WHO guidelines and the critical role of immunohistochemical markers in the subclassification of non-small cell lung carcinoma (NSCLC): Moving from targeted therapy to immunotherapy. Semin Cancer Biol. 2018;52(Pt 1):103–109. 

Last Revised: January 12, 2023

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symptoms, signs, treatment, stages of lung cancer

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Lung cancer is a neoplasm that develops from pathologically altered epithelial cells lining the inner surfaces of the bronchi and bronchial glands. Under the influence of certain conditions, epithelial cells cease to perform their function. An uncontrolled random division process is launched, as a result of which the pathological tissue grows rapidly, penetrates into nearby, and then into distant organs. The respiratory function of the lungs and other affected organs gradually decreases, intoxication with decay products increases, and if left untreated, an inevitable death occurs.

Species

In accordance with histological features, lung cancer is divided into three groups of tumors:

• small cell – accounting for about a fifth of all clinical cases and characterized by an extremely rapid aggressive course;
• non-small cell – this includes adenocarcinomas, which make up half of all cases, squamous cell carcinomas (20-30%) with a slow course and undifferentiated cancer;
• other types – bronchial carcinoids, neoplasms from surrounding tissues and metastases from other organs.

According to the location, central, peripheral and disseminated lung cancer are distinguished.

Symptoms

Most patients take the first signs of lung cancer for a common cold, since at the initial stage of tumor growth there are no specific manifestations. As the pathological neoplasm increases, the patient develops:

• Feeling of general malaise, reduced efficiency;
• elevated body temperature;
• loose cough with expectoration of sputum;
• difficult, noisy breathing;
• swollen lymph nodes;
• frequent respiratory tract infections.

Symptoms of lung cancer in men and women are practically the same. Over time, the listed manifestations intensify, they are added:

• pain in the chest, aggravated by coughing and taking deep breaths;
• shortness of breath on slight exertion or at rest;
• blood streaks or brown clots in expectorant sputum;
• headaches, bone pains;
• dizziness, intermittent loss of consciousness;
• causeless sudden weight loss, loss of appetite.

If cough, fever, increased sputum secretion continue for more than two to three weeks, you should definitely contact an oncologist for an examination.

Causes and risk factors

Although the causes of lung cancer and the mechanisms of malignant transformation of cells are still not exactly established, oncologists have studied the factors contributing to the development of the disease:

• smoking, including passive smoking;
• work in hazardous production;
• inherited predisposition to lung cancer;
• prolonged exposure to radon in the respiratory system;
• chronic diseases of the respiratory organs, including tuberculosis;
• over 40 years of age.

Men get sick 5-6 times more often than women, since among them there are much more frequent heavy smokers and workers in hazardous industries with a high level of dust or gas pollution.

Stages

In oncology, it is customary to distinguish the stages of lung cancer by the size of the tumor and the degree of its growth, spread to other organs. There are four main stages of the disease, depending on which the method of treatment is determined.

1. Neoplasm no larger than 3 cm located compactly, without penetration into the pleura. Lymph nodes are not affected, metastases are absent.
2. The tumor enlarges and obstructs the lumen of the bronchus or grows, forming a seal within one lobe of the lung. One or two metastases to regional lymph nodes may appear.
3. The size of the neoplasm exceeds 6 cm, the pathology affects the chest wall, it can reach the area of ​​​​separation of the main bronchi or the diaphragm. Metastases penetrate into distant lymph nodes on their half of the body.
4. The tumor grows into several neighboring organs, affects the esophagus, heart, stomach, gives multiple metastases to distant lymph nodes on both sides and to other organs.

For small cell tumors, a separate classification is often used, consisting of only two stages – localized within one lung and spread beyond the original lung, including to other organs.

Diagnostics

In the early stages, the disease is usually diagnosed by chance, when studying fluorographic images. When contacting for symptoms of lung cancer, a pulmonologist or oncologist usually prescribes the following diagnostic procedures:

• x-ray of the lungs in several projections for the primary detection of a tumor;

• CT scan of the chest to detect a tumor, accurately determine its size, stage, prevalence, etc.;

• MSCT of the chest to determine the exact location, size of the neoplasm and other data;

• fibrobronchoscopy – examination of the bronchi using an endoscope with a biopsy of the tumor tissue;

• transthoracic biopsy of the tumor, performed with a puncture of the chest wall;

• histological examination of the biopsy to determine the type of cancer cells and their degree of malignancy;

• blood test for tumor markers CEA, NSE, CYFRA21-1;

• cytological analysis of expectorated sputum to detect malignant cells;

• Ultrasound of the abdominal cavity to detect metastases to other organs.

Treatment

Early detection is essential for effective lung cancer treatment. In this case, after removal of the malignant tissue, a complete recovery and return to normal life is possible.

• Surgery. In the absence of sprouting into other organs and lesions of the lymph nodes during the operation, a part or the entire lung is removed. Surgical treatment is possible for patients with the first or second, partially with the third stage of the tumor. With the spread of the pathology to other vital organs or with the general serious condition of the patient, the operation is impossible.

• Radiation therapy. Directed ionized radiation that destroys malignant cells is used in combination with surgery, chemotherapy and other methods at all stages: for non-surgical removal of the tumor, destruction of residual cells and metastases after surgery, to prevent relapse or to improve the condition of inoperable patients.

• Chemotherapy. Drugs that destroy tumor cells are prescribed in combination with radiation treatment before and after surgery, as well as in inoperable clinical cases.

• Target therapy. Modern targeted drugs are used to inhibit the growth of strictly defined cell types. Targeted drugs do not destroy the tumor, but inhibit its growth, which improves the symptoms of lung cancer in women and men, prolonging the life of patients at the inoperable stage of the disease.

Forecasts

The favorable outcome of lung cancer treatment reaches 85-90% when the disease is detected at the first or second stage. Late diagnosis significantly reduces the prognosis of five-year survival. In addition, the histological type of the tumor is of great importance: in small cell carcinoma, relapses are possible in 60-80% of clinical cases. With this form of the disease, the two-year survival rate is about 50%, the five-year survival rate is no more than 15%, even in the initial stages.

Prevention

Effective lung cancer prevention measures include:

• completely quit smoking;
• in strict observance of safety measures at enterprises, the constant use of respirators and other PPE;
• in the fight against air pollution.

For smoking men over 40 years of age, it is especially important to undergo a preventive examination by a pulmonologist every year, to perform a computed tomography of the chest.

Rehabilitation

Recovery of patients after surgery to remove part of the lung includes:

• therapeutic exercises;
• diaphragmatic breathing training;
• corrective drug therapy;
• sanitation of the respiratory tract;
• bronchial drain to remove fluid.

Diagnosis and treatment of lung cancer in Moscow

If you need a high-quality diagnosis of lung cancer, contact the Meditsina clinic about this. At your service – modern tomography and X-ray equipment, a well-equipped laboratory, radiologists-diagnostics of the highest category. Consultation and treatment of patients is carried out by experienced oncologists and pulmonologists. Consultations of highly qualified endocrinologists, infectious disease specialists and doctors of other specialties are possible. Treatment is carried out in our own comfortable hospital.

Questions and answers

How long do people live with lung cancer?

The life expectancy of the patient depends on many factors, but early detection and the type of cells that make up the tumor are crucial. With non-small cell cancer of the first or second stage, the possibility of complete recovery reaches 85%. Therefore, it is necessary to undergo an annual examination in order to detect and cure a serious illness in time.

How do you know if you have lung cancer?

If a cough with sputum and a slight fever, general malaise and weakness continue for more than two to three weeks, this is a significant cause for concern. It is necessary to contact a pulmonologist as soon as possible to examine the lungs.

How to make breathing easier with lung cancer?

To make breathing easier, try to keep your back straight. Lying down in bed, put several pillows under your back and head, lie mostly on your side in a half-sitting position. Learn diaphragmatic breathing and other breathing exercises. To eliminate dryness, constantly rinse your mouth with water or a weak soda solution, drink more ordinary or mineral water.

Attention!
You can cure this disease free of charge and receive medical care at JSC “Medicina” (Academician Roitberg’s clinic) under the program of State guarantees of compulsory medical insurance (Compulsory medical insurance) and VMP (high-tech medical care).
To find out more, please call +7(495) 775-73-60, or visit the VMP CHI page

List of sources

• Averyanov, AV Rare lung diseases: diagnosis and treatment / AV Averyanov, VN, Lesnyak, EA Kogan; ed. A. V. Averyanova. – Moscow: MIA, 2016
• A. Z. Dovgalyuk. Lung cancer. 2015
• Trachtenberg, A. Kh. Neuroendocrine tumors of the lungs [Text] / A. Kh. Trakhtenberg, V. I.
• Chissov, G. A. Frank. – Moscow: Practical Medicine, 2012.

symptoms and signs, types, diagnosis and treatment of thoracic cancer

Content of the article:

• Characteristics of cancer
• Types of disease
• Causes
• First signs and symptoms
• Diagnostics
• Treatment
• Forecasts

Characteristics of cancer of the chest cavity

The chest consists of many organs, including bones and soft tissues, as well as lungs and pleura, heart and mediastinal organs (esophagus, trachea, thymus, thoracic lymphatic duct, pericardium), vessels, nerves, lymph nodes . All of them can be affected by malignant tumors. The most common type of malignant lesion of the chest cavity is lung cancer. Other types of tumors are less common and may be primary (occur directly in the chest cavity) or secondary (occur when tumors metastasize). In addition to the organs of the chest cavity, cancerous lesions may occur in the region of the pleura, diaphragm, or sternum, which limit the chest cavity. Source:
V.M. Karpov, A.F. Lazarev
Prevalence of primary multiple malignant neoplasms with lesions of the chest organs //
Russian Journal of Oncology, 2015, No. 5, pp. 53-56.

The severity, growth rate, and treatment prognosis depend on the specific type of cancer and organ involved.

Types of oncological diseases of the chest cavity

Malignant neoplasms of the chest cavity are divided into groups:

• Lung cancer . There are several types of malignant lung lesions – non-small cell, accounting for up to 80% of all types of cancer, small cell carcinomas, adenocarcinoma, large cell cancer.
• Cancer of the respiratory tract . It includes carcinoid tumors of the respiratory tract and cystadenoid, mucoepithelioid carcinomas of the bronchi.
• Mediastinal neoplasms . These include malignant lesions of the intrathoracic, extrathoracic lymph nodes, cancer of the esophagus and tumors of the thymus.
• Cardiac and vascular disorders . Primary and metastatic cancers are possible.
• Pleural neoplasms . Pleural mesothelioma and malignant fibrous tumor are especially dangerous.
• Chest wall lesions affecting bones, mesenchymal tissues and cartilage . The most common malignant tumors are multiple myeloma and chondrosarcoma.

Causes of breast cancer

The exact cause of the development of various types of breast cancer has not yet been determined. There are a number of factors that increase the risk of tumor lesions of the chest. These include:

• Genetic predisposition. In families where cancer of various localizations is common, the likelihood of tumors of the chest cavity is higher. This is due to the inheritance of defective genes that control cell division.
• Smoking is especially relevant for lung cancer, although it is also detected in non-smokers. Alcohol intake plays a role, especially for esophageal cancer. The combined use of alcohol and smoking increases the risk several times.
• Poor nutrition and deficiency of vitamin A, zinc, molybdenum increases the risk of certain types of cancer. Being overweight and esophageal reflux increase the risk of esophageal cancer.
• Chronic inflammation increases the risk of developing tumors of the chest cavity, including cancer of the heart and blood vessels, lymph nodes, lungs and esophagus.

First signs, symptoms of tumors of the chest cavity

For a long time, cancerous lesions of the chest cavity do not have symptoms. As tumors increase in size, three groups of signs may appear:

• symptoms of compression of neighboring organs, signs of cancer invading tissues and neighboring organs;
• general symptoms of breast cancer;
• specific features typical of a particular neoplasm.

For example, lesions in the mediastinal region can form a pain syndrome similar to angina pectoris. Pain may radiate to the shoulder, arm or neck, swallowing and breathing may be impaired. Source:
Saynak M, Veeramachaneni NK, Hubbs JL, Okumuş D, Marks LB
Solitary Fibrous Tumors of Chest: Another Look with the Oncologic Perspective // ​​
Balkan Med J. 2017 May 5;34(3):188-199. doi: 10.4274/balkanmedj.2017.0350. Epub 2017 Apr 6.

Among the key signs of tumors of the chest cavity, general symptoms can be distinguished:

• development of shortness of breath on exertion or at rest;
• onset of cough with sputum that may be stained with blood;
• pain during deep inspiration or expiration;
• noises, wheezing when breathing;
• frequent bronchitis, pneumonia;
• violation of the general condition – weight loss, lack of appetite, severe weakness, nausea.

For some types of cancer, specific symptoms are typical – dysphagia (difficulty swallowing), skin itching, low blood glucose levels.

Diagnosis of chest cancer

It is possible to detect breast cancer from the earliest stages. The medical center “SM-Clinic” is equipped with everything necessary for the fastest and most accurate diagnosis, including histological and biochemical studies in its own laboratory. The diagnostic process uses:

• X-ray to detect large tumors, bone and lung lesions. The method helps to determine the affected area for more targeted research.
• MRI or CT diagnostics allows you to determine the exact size of the tumor, the involvement of neighboring structures, blood vessels, bones, cartilage.
• Diagnostic thoracoscopy is indicated for pleural lesions or suspected metastases, complications of lung cancer.
• Bronchoscopy is indicated for examining the bronchial tree, clarifying the location of the tumor, and collecting material for histological examination.
• Various options for the study of sputum in order to exclude concomitant pathologies, to identify tumor cells.
• Pleurocentesis and collection of pleural fluid samples for examination (sometimes performed for therapeutic purposes).
• Biopsy of tumor sites, affected lymph nodes with determination of the type of cancer and its histochemical characteristics Source:
  M.I. Davydov, D.G. Zaridze
  Screening of malignant tumors //
  N.N. Blokhin”, 2014, v.25, No. 3-4, p.5-16.

Treatment of breast cancer

Based on the diagnosis, the final diagnosis, stage of cancer, its type and specific localization are established. Patient management is developed individually, taking into account age and diagnosis, comorbidities and general condition. Source:
Semenova EA, Nagel R, Berns A
Origins, genetic landscape, and emerging therapies of small cell lung cancer //
Genes Dev. 2015 Jul 15;29(14):1447-62. doi: 10.1101/gad.263145.115.

If possible, surgical removal of the tumor with pre- or postoperative conservative techniques is used. These include:

• Chemotherapy . Before surgery, it helps shrink the tumor so it can be removed more easily. After – to suppress the remaining cancer cells.
• Targeted Therapy targets a specific type of cancer, such as small cell lung carcinoma.
• Radiation therapy is indicated to suppress the growth of malignant cells in inoperable forms or to prepare for surgery.

Each patient’s treatment protocol is drawn up on the basis of international and domestic clinical recommendations, modern drugs and surgical intervention methods are used that reduce the risk of side effects, have proven effectiveness with the minimum possible effects on the patient’s body.

Chest cancer prognosis

With early detection of lung cancer, about 80% of patients live more than 5 years, with other breast tumors, prognosis depends on the form of cancer and the stage of its detection. The smaller the tumor and damage to surrounding tissues, the higher the chances of favorable outcomes. Source:
V.V. Starinsky, L.M. Aleksandrova,
O.P. Gretsova
Lung cancer: epidemiology, prevention //
Medicine in Kuzbass, 2014, p.30-31.

The risk of recurrence in tumors of the chest cavity is low, to prevent recurrent episodes of cancer, doctors conduct long-term follow-up with follow-up examinations.

Sources:

• V.M. Karpov, A.F. Lazarev. The prevalence of primary multiple malignant neoplasms with lesions of the chest organs // Russian Journal of Oncology, 2015, No. 5, pp. 53-56.
• M.I. Davydov, D.G. Zaridze. Screening of malignant tumors. N.N. Blokhin”, 2014, v.25, No. 3-4, p.5-16.
• V.V. Starinsky, L.M. Alexandrova, O.P. Gretsov. Lung cancer: epidemiology, prevention // Medicine in Kuzbass, 2014, pp. 30-31.
• Saynak M, Veeramachaneni NK, Hubbs JL, Okumuş D, Marks LB. Solitary Fibrous Tumors of Chest: Another Look with the Oncologic Perspective // ​​Balkan Med J. 2017 May 5;34(3):188-199. doi: 10.4274/balkanmedj.