stage 4 lymphoma life expectancy | Lung cancer | Symptoms and treatment | Life expectancy

Lung cancer | Symptoms and treatment | Life expectancy




Lung cancer is a tumor mass that develops in the lungs.
Over time, this mass extends and causes:
Disorders of functioning of the body: the tumor interferes the normal flow of air in the lungs,
Metastasis: the cancer spreads to other organs of the body.
Cancer threatens the whole body.
The tumor of the lung may develop in the cells that produce:

The bronchi
The small bronchi
The alveoli.
Tumor growth determines the increase in the number of cells in the affected party.

Types of lung cancer
More than 90% of the primary cancers develop in the bronchi, one of the two main branches of the trachea. This disease is known under the name of bronchogenique or lung cancer carcinoma.

Lung carcinoma
Lung cancer includes malignant malignancies occurring in the epithelium tissue that make up:

The bronchi
The lung tissue.
This type of tumor is over 95% of malignant lung malignancies, while the others are:

Lymphoma and connective tumors (> 0.5%).
Benign tumors (such as the Hamartoma) and low rate of malignancy (such as carcinoid): less than 5%.
Lung tumors are usually divided into two groups according to the type of treatment that can be performed.

(1) non-small cell carcinoma

Non-small cell lung tumor can be treated through surgery associated with radiotherapy and chemotherapy.

Squamous Cell Carcinoma
Squamous cell carcinoma is also called epidermoid.
This cancer develops in the bronchi of large dimensions (upper airway) and represented 40% to 50% of cases.
In general, cancer occurs in the central part of the lung and it can also affect the bronchi causing:

A stenosis (narrowing),
An atelectasis (collapse of part of the lung),
Necrosis (cell death) because of the judgment of blood circulation caused by the tumor,
A lung abscess in the area of necrosis.

This type of cancer is most common in men and smokers.

Adenocarcinoma

It is the second most common type of non-small cell lung cancer. It represents 30% to 50% of cases.

Adenocarcinoma can go for:

Bronchi: Lung adenocarcinoma,

Alveoli: bronchiolo-alveolar carcinoma. It is the least aggressive adenocarcinoma subtype.

This cancer is the air sacs in the lungs.

It manifests among non-smokers, especially among women.

It happens more outdoors compared to squamous cell carcinoma.

Although the size of this cancer is small, it may cause:

Metastasis to the lymph nodes and to the more distant organs,

Metastatic pleural effusion.

This cancer diagnosis may be long after its development.

Can be seen on the x-ray:

A (white) opacity as in the case of pneumonia,

A hard nodule

Widespread nodules.

Large cell carcinoma

Large cell lung cancer is less common. It occurs only in 10% of patients with non-small cell lung carcinoma.

It is the most aggressive type of non-small cell carcinoma.

Large cell carcinoma causes the formation of metastases in the brain in 50% of cases.

Large cell carcinoma

(2) small cell carcinoma

Small cell lung carcinoma is less frequent than the previous. This is the type of the most aggressive lung cancer, and it can be treated only with radiation therapy and chemotherapy. Stages of small cell cancer are different than normal.

Small cell lung neoplasia

Causes of lung cancer

There are very important risk factors.

Tumor of the lung, Metastasesparmi external or exogenous risk factors, there are:

Smoking: it's the most important risk factor. Smoking is associated with 90% of the cases of cancer of the lung among men and 70% of the cases among women.

The risk is the number of cigarettes smoked, the number of years of smoking and age of onset.

The cancer risk is reduced by 50% a year after quitting smoking, but never becomes the same as that of non smokers.

Passive smoking: it is the cause of 20% of the lung cancers in people who have never smoked, so it has a great importance.

The hormone replacement therapy in menopause (T.H.S.) is an important risk factor.

Occupational exposures: asbestos increases the frequency of cancer of the lung of 5% and 7%.

Internal or endogenous risk factors include:

Pulmonary fibrosis (especially among women),

COPD (this disease above 70% to 80% of cases of lung cancer).

Lung infections and scars that are then produced.

Cancer of the Lung in non smokers has the following features:

It affects younger individuals,

It is more common in women,

In the majority of cases, it is an adenocarcinoma,

He has a better prognosis (especially those that are made).

First symptoms of lung cancer

Generally, no early symptoms.

Symptoms appear when the disease reaches the advanced stage.

It is difficult to diagnose early lung cancer.

The symptoms that may indicate a lung cancer are:

Symptoms of beginning

In the early stages, the symptoms are felt especially if the tumor is located in the inner part of the lung.

One of the first symptoms is a cough accompanied by traces of blood, as well as pain in the chest. The cough may become chronic.

Dry, persistent cough that gets worse over time. A patient with chronic bronchitis should go to the doctor when the cough becomes more common or the secretions type changes.

Cancer in the outer region of the lung may also cause a cough in an ulcer of the mucosa.

A cough accompanied by catarrh and blood, called hemoptysis can be caused by:

The formation of new blood vessels in the tumor,

The appearance of a ulcer of the Mucosa

The death of the tumour tissue,

Injuries caused by coughing.

The chest pain when the tumor is based on the pleura and the sides (especially in the case of peripheral cancers). It is also possible to have a heavy feeling on the chest, as if he had a stone top.

A moderate to the sternum pain can become severe and radiate to the shoulders, neck and back.

The pain often worsens because of the cough.

Pain in the shoulder and the arm that can happen to the hand. Pancoast-Tobias syndrome is caused by the cancers that affect the upper region of the lung (apex), especially the right. These cancers can touch the first and the second side, the nerves of the brachial plexus, the artery and the subclavian vein. The patient usually arrives at the doctor's office to support his arm with his healthy arm.

Shortness of breath can be caused by:

The obstruction of the trachea or bronchi,

A large mass in the lungs which takes a lot of space,

A pleural effusion,

Inflammation of the lymph nodes,

Embolism caused by cancer cells which blocks the blood vessels.

A whistling or squeaky breathing caused by the passage of air in an area blocked in a bronchus or trachea.

Fever because infection can occur in the part of the lung or the air can't.

Pneumonia and persistent bronchitis;

Symptoms of middle-advanced stage lung cancer

The cancer has spread to the organs of the thoracic cage.

The extinction of voice;

Fatigue is permanent;

Involuntary weight loss;

Loss of appetite;

The swelling of the neck and the face;

Difficulty swallowing.

Complications caused by the spread of lung cancer in the chest

Claude-Bernard-Horner syndrome: when the tumor is located in the apex (top) of the lung and happens in the head and neck and thoracic ganglia (a group of nerves in the sympathetic chain), we can have:

Enophthalmos (sinking of the eye in orbit),

Myosis (a decrease of the diameter of the pupil),

Sweating on one side of the face,

Ptosis of the eyelid (a drooping of the eyelid).

In rare cases, these phenomena are happening all at the same time.

The superior vena cava syndrome: compression of the vena cava can be due to:

The right upper lobe cancer.

A ganglion lymphatic mediastinal (close to the bronchi) touched by cancer.

The formation of a thrombus (clot) after a venous stasis.

In 40% of cases, the cause is a small cell carcinoma. The symptoms of the vena cava compression are:

Swelling of the face, the eyelids and the neck,

Headaches (due to cerebral venous hypertension),

Dizzy,

Drowsiness,

A reduction in the field of vision,

Cough,.

Dysphagia (a malfunction of the digestive system).

Dysphonia (voice disorders),

Cyanosis.

It is a problem that must deal with immediately by using internal implants that allow the flow of blood into the blood vessel.

The paralysis of the recurrent laryngeal nerve: it occurs in case of tumor of the left upper lobe or masses on the lymph nodes under the aortic arch that compress or irritate the nerve.

The consequences are:

A difficulty about swallowing problems (dysphagia) due to the paralysis of the vocal cords (dysphonia/stridor), because this nerve innervates the intrinsic muscles of the larynx and the upper part of the esophagus.

Paralysis or irritation of the nerve phrenique: Mediastinal tumor (in the center of the chest) can compress the nerve phrenique by causing:

A hiccup (because of the irritation of the nerve),

Pain in the shoulder and neck,

Dyspnea (if the phrenique nerve palsy causes the decrease in the movement of the diaphragm on one side).

Cardiac disorders: when the tumor or metastases based on the heart, they can cause:

Arrhythmia,

A buildup of fluid in the pericardium (membrane of the heart),

A swelling of the heart.

These problems can lead to heart failure.

The heart and the pericardium metastasis occur in 15% of cases.

Penetration into the esophagus: this is usually caused by:

Tumors in the main or in the left lower lobe bronchus

Mediastinal lymph nodes.

The consequence is dysphagia (difficulty swallowing), first with solids and then also with liquids.

Penetration in the trachea or a bronchus: this is a rare case, but we can have an broncho-esophageal fistula (abnormal communication channel).

The consequence is the sliding of the food eaten in the lung, which can cause inhalation pneumonia.

Terminal cancer final symptoms

Abnormalities in fingers or nails, as the excessive growth of the tissues at your fingertips (digital clubbing),

Skin pale or bluish,

The swelling or joint pain,

Bone pain caused by metastases (in 30% to 40% of cases),

Neurological Disorders: the sagging of eyelids, the narrowing of the pupil.

Diagnosis of lung cancer

The doctor checks the patient's history and perform a physical examination, where it controls the lungs and latero-cervical lymph (the side area of the neck) and those above the collarbone.

They are inflated only at the advanced stage, in 20% of cases.

Instrumental exams

The main test for the diagnosis of lung cancer is the chest x-ray.

The x-ray may show the presence of:

Opacity in the lungs,

An atelectasis (lung collapse),

A pleural effusion, we see a large white stain and sometimes the deviation of the bronchi.

Laboratory tests

Blood tests,

Research of tumor markers. Even if ' they are present or if they increase in certain types of malignancies, this does not make the diagnosis. However, they are useful for monitoring of the disease.

The main ones are:

CEA (carcino-embryonic Antigen) which is more specific in the case of adenocarcinoma,

The NSE (enolase neurospecifique) and Chromogranin in cases of small cell lung carcinoma and neuro-endocrine tumors,

CYFRA 21 (a cytokeratine) in the case of squamous carcinoma.

The review (of cells) cytological and histological (of tissue) of expectoration (secretions). It takes 3 samples taken on three different days. This can give a false negative result in case of peripheral tumor (in the outer region). It is very useful in case of carcinoma in squamous cells that causes higher desquamation.

Biopsy

The biopsy is the review of a sample of tissue from cancer.

Thanks to the biopsy, the pathologist analyzes a tissue sample to determine the type of cancer. The biopsy may be performed for more invasive tests, like:

The bronchial fibroscopy (or Bronchoscopy) foresees the introduction of a bronchoscope (a small probe with a camera) who travels to the bronchial Airways. During this review can take tissue samples for analysis.

The puncture trans-thoracique biopsy under scanner: local anesthesia is necessary to conduct this review. The doctor inserts a needle into the lung from spotting of a scanner and a sample taken.

The thoracentesis: this is the removal of pleural fluid through the chest. In the case of pleural effusion, cytological examination of the collected liquid can show the presence of cancer cells. This means that the tumor is advanced.  If the cancer came to the pleura, it is not operable.

Adenocarcinoma causes especially the presence of cancer cells in pleural effusion. Anyway, it cannot be useful for diagnosis in more than half of the cases.

Surgical biopsy by thoracoscopy: this review is done under general anesthesia. The surgeon makes three small incisions and it inserts the thoracoscope, i.e. a probe fiber-optic that allows to study the lungs and pleural cavity. During this examination, the surgeon takes tissue for analysis.

This review is more invasive and hospitalization is necessary.

Instrumental exams by imaging

Also, an individual may do other tests to measure the expansion of the cancer:

A scanner,

Imaging by magnetic resonance (MRI),

A pet (positron emission tomography) scan.

Staging of lung cancer

The staging of lung cancer is an important area of study because it helps doctors understand how cancer is developed.

Depending on the stage and the seriousness, the doctor determines:

The prognosis of cancer,

The treatment.

Stages of small cell cancer stages of small cell lung cancer are two:

Limited stage: the tumor is localized only in the lung.

Extensive stage: the tumor has developed remote metastases.

Stages of non-small cell cancer

Stages of non-small cell lung cancer are normal.

Stage I

At the initial stage, the tumor mass:

At a diameter of less than 3 cm.

Not yet spread.

You can therefore remove it easily with surgery.

Stage II

At this stage, cancer spreads slowly to nearby areas.

This stage is divided into:

Stage 2A:

Cancer is between 3 and 4 cm,

Nearby lymph nodes are affected.

Stage 2b:

Cancer is between 4 and 7 cm,

Nearby lymph nodes are affected,

Cancer can also be spread:

The diaphragm;

At the lung wall.

To the chest wall;

To the external wall of the heart (pericardium).

Survival rates of cancer of the Lung in stages 1 and 2

The 5-year survival is 65% to 80%.

Lung cancer

Lung cancer

Stage III

At this stage, the cancer develops more. It can spread to the blood vessels that connect the lungs to the heart. It is a particularly dangerous and irreversible phase.

Stage III is divided into two subtypes.

In the first phase called 3A, cancer:

At a diameter of 3 cm to 7 cm.

Nearby lymph nodes and those of the thorax are achieved,

Spread to the chest wall, diaphragm and the pericardium.

In the second phase called 3B, the cancer:

Extends aggressively, reaching the heart, the trachea, the esophagus.

Affects the lymph nodes in the chest.

Treatment for stage 3 lung cancer

In most patients, the tumor in phase 3b is difficult to remove surgically. Treatment is limited to radiotherapy and chemotherapy.

Survival of stage 3 lung cancer

Stage 3 lung cancer survival rate depends on therapy and the State of health of the patient.

However, the average survival varies from 7 to 17%.

Only 5-10% of patients with stage 3B lung cancer survive up to 5 years.

Patients undergoing chemotherapy are more likely to survive if their lifestyle is healthy.

The prognosis of lung cancer patients following chemotherapy is best. Indeed, the percentage of 5-year survival is 15-20%.

These statistics are not very meaningful, because they do not consider:

Genetics,

The way of life of the patients.

The prognosis for lung cancer is generally poor because of the lifestyle of most of the patients after diagnosis.

Stage 4 lung cancer

It represents the most serious stage because there is no treatment.

The cancer has spread to other parts of the body. The only solution is the limitation:

Damage,

Symptoms.

The final stage or stage IV lung cancer is an irreversible disease where cancerous cells have spread to other healthy organs of the body (distant metastases).

The symptoms of stage 4 lung cancer depend on the location of the primary tumor and metastases.

The staging is based on the spread of cancer to the organs of the body.

After all these diagnostic tests, the doctor establishes the course of treatment and the prognosis for fourth stage lung cancer.

In the Terminal phase, the cancer has spread from the breast to other organs (lung metastasis).

Symptomatic treatment as soon as the diagnosis is essential to treat cancer.

Stage 4 lung cancer treatment

Is chemotherapy or radiation therapy to destroy cancer cells and to slow their development.

We can't remove the sick part at the fourth stage by surgical intervention because it is not effective.

Prognosis and life expectancy for lung cancer

The survival rate depends on the physical condition of the person and treatment.

In most cases, the third stage of lung cancer led to phase 4, deadly.

cerebral metastasis

It must take into account different factors to establish the prognosis and life expectancy.

It is important to know:

The age,

Sex,

The State of health of the individual,

The tumor extension,

The response of the patient to treatment, etc.

These factors play a fundamental role in the prognosis of Terminal.

That have a good prognosis, so a higher survival rate cancers are those patients:

Asymptomatic,.

Suffering from symptoms related only to the primary cancer.

Patients with a poor prognosis are those who have systemic as symptoms:

Loss of appetite (anorexia at 35%),

Weight loss (40-50%),

Asthenia (30%),

Symptoms related to metastasis.

Patients who have no objective clinical or laboratory changes were generally less likely to have metastases:

To the brain,.

To the bone.

A stomachache.

The rate of survival at the fourth stage is very low.

Only 5-10% of people with lung cancer survive up to 5 years.

In non-small cell cancer, only 10 to 15 percent of people survive up to 5 years.

Compared to other types of cancer, the prognosis of lung carcinoma in stage 4 is bad.

Late diagnosis is one of the main factors that determines the low rate of survival in people with lung cancer.