Lung cancer

Lung cancer - one of the most frequent cancer sites in men and women over the age of 40 years. The risk of lung cancer is significantly higher in smokers. Thus, when smoked two or more packs of cigarettes a day rate of lung cancer increases by 15 - 25 times. Other risk factors - work on asbestos production, irradiation.Symptoms of lung cancer: cough, sputum mixed with blood, chest pain, recurrent episodes of pneumonia and bronchitis, respiratory disorders can be significant in the development of hypoventilation, and atelectasis of lobe or lung. Early forms of lung cancer are oligosymptomatic and emerging then these symptoms are not specific for lung cancer. Meanwhile, clinical analysis of the dynamics of such symptoms is important because it aims at the timely conduct additional surveys and establishing the correct diagnosis. Importance for the diagnosis of lung cancer has repeated sputum cytology, lung radiography, bronchoscopy with biopsy of the tumor, transthoracic biopsy of the tumor.

Morphological and radiographic studies provide a differential diagnosis with tuberculosis, chronic pneumonia, adenoma, carcinoid, and various benign tumors and metastases in lung tumors at other sites.Distinguish between central lung cancer, growing mainly endo-or peribronhiapno (80%), peripheral cancer, is rarely diagnosed mediastinal form miliary kartsinoz, etc. According to the morphological structure of isolated squamous (epidermoid) carcinoma, hell-nokartsinomu, small-and large-cell carcinoma.Lung cancer metastasizes to the lymph nodes of the root, paratracheal, para-aortic lymph nodes and bifurcation. In the later stages of the disease develop metastases to distant tissues and organs (supraclavicular lymph nodes, bone, liver, brain, lungs, etc.). Early metastasis and an aggressive course characterized small cell lung cancer.Treatment of lung cancer depends on stage of disease. Radical surgery (pulmonektomiya, lobectomy with removal of regional lymph nodes) can hold only 10-20% of patients when lung cancer is diagnosed at an early stage. With locally advanced form of the disease produce an extended pulmonektomiyu with the removal of the bifurcation, tracheobronchial, paratraheapnyh lower-and middle-stennyhlimfaticheskihuzlov, and if necessary, with resection of the pericardium, diaphragm, chest wall. If the operation is not possible because of the prevalence of or in connection with the presence of contraindications, radiotherapy. Objective effect, accompanied by significant symptomatic improvement is achieved with the 30-40% of patients.Chemotherapy for inoperable non-small cell lung cancer and metastases is effective in 20-30% of patients. Usually used a combination of cyclophosphamide, adriamycin, vincristine or cyclophosphamide, adriamycin and tsisplati-on. In addition, using different combinations of 5-fluoro-ratsil, methotrexate, etoposide, bleomitsetin, mitomycin C, prospidin.With small cell lung cancer a priority is to assess the extent of the disease, which is achieved by carrying out skeletal scintigraphy, bone marrow biopsy, liver ultrasound, computed tomography of the brain. With localized and disseminated forms of the disease the main treatment is chemotherapy. As an additional method of applying radiation therapy. Surgical intervention is used very rarely.Chemotherapy using a combination of cyclophosphamide, adriamycin, methotrexate, or cyclophosphamide, adriamycin, and vincristine, or cisplatin and etopoztsda.For localized small cell lung cancer chemotherapy is carried out at intervals of 3-4 weeks for 1-1,5 years. Already at the beginning of treatment or after 3-4 cycles of chemotherapy may additionally be used radiotherapy (30-40 Gy) to the zone of a lung tumor and regional lymph nodes. In achieving complete remission with a view of frequency of metastatic brain lesions appoint radiation therapy to the brain (20-30 Gy) to prevent the growth of metastases. As a result of comprehensive treatment for localized disease achieved a significant therapeutic effect in 90% of patients in complete remission - 30-50%. Results of treatment of disseminated lung cancer is much worse.

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