Diagnosis of lung cancer - questions to the oncologist
How to recognize lung cancer?
During periodic examinations in my workplace, I was diagnosed with so-called "Circle shadow located przyklowokowo." I am 31 years old and I do not smoke. Could it be cancer?
Answer: At this age, and especially because the Lord does not smoke the risk of cancer, he is very doubtful. Of course, a number of tests need to be carried out to determine the nature of the change. In addition to cancer, it may be tuberculosis (actually a tuberculoma, that is, an organized old campfire). It may also be a benign lesion such as chondroma, fibroma or neuroma. You have to think about sarcoidosis (a disease in which the lymph nodes are enlarged by the lungs).
Diagnosis of lung cancer is as follows:
♦ radiological examination of the lungs and chest
♦ tomography of the lungs
♦ cytological examination of sputum
♦ bronchofiberoscopy with removal of bronchial secretions and tumor specimens for histological examination
♦ fine needle aspiration biopsy performed by the chest wall under the control of CT or by the bronchial wall
♦ computed tomography (to determine possible infiltration)
This is a model that I have simplified a bit. In your case you will probably end up in bronchoscopy and microscopic examination. I emphasize once more - I doubt that you have cancer.
bow. med. Tomasz Sarosiek oncologist
Symptoms of lung cancer
What are the typical symptoms of lung cancer? There are no such early symptoms. They are, but not characteristic, such as, for example, cough.
Answer: Here are the most common symptoms of lung cancer:
1. A chronic, difficult to explain cough may be the first symptom preceding the diagnosis of cancer (in 80% of patients). The cause may be a tumor infiltrating the bronchial wall or increasing in its light. Then he becomes a foreign body, acting as the cause of a persistent, persistent cough. A blood clot may be associated with cough.
2. In approximately 20% - 50% of patients lung cancer is a symptom of hemoptysis. This symptom should be differentiated with tuberculosis, but in any case, the presence of a tumor should be suspected.
3. Recurrent inflammations occur in 40% of patients.
4. Dyspnoea (15%), However, dyspnea resulting from the occlusion of the large bronchial light most often occurs earlier, due to concomitant diseases that limit the respiratory surface - emphysema, bronchoconstriction in smokers.
5. Painfulness is associated with infiltration of the tumor on the pleura, mediastinum, chest wall. Focused on the chest area in about 15% of patients.
Look out for a persistent cough with haemoptysis!
Patients with a persistent cough or a change in their character, who do not undergo treatment or recurrent pneumonia and always have haemoptysis - should report to the physician 1 or directly to the oncologist. They should also expect referrals for radiological examinations. Looking at an X-ray, the doctor's suspicion should arouse: the presence of a circular shadow, a change in the cavity and / or mediastinum outline, the presence of atelectasis or the presence of pulmonary infiltration. The definitive diagnosis of cancer is an anatomopathological confirmation with a histological type of tumor. The material for these tests is obtained during bronchoscopy: tumor specimens, brush swab, bronchial lavage, transbronchial biopsy and mediastinoscopy, videotoracoscopy and thoracotomy.
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How to recognize lung cancer? (Cont'd)
My father died of lung cancer. He smoked a lot. However, as I remember, because I often talked to him, he did not complain about anything special. He came to the hospital with dyspnea and soon died.How can you diagnose this disease early?
Answer: Lung cancer is an insidious disease. It develops imperceptibly, and once it begins to give symptoms it is usually too late for any treatment. This tumor is usually detected in the lung photo review by accident. The change is usually described as a circle shadow. Symptoms include: cough, recurrent lung inflammation, shortness of breath and chest pains. Dyspnoea is associated with the closure of the lumen of large bronchi, tumor masses, exudate, most often bloody in the pleural cavity (pleura is a "bag" in which the lung is closed allowing negative pressure in the chest). In some patients lung cancer is haemoptysis. This symptom should be differentiated with tuberculosis, but in any case, the presence of a tumor should be suspected. Hoarseness in the course of lung cancer is usually a sign of its "inoperability", i.e. a large advancement preventing surgery. It is caused by infiltration of the retrograde laryngeal nerve (this nerve is responsible for larynx movements). Vein upper vein syndrome (a large vein responsible for draining the blood from the upper half of the body to the heart) occurs in the case of infiltration or compression of the primary tumor or enlarged lymph nodes: face and neck edema, cyanosis, jugular distension. This syndrome may lead to swelling and edema These two conditions can lead to death, and the enlargement of supraclavicular and neck lymph nodes is common.
bow. med. Tomasz Sarosiek oncologist
Tomography is not enough for an unambiguous diagnosis of cancer.
In my 80-year-old grandmother, lung cancer was detected in a tomographic examination. Should CT scan show whether the cancer is malignant or not ??? Doctors do not want to operate due to grandma's health. Grandma is in good mental condition, she enjoys life. Doctors also did not recommend bronchoscopy. Is chemotherapy only used in case of malignant tumor?
Answer: I would be cautious in diagnosing cancer only after tomography. If the neoplastic process spreads or gives metastases to the lymph nodes, the malignant process can be recognized with great certainty. Otherwise, the basis is bronchoscopy and histopathological examination. If the above criteria are not met, probably an old tuberculous outbreak may be suspected. I do not know what is the diagnosis - depending on the type of cancer, surgery (here contraindicated due to age and burden) or chemotherapy combined with radiotherapy is performed.
/ s / oncologist dr n med D.Michalik
TYPES OF LUNG CELLS
What types of lung cancer do we know?
You write about different types of lung cancer. What are they different?
Answer: Lung cancers are divided based on their microscopic appearance. However, based on the interview itself, the research and the dynamics of the disease, it is possible to predetermine what type of cancer you are dealing with. Generally, it can be said that we deal with primary and secondary changes (metastases to the lungs). Mixed histological forms of lung cancer are common. However, let's concentrate on primary tumors (it also gives this distinction with some simplifications, mentioning only epithelial cancers):
- squamous cell carcinoma (40-50% of cases), growing relatively slowly; in the early stage, you can try the complete surgical treatment)
- small cell carcinoma (25-30%) grows very rapidly; at the moment of diagnosis, metastases are already 80% metastatic; treatment consists only of chemotherapy and radiotherapy; prognosis is bad
- adenocarcinoma - adenocarcinoma (occurs mainly on the perimeter of the lung, relatively frequent in women)
- multicellular cancer
- glandular-squamous cell carcinoma
bow. med. Tomasz Sarosiek oncologist
What is "small cell lung cancer".
It was discovered by my grandfather when he was hospitalized because of dyspnea. He then became very "blue" and breathed quickly. Answer: Small cell lung cancer is one form of the cancer of this organ. The name comes from the image of the microscopic lesion (sometimes also referred to as oat cell carcinoma). Unfortunately, the prognosis is serious. About 80% already have distant metastases (based on the interview, you can also suspect it in a given case). This cancer is characterized by very high dynamics of growth and enlargement of the primary lesion.Treatment consists of the use of chemotherapy and radiotherapy. The results are relatively good, often reducing the tumor and the withdrawal of symptoms caused by it. This cancer gives metastasis practically everywhere (lymph nodes, liver, kidneys, adrenal glands, and especially to the brain).
lek.med. Tomasz W. Rosochowicz
What is the Pancoast syndrome?
Answer: Pancost syndrome is usually caused by squamous cell carcinoma. It is a set of characteristic symptoms caused by tumor infiltration at the top of the lung. It is characterized by the presence of very severe shoulder pain and the paraspinal region of the shoulder blade. There may be ulnar pain in the arm, forearm and toe IV and V. Should the treatment be started from the histological diagnosis (biopsy), the diagnosis determines the method of treatment. Due to the fact that the centers responsible for regulating some of the eye's functions are located here, so-called Horner's syndrome (narrowing of the pupil, drooping of the eyelid and withdrawal of the eyeball deep into the eye socket). Sometimes the swelling of the arm appears. The tumor can destroy the bones and ribs and the first thoracic vertebra.
lek.med. Tomasz W. Rosochowicz
