About this disease
What it is about
Lung cancers are caused by defective cells in lung tissue that develop over a lifetime as a result of genetic changes, chronic inflammation and immune processes. Immune control is also crucial for the spread of the disease in the body. For the best possible therapy and a better prognosis, it is important to study the specific characteristics of each tumor on the tissue in addition to the exact extent of the disease.
Types
A distinction is made between non-small cell and small cell lung carcinomas. Among the non-small cell carcinomas, there are adenocarcinomas and squamous cell carcinomas and other rarer subtypes. The more than 20 subtypes known to date and defined by molecular characteristics of the cells differ with respect to biological behavior and aggressiveness. New types are continuously being defined. Targeted therapies are available against many characteristics. Immune markers of cancer play a role in the control and spread of the disease in the body and determine the choice of therapy.
Symptoms and consequences
Sometimes the disease is detected without symptoms when a lung x-ray is performed for other reasons. Screening programs with CT for at-risk individuals are under development. Important warning signs include a new onset persistent cough or an altered chronic known "smoker's cough." Shortness of breath, blood in sputum, hoarseness, dysphagia, and pain often do not occur until further spread. Offshoots (metastases) in lymph nodes, bones, liver, brain or the other lung may cause symptoms there.
What we do for you
Examination and diagnosis
After suspicion on X-ray, a computed tomography (CT) scan is performed. If confirmed, further extension can be detected by PET-CT and, if neurological symptoms are present, by brain MRI. Depending on the location of the focus, tissue sampling is performed by airway endoscopy (bronchoscopy), which also includes sampling from the lymph nodes adjacent to the airways, or by CT-guided puncture. A lung function test, if necessary under stress (spiroergometry), indicates the respiratory function reserves before surgery or radiation.
Treatment
The tumor board discusses whether and how surgery can be performed. In order to cure the disease, chemotherapy is often necessary for a limited period of time. If the lymph nodes in the chest are affected, radiotherapy with simultaneous chemotherapy can be performed instead of surgery, followed by immunotherapy for better tumor control. If there is spread to organs, therapy is given with drugs consisting of chemotherapy or immunotherapy or targeted agents against known molecular features of the tumor. Painful bone metastases or brain metastases are irradiated.