Lung cancer is a group of malignant tumors that appear in the tissues of the lower respiratory tract, mainly at the level of the bronchi or alveoli. There are different histological subtypes with less or more aggressiveness (the most frequent are adenocarcinomas, squamous cell carcinomas and microcytic carcinomas). The main cause of lung cancer is smoking, although it is not the only one, there are other toxic pollutants of industrial or environmental origin that through inhalation are also capable of genetically and epigenetically damaging the respiratory cells and end up producing the disease. In never-smoking patients with lung cancer, a significant percentage present alterations or genetic mutations produced spontaneously (not inherited) that would explain the development of the disease. The hereditary factor in this disease has little weight, and there may be families with a greater predisposition than others, but with little significant differences compared to other etiologies.
What are the symptoms of lung cancer?
The most frequent symptoms with which lung cancer develops are:
– hemoptysis (or blood in the sputum)
– persistent cough
– chest pain
– dyspnea or shortness of breath
– toxic syndrome (tiredness and loss of appetite and/or weight).
How to diagnose lung cancer
The fundamental test for the diagnosis of lung cancer is the CT or thoracic scan, which allows a radiological diagnosis of the suspicious lesion. The indication of performing this test on a regular (annual) basis in persons at risk, such as heavy smokers or long-term smokers, is currently being debated in order to make an early diagnosis that favors a cure. Another fundamental test for diagnosis and especially for statification of the disease is PET/CT. Finally, biopsy, which can be performed by bronchoscopy, EBUS (echo-bronchoscopy) or by transthoracic puncture (in more peripheral lesions).
Routes of treatment for lung cancer
The treatment of lung cancer will depend on the histological subtype, as well as the genetic and/or molecular profile of the patient (increasingly relevant in the selection of more personalized treatments). It will also depend on the stage of the disease: thus in earlier stages (stages I and II) surgery and stereotactic radiotherapy (for patients with a higher surgical risk) are the treatment of choice. In locally advanced stages (stage III) the fundamental treatment will be radiotherapy and chemotherapy, sometimes combined with monoclonal antibodies (and surgery only in selected cases). In advanced stages (stage IV) the treatments will be systemic (chemotherapies, monoclonal antibodies and/or immunotherapies), in order to delay the progression of the disease as much as possible and thus achieve a longer and, above all, better quality of life for the patient.
What is the future outlook for this disease?
Fortunately, as specialists in medical oncology, we have more and more weapons with which to treat lung cancer. This allows us to look to the future with more optimism while giving our patients more opportunities to overcome or cope with this disease.