Lung cancer

Lung cancer is a malignant tumor that forms from the epithelial cells of the bronchi. Most often, the neoplasm occurs in the right lung and affects the upper respiratory tract — the pharynx, larynx and subglottic trachea. Standard treatment protocols do not always give a favorable result and require individual solutions in each case. The combination of modern methods of surgical treatment together with innovative therapy gives the patient a chance for a full recovery without relapse.

According to the International Agency for research on cancer, lung cancer is recognized as the most dangerous cancer for men. After breast cancer, bronchogenic carcinoma has the second highest mortality rate among women. To diagnose cancer at an early stage, you need to go through an annual check-up. If you want to sign up for an oncology check-up, leave a request on the MedTour website.

Causes of lung cancer

Researchers at the International Agency for research on cancer estimate that cancer cases will grow 45-47% by 2040. These indicators are influenced by the living conditions of people and the ability of the healthcare system to control the situation related to cancer.

The most common causes of lung cancer are:

• Hereditary predisposition (cases of lung cancer in the immediate family);
• Chronic respiratory diseases and endocrine pathologies;
• Contacts with carcinogenic substances (compounds of arsenic, nickel, chromium, cadmium);
• Air pollution (release of physical, chemical and biological substances harmful to health into the air);
• The influence of radioactive radiation (excess ionizing radiation causes almost all forms of malignant tumors, except for chronic lymphocytic leukemia, Hodgkin’s disease, cervical and prostate cancer);
• Active and passive smoking (components of tobacco smoke change the work of the protein structure of DNA, which makes genes vulnerable to cell mutations).

The main risk factor for lung cancer is inhalation of carcinogens. About 90% of all cases of bronchogenic carcinoma are associated with smoking, namely with the action of carcinogens contained in the smoke of tobacco products.

Experts attribute the patient’s age to an indirect factor in the development of lung oncology. According to statistics, the disease is most often diagnosed in people 55-75 years old.

If you have a family history of lung cancer, you should be tested even at a young age. In the presence of additional risk factors, the disease progresses faster. To identify a predisposition to lung cancer or to recognize a disease at an asymptomatic stage, it is necessary to undergo an oncology check-up. To sign up for an oncocheck-up clinic, leave a message on the MedTour website.

Lung cancer symptoms

The disease is difficult to identify, because at the very initial stage it develops asymptomatically. At stage 2A, lung cancer does not have a direct symptomatology with the respiratory system, so it cannot be recognized based on general complaints.

Typical manifestations of lung cancer, in which you need to urgently consult an oncologist:

• Shortness of breath when climbing stairs or walking for a long time;
• Dry cough that does not go away with time;
• Chest pain;
• Hemoptysis (discharge of bloody sputum when coughing up);
• Loss of body weight without changes in the diet.

Indirect signs may indicate the development of lung cancer: lethargy, apathy, a slight increase in body temperature. Subfebrile temperature (about 37.3° C) can mask cancer as sluggish bronchitis or pneumonia.

Advanced lung cancer in later stages is manifested by:

• Bone pain;
• Yellowness of the skin and eyes;
• Neurological symptoms (dizziness, tinnitus).

Diagnosis of lung cancer

The scope of examinations depends on the capabilities of a particular medical institution: equipping with diagnostic devices and the availability of modern laboratories. Most hospitals in the CIS countries lack modernized equipment for detailed examination of patients with cancer diagnoses.

In 50% of cases, the neoplasm in the lungs is secondary. That is, initially a cancerous tumor arose in another organ — more often in the mammary gland or intestines. Therefore, when it is necessary to conduct a thorough study not only of the lungs, but also of the neighboring structures.

Qualitative diagnostics for lung cancer includes:

• Laboratory analyzes of blood and urine;
• Tumor marker test;
• Sputum cytology;
• Pleurocentesis (puncture of the pleural cavity);
• CT and chest x-ray;
• Mediastinoscopy (diagnosis of lung tissue through minimal access in the chest);
• Bronchoscopy (examination of the trachea and bronchi);
• Endobronchial ultrasound (modern bronchoscopy with the possibility of taking samples of lymph nodes for analysis);
• Transthoracic aspiration biopsy (examination of elements of malignant tissues).

The most important stage of diagnostics in foreign clinics is PET-CT. This is a key examination method, without which the oncologist will not make decisions about the stage of the cancer and the methods of treatment. PET-CT allows the doctor to see the localization of even small metastases up to 3 mm in size.

Examples of the cost of PET-CT examinations for lung cancer in different countries:

• Turkey — from $800;
• Germany — from $1 400;
• Israel, Spain — from $1 800.

In foreign clinics for patients with lung oncology, doctors examine in detail the tissues in the most inaccessible areas. For this, doctors perform the ENB procedure using an electromagnetic navigation bronchoscope. This study allows to select an individual and effective treatment for each case. To undergo diagnostics in an oncological center with modern equipment, leave a request on the MedTour website.

Survival

In 80% of cases with lung oncology, a non-small cell type of cancer occurs. Small cell cancer accounts for about 20% of all lung cancers.

All statistics are approximate, as they include individual factors for the development of the disease, the general condition of the patient and the methods of therapy used. Five-year survival at stage 1 is 60% of cases with non-small cell cancer, for small cell cancer — 40%, at stage 2 — 40% and 20%, at stage 3 — 5% and 15%, at stage 4 — 5% and 10%.

If patients are susceptible to pembrolizumab (trade name Keytruda), immunotherapy can prolong life by several years. Immunotherapy drugs have been shown to be effective against mutations in cancer cells, and are used abroad in addition to standard treatment protocols.

In the world of oncological practice, there are cases of complete cure of patients from lung cancer at different stages. Thanks to surgical treatment in combination with innovative therapy, there is a chance to achieve complete remission. To undergo an extended course of treatment for lung cancer with the best oncologist, leave a request on the MedTour website.

Lung cancer stages

Oncologists identify 4 stages of lung cancer. The duration of this or that stage is individual in each case. It depends on the type of tumor and its growth rate.

The disease is characterized by the following stages of neoplasm development:

• Stage 1 — the tumor is within 3 cm, is located in the segments of the lung and does not have metastases.
• Stage 2 — the tumor grows to 6 cm, located in the segments of the lung or bronchus. There may be metastases in the lymph nodes on the side of the lesion by malignant cells.
• Stage 3 — the tumor is more than 6 cm, it grows into other parts of the lungs and bronchi. Metastases affect the mediastinal lymph nodes.
• Stage 4 — a tumor in the lungs more than 7 cm, metastases spread to other tissues and organs.

Depending on the type of malignant cells, lung cancer is divided into 2 types: small cell (SCLC) and non-small cell (NSCLC). They differ in the nature of the manifestation of the disease and the response to the treatment program.

Lung cancer treatment

Depending on the patient’s condition, the type and stage of lung cancer, doctors prescribe a combination of treatments. As a rule, this is surgery and various types of therapy.

Surgery

During the operation, the malignant tumor is removed with part of the lung. In some cases, surgeons perform complete removal of the lung. With metastases, regional lymph nodes are also removed.

Types of surgical interventions:

• Wedge resection — removal of the tumor and a small amount of surrounding healthy tissue;
• Segmentectomy — removal of a segment of the lung lobe (in the right lung there are 3, in the left — 2 lobes);
• Lobectomy — removal of an entire lobe of the lung;
• Bilobectomy — removal of two lobes of the lung;
• Pneumonectomy — complete removal of 1 lung;
• Extended pneumonectomy — removal of an entire lung with resection of the great vessels.

Chemotherapy

Therapy with special drugs can stop the division and growth of cancer cells. The patient takes chemotherapy drugs in tablet form or through intravenous injections.

Chemotherapy for lung cancer is used to:

• Reduce the size of the neoplasm before surgery;
• Destroy the remnants of cancer cells and prevent relapse after surgical treatment;
• Slow down the growth of a malignant tumor and alleviate the patient’s condition at an advanced stage of cancer.

Radiotherapy

The method of treatment consists in exposing the tumor to ionizing radiation. Radiation therapy for lung cancer is carried out using special installations — linear accelerators.

Radiotherapy for lung cancer is indicated for patients:

• As the main method of treatment, in the case of an inoperable tumor or in the presence of contraindications to surgical intervention;
• For the destruction of metastases with extensive spread of the neoplasm;
• After surgery, to exclude relapse in the presence of small metastases;
• To reduce symptoms in the late stage of the disease.

Modern radiation therapy options:

• Tomotherapy — the system combines CT and linear accelerator. Using the built-in CT scanner, the doctor performs precise irradiation of the tumor without affecting healthy tissues.
• CyberKnife is a radiosurgical unit that allows doctors to irradiate tumors that cannot be operated on in the usual way.
• Proton therapy is a device that destroys a tumor using accelerated ionizing particles. They act on neoplasms without harming healthy tissues.

Lung cancer treatment regimens by stage

The combination of treatment methods may differ depending on the individual manifestation of the disease: the severity of symptoms, the size of the tumor and the degree of damage to adjacent structures. International treatment protocols have been developed for each stage and type of lung cancer.

Stage 1

Non-small cell carcinoma:

• Segmentectomy or lobectomy;
• Radiation, targeted, or chemotherapy after surgery.

Small cell carcinoma:

• Surgery to remove the tumor and regional lymph nodes (if necessary);
• Postoperative radiation or chemotherapy.

Stage 2

Non-small cell carcinoma:

• Lobectomy or pneumonectomy with removal of regional lymph nodes;
• Chemotherapy before surgery and radiation therapy, which may be given before and / or after surgery.

Small cell carcinoma:

• Chemotherapy, possibly in combination with radiation therapy;
• If mutations are detected — additional targeted or immunotherapy.

Stage 3

Non-small cell carcinoma:

• Radiation or chemotherapy before surgery;
• Radical operation;
• With genetic mutations — targeted or immunotherapy.

Small cell carcinoma: options for combinations of radiation, chemotherapy, immuno- and targeted therapy.

Stage 4

Most often, patients with stage 4 lung cancer are shown chemotherapy in combination with treatment with immunologic drugs. To relieve symptoms and reduce the rate of tumor growth, doctors additionally use radiation therapy.

According to cancer research organizations, the last few years have seen a revolution in the treatment of lung cancer. Doctors of leading clinics take on the treatment of patients even at a late stage of the development of the disease. To go for treatment to a foreign hospital and receive innovative treatment for bronchogenic carcinoma, leave a request on the MedTour website.

Benefits of diagnosing and treating lung cancer abroad

The effectiveness of treatment depends on the exact diagnosis. Modern devices allow doctors to conduct a detailed examination of the body and identify the slightest deviations from the norm. This is especially important in lung cancer, since metastases can spread to the brain and lead to irreversible consequences.

For small cell lung cancer, head radiotherapy is always included in European treatment protocols. The procedure is carried out so that metastases do not grow in the parts of the brain.

Innovative examination methods for effective treatment of bronchogenic carcinoma

Thanks to special genetic tests, foreign oncologists can determine the degree of tumor malignancy and the rate of its growth. Such an analysis allows the doctor to identify a genetic mutation and choose the best targeted drug or immunotherapy that does not have pronounced side effects, unlike chemotherapy.

In advanced stages of lung cancer, doctors abroad perform scintigraphy on patients. This is a modern method of radiation diagnostics, thanks to which the smallest metastases in the bones can be detected.

New techniques used abroad for the treatment of lung cancer

Although targeted and immune therapies are not new treatments, they are not available in all healthcare settings. Leading cancer centers in Europe, Israel, Turkey and the United States use modernized drugs for targeted and immunotherapy.

The following modern methods of lung cancer treatment are available in foreign oncology clinics:

• Cryotherapy. Using liquid nitrogen, the doctor freezes the neoplasm. As a result, cancer cells stop multiplying and the tumor dies. Oncologists use cryotherapy at all stages of the disease. The technique is effective not only as an independent procedure, but also for preparing for the removal of a large tumor.
• Photodynamic therapy. The doctor injects the patient with an anticancer drug into the area of ​​the neoplasm and activates the drug with a special laser. This is the destruction of the vessels that feed the tumor, which leads to its death. Photodynamic therapy is suitable for the treatment of early lung cancer.
• Immunotherapy. For the treatment of all types of lung cancer, oncologists prescribe the immune drug Keytruda. The medicine helps the body identify cancer cells in order to fight them on its own.

Progressive cancer centers are actively involved in the search for new treatments for lung cancer. TOP doctors carry out therapy that is effective even at stage 4 of the disease, in which standard treatment protocols do not help. To contact the clinic and receive innovative therapy, leave a request on the MedTour website.

How much does lung cancer treatment cost abroad

The cost of treating pulmonary carcinoma is individual for each patient. The price will depend on the complex of prescribed diagnostic procedures, therapy options and surgical techniques.

Examples of the cost of treatment in clinics in different countries

Targeted drug therapy includes: the cost of the medicine prescribed by the oncologist, nursing care (may be paid separately according to the terms of the clinic). Targeted therapy prices may differ depending on the specific drug and the duration of its use. The cost of targeted therapy in hospitals in Israel, Turkey, Italy, Germany and a number of other countries will range from $1 200 to $10 000.

Radiation therapy for lung cancer in Turkish hospitals costs from $6 000. In Israel, Germany, Spain, South Korea — from $8 000. The final cost of radiation therapy will be formed based on the installation used by the doctor and how many radiation sessions the patient has to undergo.

As a rule, in the treatment of oncological diseases, the patient stays in the hospital from several weeks to several months. The cost of lung cancer therapy is added to the cost of living in the clinic or in a nearby hotel.
Inpatient day at the clinic for patients with oncology:

• Turkey — from $500;
• Israel — from $1 000.

Thanks to the MedTour service, relatives accompanying the patient will be able to save about 20% on apartment rentals. The coordinating doctor will help with the selection of the hotel and book the required number of rooms.

Prognosis for patients diagnosed with lung cancer

It is very difficult to make an accurate prognosis at one stage or another of the disease. This is due to the structural features of cancer cells and their different growth rates.

The prognosis for lung cancer depends on the following factors:

• The size and location of the neoplasm;
• The extent of the spread of metastases;
• The presence of genetic mutations;
• Age, chronic diseases and general condition of the patient.

To find out about the best options for treating lung cancer in foreign clinics, leave a request on the MedTour website. The coordinating doctor will advise you and help you choose the most suitable cancer center.

Published: 13.08.2021

Updated: 20.08.2021

Medical expert:

PhD. Olexandr Voznyak

Medical author:

Ilona Baidiuk

Information on this webpage verified by the medical expert

Medical Doctor, oncologist, PHD student

Kateryna Maliarchuk