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Lung adenocarcinoma
Lung adenocarcinoma is considered one of the most common forms of non-small cell lung cancer. This disease occurs in approximately 40% of diagnosed malignant pulmonary tumors. Presumably, it occurs in cellular large-bronchial structures, but when detected it is defined as a peripheral cancer of the lung with asymptomatic course.
Causes of adenocarcinoma of the lungs
According to statistics, most often the disease is detected in male patients. This can be explained by the peculiarities of professional activity (work in harmful production, inhalation of chemical and toxic substances) and a greater propensity to bad habits. Female patients are more likely to find only certain types of disease - for example, bronchopulmonary form of adenocarcinoma.
Predisposing factors of tumor formation are:
- long-term experience of smoking (there is evidence that the daily inhalation of tar and nicotine increases the risk of tumors 20-30 times);
- alcoholism;
- ecological features of the locality (large industrial facilities, highways located nearby, as well as unsatisfactory water, atmosphere, soil);
- inaccuracies in nutrition (increased use of carcinogens - semi-finished products, fast food, fat, fried foods);
- long-term presence in premises with polluted air (dust, soot, etc.);
- work related to the production and exploitation of asbestos;
- regular entry into the lungs of radon, which is due to the peculiarity of the geographical location;
- radioactive damage of the lungs;
- chronic infectious and viral diseases of the lungs;
- hereditary predisposition.
Most diagnoses of pulmonary adenocarcinoma are diagnosed after 60 years, so age can also be classified as predisposing factors to the disease.
Also, a secondary cause of the disease can be considered uncontrolled long-term use of hormonal medications to treat other pathologies in the body.
Symptoms of adenocarcinoma of the lungs
Unfortunately, malignant diseases in most cases do not show themselves as any specific symptoms, and lung adenocarcinoma is no exception.
Of the non-specific signs of oncology, we can name the following:
- decrease or disappearance of appetite;
- general weakness, fatigue, reduced efficiency;
- drowsy condition;
- weight loss;
- progressive anemia.
In the future, the symptomatology grows, intensifies, all the new signs appear:
- causeless cough, usually with a small amount of sputum;
- shortness of breath during physical activity, and with time and at rest;
- soreness and uncomfortable condition behind the sternum;
- an increase in the lymph nodes under the jaw, under the arms, etc .;
- slight increase in body temperature;
- often recurring pulmonary diseases, which are extremely poorly treatable.
If metastases develop - daughter tumor cells that are carried throughout the body - then the symptomatology will depend on which specific organ the metastasis turns out to be.
Stages of adenocarcinoma of the lungs
The effectiveness of therapeutic measures directly depends on the spread of the disease throughout the body. On this basis, four stages of the tumor process are distinguished:
- in the first stage, the malignancy of the tissues does not leave the lungs;
- in the second stage the tumor is small, up to 60 mm, but there is a penetration of metastases into the lymph nodes;
- in the third stage, the tumor completely covers the entire pulmonary lobe, metastases in the lymph nodes are present;
- In the fourth stage, the second lung is affected, and metastases are detected in the remotely located organs.
Because of the scarcity of symptoms, adenocarcinoma of the lungs of the 4th stage is most often detected. However, this pathology can be successfully treated with modern methods.
Diagnosis of lung adenocarcinoma
Timely diagnosis of malignant neoplasms makes it possible to make the treatment more effective, and in oncology this is a very important point. Of course, much depends on the patient himself, who must turn in time for help.
To identify the tumor or clarify the diagnosis, the following diagnostic methods are used:
- Radiography of the chest is one of the most popular procedures for detecting malignant lesions in the lungs. Often tumors are detected by chance - for example, in the course of preventive fluorography.
- Computer and magnetic resonance imaging are considered the most modern methods of obtaining information when a doctor can examine and assess the state of the respiratory system in different angles. This gives the most complete picture of pathology, with the scale of neoplasm, spread and metastasis.
- Ultrasound is also a procedure number 1 for the diagnosis of the disease, but its informativeness in oncology is somewhat overstated.
- Bronchoscopic examination is performed using a special apparatus - an endoscope. The device consists of an elastic fiber-optic tube equipped with a video device and a lighting device. The tube is injected intra-tracheally and helps to examine the internal state of the trachea with the image output to the monitor.
- The study of blood on the content of oncomarkers indicates the presence of malignant diseases in the body.
- Biopsy is a very important and fundamental research, without which it is difficult to imagine modern oncology. The essence of the method consists in taking the element of the affected tissue with its further investigation. According to the sample taken, the malignancy of the process can be determined with accuracy. The material for analysis is taken simultaneously with bronchoscopy, or with transthoracic puncture (which is less desirable and is done only as a last resort).
Differentiation of lung adenocarcinoma
Cancer tumors can differ in different characteristics and parameters, so they are often divided into certain types, species and subspecies.
For example, according to the distinctive features of malignant cells from healthy to tumors, several categories of differentiation are used. By the way, highly differentiated and normal cellular structures practically do not differ in any way.
The term "highly differentiated lung adenocarcinoma" explains the fact that intracellular transformation consists only in a change in the size of the cell nucleus - its elongation is observed. This suggests that this form of the disease for a long time does not show any symptoms until it grows to a certain size. Nonspecific signs, of course, can be present - it is general weakness, apathy, loss of interest in food, emaciation, erythrocytopenia.
Highly differentiated adenocarcinoma of the lung is found in 60% of all cases of malignant lesions of the pulmonary system, most often in male patients. This pathology can take the form of a nodule, or a large tumor. It can occur in acinar form (with predominance of glandular structure) or in papillary form (with papillary structure). Both currents are prone to increased mucus formation.
As we said above, the disease does not appear at first. Somewhat later, the first signs appear:
- the release of a large amount of sputum, possibly with particles of pus or blood;
- coughing attacks, increased temperature indicators (not responding to conventional antipyretic agents);
- shortness of breath, both with exercise and at rest.
Moderately differentiated adenocarcinoma of the lung resembles a highly differentiated disease according to the nature of the process. However, in this case there is a pronounced change in cellular structures. Now they are relatively easy to differ from normal ones, since the number of cells with atypical structure and those that pass the fission phase is steadily growing, and it is impossible to notice them.
In addition, moderately differentiated adenocarcinoma occurs more severely than others, with a high degree of risk of development of concomitant diseases and consequences. This form of the tumor is prone to metastasis, mainly in the lymphatic and in the nearest lymph nodes. It is interesting that in patients younger than 30 years, widespread metastases with pulmonary adenocarcinoma are almost not observed.
Low-differentiated lung adenocarcinoma is distinguished by the primitive nature of cellular development. Such structures are difficult to compare with any tissues of the body, therefore, evaluation of the structure and mechanism of development of this tumor is difficult. However, a low-grade neoplasm has the highest degree of malignancy. The tumor grows very quickly and already in the initial period of its development can spread throughout the body. Of course, this form of adenocarcinoma is considered the most unfavorable regardless of the stage of growth.
Treatment of pulmonary adenocarcinoma
Treatment for pulmonary adenocarcinoma may consist of surgical removal of the tumor, chemotherapy and radiation. Most often, these therapeutic methods are used in a complex - the treatment regimen is determined by the oncologist on the basis of the results of the patient's analyzes and studies.
As with other malignancies, the goal of treatment is to completely remove the tumor, or, if this can not be done, then prolong the life of the patient, alleviating his suffering.
Surgery is mandatory in the first and second stages of adenocarcinoma, that is, approximately 10-30% of the diseases. If the process of spreading metastases to distant organs has already begun, then it is no longer necessary to count on an operation alone. In addition, surgery may be impossible if the malignant formation is located close to the trachea, or the patient is diagnosed with severe heart disease.
The type of intervention on the lungs is selected depending on the size and location of the lesion. For example, a surgeon can remove a portion of the pulmonary lobe, the entire lobe or completely one lung. At the same time, the affected lymph nodes are also removed.
The rehabilitation period in post-operative patients is not easy, patients need careful care, perhaps for several months. At first, people undergoing surgery experience difficulty breathing, shortness of breath, chest pain. Elderly patients need longer rehabilitation.
- Radiation therapy is used before or after surgery. The essence of irradiation is the use of special rays capable of destroying cancer cells. In most cases, radiation treatment is combined with surgery and drug therapy.
Brachytherapy may also be prescribed instead of rays. This method is a kind of radiation therapy, when the substance emitting radiation is placed directly to the affected organ in the form of granules. The huge advantage of this method is that radiation does not affect the tumor from the outside, that is, it does not need to overcome layers of healthy tissues. Thanks to this, brachytherapy has much fewer side effects and complications.
Radiation therapy can be used if the patient for any reason refuses surgery, or if the operation becomes impossible or meaningless. Side effects after radiation therapy is a feeling of constant weakness, fatigue, an increase in the degree of susceptibility to infectious diseases, a violation of blood coagulability.
Chemotherapy for lung adenocarcinoma can stop the development of malignant cells, prevent their division and cause their death. There are more than sixty types of chemotherapy. The most famous among them are the following:
- Cisplatinum
- Carboplatin
- Gemcitabine
- Vinorelbine
- Paclitaxel
- Docetaxel.
Most often, these drugs are not taken separately, but in combination with each other. Medications are prescribed both in tablet form and in the form of intravenous injections. Calculation of doses for chemotherapy is strictly a doctor's decision, since it is difficult to determine the exact amount of the drug: at too low a dose, treatment will become ineffective, and excessive doses will lead to severe toxicity and the appearance of significant side effects. Usually the dose is calculated based on the value of the PPT - the surface area of the patient's torso. PPT is calculated individually using a specially derived formula, where the key indicators are the body weight and the patient's growth.
Also, one of the methods of dosing can be the determination of the amount of chemotherapy in the blood plasma for a certain period of time, followed by dose adjustment for optimal action. So you can calculate the minimum toxic effect of the drug against the background of effective treatment of the tumor.
The course of drug treatment usually lasts several days. At the end of the course, the patient is given a break to restore and alleviate the symptoms of intoxication, after which the treatment is resumed. The total number of procedures is calculated individually.
It is known that chemotherapeutic drugs often cause side effects, although doctors assure that such manifestations can be controlled. What kind of side effects are we talking about?
- Increased sensitivity of the body to infections - this condition usually manifests a week after the end of the course, reaching a maximum after 2 weeks. After that, the immunity begins to recover and before the resumption of treatment is normalized. Control this process by periodically taking blood for analysis: if the blood picture is unsatisfactory, then further procedures may be postponed.
- The appearance of bruising and bleeding is the result of worsening blood clotting by lowering the level of platelets. This condition is quite serious danger, as the bleeding tissues can develop into full-fledged bleeding, which requires immediate medical attention.
- Anemia is a very common side effect. Anemia occurs due to a decrease in the level of erythrocytes and, accordingly, hemoglobin, which is manifested by a feeling of constant fatigue, weakness and apathy.
- Attacks of nausea and vomiting can start unexpectedly. In such cases it is necessary to consult a doctor who will prescribe medications that eliminate this problem.
- The stomatitis and soreness of the gums are eliminated by ordinary mouth rinses. To avoid unnecessary mechanical injuries to the oral mucosa, you should eat the rubbed food and drink a high-calorie liquid.
- Hair loss is a frequent and very unpleasant side effect, especially for female patients. You can ask the doctor to replace the drug that causes this effect, or to accept and wear a wig or scarf. In most cases, the hairline is restored several months after the last course of treatment.
Treatment of adenocarcinoma does not always have the same effect on patients: one who ill reacts painfully to radiation, while the other does not cause any negative consequences. Someone suffers from side effects of drugs, but to someone they are the best fit. That's why doctors insist on an individual approach to treatment: it is important to listen to the doctor and follow all his recommendations.
Prevention of pulmonary adenocarcinoma
To reduce the likelihood of adenocarcinoma of the lungs, you must adhere to the following rules:
- Refuse to smoke. Proved: the more cigarettes a person smokes per day, the more he has the chance of developing a cancerous tumor in the lungs.
- Avoid prolonged exposure in dusty premises, as well as in enterprises where air contains particles of harmful chemicals, carcinogenic and toxic substances. Workers of harmful industry should take measures to protect the respiratory tract: wear respirators, gas masks, special suits. In the shops and premises of such enterprises, air-filtering devices, smoke dust collectors, waste accumulators, etc. Should be installed.
- Timely treat acute and chronic diseases of the respiratory system, periodically conduct preventive examinations and studies of the respiratory system. This is especially true of those people who have already had cases of malignant lung damage in the family, as well as those living in unfavorable ecological conditions, near large automobile routes, industrial facilities, power stations.
- Avoid contact with potentially dangerous carcinogens, which include arsenic, chromium compounds, various resinous substances, radon, asbestos, nickel. It is necessary to refrain from inhaling these substances and their vapors.
To protect yourself from malignant diseases will help also proper nutrition. Specialists have proved that food of predominantly vegetable origin, a minimum of fried foods, animal fats, salt and spices, as well as the exclusion of preservatives and colorants, will help to reduce the risk of development of oncology in the body as a whole.
Also, moderate physical activity is important, since regular natural ventilation of the lungs improves blood circulation and accelerates the excretion of toxic substances from the body.
Prognosis of lung adenocarcinoma
Survival in adenocarcinoma of the lungs can depend on the type of tumor and the stage of its development.
At the first and second stage, the prognosis is considered very favorable, especially with a five-year survival rate. The overall survival is 50 to 70%.
With a tumor of the third stage, about 20-25% of patients survive for five years, whereas in the first year about half of all cases survive.
Malignant disease of the fourth stage has the worst prognosis - for five years only up to 10 patients out of a hundred can survive, although within 10 months this figure can be about 50%.
The low-differentiated tumor is distinguished by the most aggressive development of all the varieties of adenocarcinoma. Without therapeutic measures, patients can die within 2-4 months after the diagnosis is made. Nevertheless, such a tumor is considered to be more sensitive to radiation and drug treatment, so it is not worthwhile to delay taking measures. The life expectancy of patients can be increased by using a comprehensive treatment that involves all possible methods.
Lung adenocarcinoma is a serious and complex disease, like any other malignant tumor. However, such a disease can be cured. The main thing is not to despair and follow all the recommendations of the treating doctor.