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Cells in the body are constantly renewing themselves. But when harmful substances enter the body or foreign agents (viruses, bacteria) attack the body, normal cell division is disrupted. This is how cancerous growths are formed. Lung cancer or bronchogenic carcinoma is a fairly common form of oncology worldwide. The lesion of lung tissue by a malignant process takes the leading place among other oncologic diseases. Therefore, the treatment of lung cancer in all countries, including Germany, takes center stage. In men, the pathology is two to ten times more common than in women, depending on the region. The risk of cancer increases with increasing age.
Risk factors
For several decades, hundreds of studies on the influence of external environmental factors on the development of oncologic process in the respiratory system have been performed all over the world. According to the results of scientific searches the following risk factors for pathology development were identified:
- smoking,
- viruses,
- dust,
- genetics,
- radiations
The presence of several of them in a person at once, increases the likelihood of developing the disease.
A major risk factor for lung cancer is smoking. A large number of clinical studies have shown that smoking and tobacco use have a damaging effect on lung tissue. Cigarettes contain substances that change the structure of DNA. Smoking has also been proven to lower the immune system. This leads to the malignancy of the pathologic process. Smoking people develop cancer 20 times more often compared to non-smokers. At the same time, women taking hormonal drugs have a higher risk of death due to damage to the respiratory system.
Another common cause is viral infections. They have been found to affect the cell cycle, leading to uncontrolled cell division. Unlike viruses, bacteria have no direct effect on the development of cancer. However, frequent bacterial infections reduce immunity, which leads to increased susceptibility to viruses and external carcinogens.
A recent study demonstrates a direct link between lung cancer and the concentration of dust in the air: the smaller the dust particles, the deeper they penetrate tissues and initiate dangerous changes.
Symptoms
About 60,000 cases of lung cancer per year are diagnosed as early as stage 3-4 of the process.
Therefore, it is very important to pay attention to even minor irregularities in the respiratory system. German specialists thoroughly interview the patient for any symptoms characterizing the respiratory system. Thanks to their vast experience, German clinicians are able to make an accurate differential diagnosis between cancer, pneumonia, bronchitis and tuberculosis.
Symptomatology depends on the form of cancer, volume and metastasis to other organs and structures of the body.
Highlight:
- Central cancer
- Peripheral cancer
Central cancer — is a form in which the primary focus of the formation is located in one of the main bronchi. When the size of the carcinoma increases, the patient has a cough. At first, the cough is non-productive (dry), and then there is abundant sputum. Sometimes there may be streaks of blood in the sputum. When the formation sprouts into the nerve plexus, painful sensations appear, their intensity depends on the degree of damage to the nerve fibers. If the carcinoma is so large that it blocks the vessels, the patient has a syndrome of compression of the superior vena cava: swelling of the upper half of the trunk, puffy face, swelling of the veins of the upper extremities, neck and chest.
In peripheral cancer the tumor process is located deep in the lung tissue. This type is more dangerous, because the first symptoms will appear only when the carcinoma is large. And due to the absence of nerve endings in the lung tissue, the tumor does not manifest pain in the early stages. When it sprouts into the vessels, layers of blood are observed in the sputum.
In addition to specific symptoms, as with all types of neoplasms, lung cancer is characterized by neoplastic syndrome. It includes:
- general weakness,
- fatigue,
- weight loss,
- temperature rise
- sweating.
At later stages, when metastases appear, there are symptoms of damage to internal organs, signs of decay of the tumor mass (pulmonary bleeding, atelectasis, etc.).
Diagnostic methods
Usually a patient seeks help when a cough appears, which does not go away for a long time. During examination and questioning, the doctor may suspect cancer if, in addition to coughing, fever, the patient notes a sharp weight loss, pallor of the skin and mucous membranes. After examination, the specialist will send the patient to perform an X-ray examination of the chest organs. X-rays are sufficient to diagnose more than 80% of formations. Given the scanty symptomatology in the early stages of the disease, it is very important to undergo preventive examinations, which include the performance of fluorography. If the X-ray or fluorogram shows a pathological focus, a more detailed examination is required.
Then, after X-ray, a bronchoscopy is performed and a sample of cells is taken for histologic examination. If atypical cells are detected in the analysis, they indicate the presence of an oncological process.
On a side note! The correct evaluation of radiographs depends primarily on the experience of the radiologist. In German oncology centers, specialists receive additional training in the evaluation of radiographs to ensure that the correct diagnosis is made.
More detailed diagnostics include:
- Computed tomography: allows to assess the volume and location of the pathologic focus, the presence of metastases.
- Positron emission tomography. Thanks to PET, it is possible to distinguish benign from malignant lesions without biopsy, which avoids complications such as bleeding, development of atelectasis, etc. PET accurately determines the degree of tumor metastasis and detects it at the earliest stages.
- Ultrasound modes of investigation. Several variants of this method are used in Germany: EBUS (endobronchial ultrasound) and EUS (endoesophageal ultrasound). The examination is performed using an endoscope with an ultrasound transducer at the end of it, which shows information about nearby organs and possible metastases.
- Transthoracic biopsy. It is performed to obtain a sample of the pathologic focus. Not always possible, as this method of diagnosis is invasive and may cause bleeding.
- Oncomarkers. In Germany, tests for cancer markers of lung lesions (cancer-embryonic antigen, tissue polypeptide antigen, neuron-specific enolase and others) are performed. Oncomarkers are rarely used for diagnosis. They are determined to assess the prognosis of the disease and the effectiveness of treatment. The level of oncomarkers is an assistant in determining the direction of treatment.
Note! German cancer centers use an advanced method of examining the bronchopulmonary complex.
SuperDimension Bronchus System — is a system in which a probe is inserted into deep tissue structures and the pathological focus is detected using electromagnetic navigation. The technique allows penetrating into the deep lung structures and detecting malignant processes at early stages.
Obligatory together with instrumental methods of examination are prescribed blood tests to determine the degree of damage to other organs and systems and the severity of pathology.
Recommended! If there are complaints of respiratory abnormalities and there are risk factors, lung cancer in a family member in previous generations, you should see a doctor and undergo a qualified examination.
Lung cancer treatment in Germany
The main method of fighting cancer is its removal. The volume of surgery depends on the stage of pathology, its prevalence in the nearest organs and tissues. At the initial stages of the disease, minimally invasive technologies are used:
- endoscopic,
- ultrasonic,
- cryodestruction.
German clinics perform minimally invasive surgery using miniature cameras. This is called Video-Assisted Thoracoscopic Surgery (VATS). After surgery, patients recover much faster and experience less pain.
If the tumor is large, a lobectomy (removal of the lobe of the lung with the pathological focus) or a pulmonectomy (removal of the entire affected lung) is performed. If the tumor closes the lumen of the bronchus, in order to restore adequate breathing, stenting is performed, i.e. a tube is placed in the lumen to ensure the patency of the bronchus.
In addition to surgical intervention, additional treatment methods are performed: radiotherapy, chemotherapy and radiation therapy, bioactive drugs are administered.
Chemotherapy
There are several types of chemotherapy:
- adjuvant therapy. It is performed after the tumor is removed to destroy any remaining cancer cells;
- non-adjuvant therapy. It is administered before surgery to kill tumor cells and also to evaluate the effectiveness of the measures used;
- systemic form. It is performed for therapy of the metastatic form.
Application depends on the patient’s condition, the size of the tumor, and the effectiveness of surgical intervention.
Radio or radiation therapy
The essence of the method: high energy radiation is applied to the area of the neoplasm. The radiation causes disturbances in the cell reproduction cycle. Cancer cells stop multiplying due to damage to their DNA. Tumor cells are highly sensitive to radiation, as they divide faster than healthy cells and have no mechanisms to recover from damage. There are two types of radiotherapy:
- remote — the radiation source is located outside the body.
- high-dose — radiation is delivered using a device placed in the body directly near the tumor mass.
Recently, stereotactic radiotherapy has been used, which allows irradiating the focus from 1 millimeter due to the synchronization of the process with the phases of inhalation and exhalation of the patient. The method is used in case of solitary lung metastases or in case of oncoprocess not amenable to surgical intervention.
On a side note! Germany is using an innovative method of radiotherapy — IMRT RAPID Arc. The advantage of this method is the destruction of the tumor mass without affecting the surrounding tissue.
Biotherapy and immunotherapy
It is performed to reduce the size of a cancerous growth or when it has spread to blood vessels.
Various chemopreparations and radioisotopes are injected directly into the pathological focus. The intervention takes little time and is minimally invasive.
On a side note! Trials of a new immune drug have been completed pambrolizumab. It is a drug from the monoclonal antibody group. A study has shown that its use in combination with other treatments improves the prognosis for patients with non-small cell cancer. This is just one of many clinical trials being conducted in clinics in Germany.
Palliative care
When the cancer is too advanced or terminal (too large and metastasized throughout the body), palliative measures are taken. They are aimed at reducing pain, maintaining a satisfactory quality of life and correcting complications.
- Surgery: only a part of the tumor is removed to reduce its impact on surrounding organs and tissues.
- Palliative chemotherapy. It is aimed at destroying cancer cells. More gentle chemotherapy regimens with fewer side effects are carried out, but it does not carry the goal of complete removal of pathological tissues.
- Hormone therapy. Hormonal medications are prescribed to improve overall health.
- Radiotherapy: prolongs the life of patients on average in 40% of cases by six months, and when combined with other methods almost up to 3 years.
- Oxygenation. It is used to improve well-being.
- Correction co-morbidities.
- Counseling psychologist.
On a side note! Germany is constantly improving surgical techniques, conducting clinical trials of new drugs, and developing targeted medicine.
Cost of lung cancer treatment
The price depends on the volume and stage of the process, the condition of the patient, concomitant pathology.
Initially, the stage of the process is diagnosed, after which the scheme of therapy is determined.
| Name of service | Price, € | Optional |
|---|---|---|
| Diagnostics | 3800-5250 | 4 days inpatient |
| Thoracotomy segmental resection | 13500–17000 | 10 days, inpatient |
| Radiation therapy | 12500–13000 | 39 days, outpatient |
| Chemotherapy | 3200–4600 | 5 days, outpatient |
Forecast
The prognosis depends on the stage and form of the cancer.
Two forms of cancer process are distinguished: small cell and non-small cell.
Non-small cell develops slowly and responds better to treatment interventions.
Consider the 4 stages of small cell cancer.
- Size is about 6 cm, no metastases. The 5-year survival rate will be about 70%.
- The size reaches 7 cm, metastasizes to the nearest lymph nodes, pleura. The survival rate is 40%.
- The third stage is characterized by the presence of metastases in nearby organs and tissues. Vessels, esophagus, trachea are affected. The survival rate is 20%.
- Terminal stage of the process: distant organs and tissues are affected by metastases.
The small cell form is characterized by accelerated growth and rapid spread throughout the body. In only 3% of cases, oncologists can achieve a 5-year survival rate.
Another severe form of cancer process is Pancoast tumor. It is formed in the apex of the lung and, because it is located near vital organs and vessels, in most cases it is not removed. Such patients are treated with chemotherapy and radiation therapy.
Important! Multidisciplinary approach (participation of doctors of different specialties) and combination of different methods of treatment of pathological tissue in German clinics greatly increases the survival rate of patients.
How to choose the right clinic?
Many clinics in Germany treat lung cancer. When choosing an oncology center, it is important not to make a mistake: the level of qualification of specialists working in the medical institution, compliance of medical equipment with modern requirements, availability of conditions for an interdisciplinary approach, application of unique methods are all indicators. In turn, among qualified pulmonologists and thoracic surgeons, it is necessary to choose one who has extensive experience and a high percentage of positive results in the treatment of oncopathology specifically identified in the patient. A qualified oncologist specialized in the treatment of lung cancer should have a sufficient number of scientific publications. A doctoral degree or the title of professor indicates the quality of theoretical knowledge and practical experience.
On a side note! All of the above information can be, but is not easy to find in free access. It is available from so-called insiders, i.e. those who can directly observe the activities of the clinic and of each surgeon, pulmonologist, oncologist.
Recommended! The choice is better to start not with the clinic, but with the leading specialist.
What do you mean lead oncologist, surgeon, pulmonologist?
- Extensive experience in treatment activities with positive results.
- Highly specialized and qualified in thoracic( thoracic) medicine.
- A weighty list of scientific papers.
- Recognition by the global medical community of thoracic medicine.
Important! «German Clinics» Thanks to many years of daily patient transfer and follow-up work, have knowledge of the real current rating of every clinic and every specialist in Munich.
What is the benefit of choosing the right clinic and lead specialist?
Provides accurate diagnosis, correct diagnosis, safe and effective treatment, individual approach, participation of doctors of different specialties in the process. As a result, the patient gets a chance to recover, improve the quality of life and increase its duration.