Lungenkrebs

Lung cancer begins in the airways or air sacs of the lung. About 85 percent of cases are non-small cell lung cancer, mainly adenocarcinoma and squamous cell carcinoma; the rest are small cell lung cancer, which grows and spreads faster. People sometimes call it chest cancer.

Early non-small cell cancers are treated with surgery or focused radiotherapy with curative intent. Unfortunately many cases are found late. Treatment of advanced disease has changed greatly with targeted tablets for tumours carrying particular gene changes and with immunotherapy, but these control the disease rather than remove it in most people.

Symptome

• A cough lasting more than 3 weeks, or a change in a long-standing cough
• Coughing up blood
• Breathlessness or wheeze that is new
• Chest or shoulder pain that persists
• Repeated chest infections or one that does not clear
• Hoarseness, weight loss, loss of appetite or tiredness
• Swelling of the face and neck, bone pain or headaches when the cancer has spread

Ursachen und Risikofaktoren

Smoking causes the large majority of cases, and risk rises with the amount and duration; it falls steadily after stopping but never quite to that of a never-smoker. Passive smoking, radon gas in homes, asbestos, diesel fumes, silica, air pollution and previous chest radiotherapy contribute. COPD and lung fibrosis raise risk independently. Lung cancer in people who have never smoked is increasingly recognised, particularly adenocarcinoma in women, and these tumours often carry treatable gene changes such as EGFR or ALK.

Wie es diagnostiziert wird

• Chest X-ray and CT: A CT scan of the chest and upper abdomen is the main imaging test. Low-dose CT is used for screening heavy smokers aged roughly 50 to 80.
• PET-CT: Shows active disease in lymph nodes and distant sites, and is required before treatment with curative intent.
• Biopsy: Tissue is obtained by bronchoscopy, by endobronchial ultrasound (EBUS) sampling of chest lymph nodes, or by CT-guided needle through the chest wall.
• Molecular and PD-L1 testing: The tumour is tested for EGFR, ALK, ROS1, KRAS and other changes, which decide whether a targeted tablet or immunotherapy is appropriate.
• Brain MRI and lung function tests: MRI checks for spread in higher-stage disease. Breathing tests establish whether you can safely undergo lung surgery.

Behandlungsmöglichkeiten

• Surgery: Lobectomy with lymph node removal, usually by video-assisted or robotic keyhole surgery, for early-stage non-small cell cancer in people with adequate lung function.
• Stereotactic body radiotherapy: High-precision radiotherapy in 3 to 8 sessions for small tumours in people who cannot or prefer not to have surgery.
• Chemoradiotherapy: Daily radiotherapy over about 6 weeks with chemotherapy for locally advanced disease, often followed by a year of immunotherapy.
• Targeted therapy: Daily tablets such as osimertinib or alectinib for tumours with the matching gene change.
• Immunotherapy and chemotherapy: Infusions every 3 to 6 weeks for advanced disease without a targetable change, and the main treatment for small cell lung cancer.
• Palliative and supportive care: Relief of breathlessness, pain and cough, drainage of fluid around the lung and airway stents, alongside active treatment.

Wenn es dringend ist

Call emergency services for coughing up more than a few teaspoons of blood, sudden severe breathlessness or chest pain, swelling of the face, neck and arms with prominent veins, new confusion or seizures, or back pain with leg weakness or loss of bladder control. These complications need the nearest hospital at once. Fever during chemotherapy is likewise urgent.

Reisen nach Türkiye zur Behandlung

A persistent cough or blood in the sputum needs a chest X-ray near home this week, not a journey. Travel can be useful for PET-CT and EBUS staging with full molecular testing if these are slow to obtain, for a second opinion, for a planned keyhole lobectomy with about 2 to 3 weeks before flying home, or for a short stereotactic radiotherapy course. Ask the surgeon about air travel after lung surgery. Immunotherapy and targeted treatment continue for months to years and need an oncologist where you live.

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