Lung Cancer – what do we need to know?

The cancer cells can then become “ invisible ” and take on the characteristics of healthy cells, making them “ immortal ”, so to say. The changes in the genetic material usually occur spontaneously; it is not assumed that one has an inherited , general tendency towards cancer.

Several factors can play a role in the development of lung cancer. Particular emphasis should be placed on harmful substances that enter the lungs through contaminated air, such as tobacco smoke, asbestos, arsenic, chromium, nickel, cadmium, aromatic hydrocarbons and diesel exhaust fumes . These substances contribute to lung tissue cell damage until they finally turn into cancer cells. Genetic factors can also play a role in tobacco consumption . Gender is also an issue since there are differences in nicotine metabolism and clearance between men and women. Nine out of ten cases of lung cancer in men and at least six out of ten in women are caused by active smoking. The risk of lung cancer increases significantly with the number of cigarettes smoked per day and the duration of smoking. Young smokers are particularly at risk, as the lung tissue of young people is even more sensitive. Men have a 24 times higher risk of lung cancer if they were lifelong smokers compared to non-smokers. The longer ago cigarettes were last smoked, the lower the risk of lung cancer. Nonetheless, an equivalent risk level to that of non-smokers is never fully reach ed; even after a smoking abstinence of over 30 years, it is still significantly higher than for non-smokers of the same age. E-cigarettes are not harmless either. The aerosol, the vapor inhaled from e-cigarettes, contains nicotine as well as carcinogenic and toxic substances (e.g. formaldehyde and acetaldehyde). People who smoke pipes, cigars and cigarillos also have an increased risk of lung cancer. Depending on the intensity of smoking, it is greatly increased compared to that of non-smokers.

How can lung cancer be diagnosed? In order to rule out lung cancer, samples of lung tissue must be taken and examined for tumor cells in the laboratory. Bronchoscopy, a.k.a. lung endoscopy, is therefore the most important method for the definite diagnosis of lung cancer.

Non-small cell lung cancer (NSCLC) is defined as a type of lung cancer that does not fall into the category of small cell lung cancer (SCLC). It is an epithelial lung cancer; it develops from epithelial cells. Around three quarters of all bronchial carcinomas are NSCLC. Histologically, squamous cell carcinoma s, adenocarcinomas and large cell carcinomas can be characterized as the most common subtypes of NSCLC. Subtypes that differ histologically, such as the Pancoast tumor or neuroendocrine tumors of the lung, occur considerably less frequently. In the majority of cases, the development of NSCLC is linked to cigarette smoking. However, people who have never smoked can also develop this type of lung cancer.

“In 2018, about 21,930 women and 35,290 men were diagnosed with lung cancer in Germany. 16,514 women and 28,365 men died from this disease. This makes lung cancer the most frequent cause of death from cancer in men and the second most frequent in women.”

([1], transl. C. Lobitz)

What are the symptoms of lung cancer? Persistent acute cough that lasts for more than two to three weeks despite adequate treatment, e.g antibiotics.

Chronic cough that changes its character

Bloody and bloodless sputum

Wheezing breathing, shortness of breath

Fever attacks and night sweats

Fatigue

What examinations are carried out? The usual examinations for suspected lung cancer include laboratory tests, X-rays, bronchoscopy, computerized tomography (CT) and ultrasound. If lung cancer is detected, further examinations are carried out to determine whether the tumor has already spread and to detect any metastases.

When is a CT scan of the lungs performed? A CT scan of the thorax is performed to rule out tumors, pulmonary embolism, pulmonary hypertension, pulmonary fibrosis, progressed COPD or pneumonia in high-risk patients.

What is lung cancer screening? Lung cancer screening is usually carried out using computer tomography. The mortality rate from lung cancer can be significantly reduced, particularly in risk groups. A corresponding screening program – similar to that for bowel or breast cancer – is currently being discussed and prepared throughout Germany.

What are the next steps? In the case of lung cancer, a screening program using low-dose computer tomography (LD-CT) is particularly useful, due to the large prognostic differences depending on the tumor stage and the often very late diagnosis of lung cancer. Early detection using modern low-dose CT significantly improves the chances of therapy, which has now been proven by a number of scientific studies. The government is preparing to introduce an early detection program in Germany.

EXERCISE:

1. People who have never smoked can also develop NSCLC. A) True B) False

2. What are the symptoms of lung cancer? A) Wheezing breathing B) Fatigue C) High blood pressure D) High cholesterol E) Bloody sputum

3. The risk of lung cancer increases significantly with the number of cigarettes smoked per day and the duration of smoking. A) True B) False

You’ll find the answer below.

BIBLIOGRAPHY 1. Dtsch Arztebl Int 2023; 120: 387–92; DOI: 10.3238/arztebl.m2023.0099 2. www.cancer.org 3. www.dict.cc 4. www.krebsdaten.de 5. www.mayoclinic.org 6. www.nhs.uk 7. www.webster-dictionary.org

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTL. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten.

Kontakt: mail@lobitz-seminare.de

www.lobitz-seminare.de

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Lösung für Exercise:

1. A

2. A, B und E

3. A

Lung Cancer – what do we need to know?

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