Peripheral lung cancer

Lung cancer is 5-7 times more common among men. This is explained by the prevalence of tobacco smoking among men. Smoking is considered the most significant risk factor for lung cancer because it affects the vast majority of patients. Less importance is attached to the hereditary factor, because the presence of malignant lung disease in close relatives has little effect on predisposition. Environmental factors such as smoking or working in a smoky or dusty room have a much stronger influence. Long-term inflammatory processes in the lungs can also affect this.

A peripheral lung tumor develops in the peripheral parts: from the alveoli and bronchioles, in contrast to central cancer, which occurs near the root of the lungs and large bronchi. In the periphery, the malignant process does not cause difficulty breathing or coughing for a long time, so in the early stages it may not manifest itself at all. Symptoms of such cancer appear when the tumor has already invaded the pleura or spreads to large bronchi. Thus, peripheral lung cancer is usually detected in late stages, when the chances of successful treatment are low.

According to statistics, of all pulmonary neoplasms, peripheral cancer makes up no more than a third. Most often, malignant tumors are found in the upper sections, less often in the lower sections, and least often in the middle sections. Peripheral lung cancer is mainly represented by adenocarcinomas. This type of malignant neoplasm is highly treatable, but in the early stages.

There are 3 clinical forms of peripheral lung cancer:

• Nodal form.
• Pneumonia-like. Formed by the fusion of several primary nodes. It occurs as pneumonia, which causes many diagnostic errors. Histologically, this form almost always indicates adenocarcinoma.
• Apical form. Apical lung cancer (apical, Pancoast cancer) is localized only in the apex. In later stages, it manifests itself with specific symptoms when the tumor spreads to the brachial and cervical plexuses.

When the malignant process spreads to the bronchi, a cough, blood in the sputum, and shortness of breath appear. Germination into the pleura causes pain in the chest and accumulation of fluid in the pleural cavity, and on the affected side. Body temperature may rise, which is often mistaken for an infection. Specific symptoms are accompanied by general ones: weakness, fatigue, weight loss, pallor.

Peripheral cancer of the right lung is clinically in no way different from peripheral cancer of the left lung, except in cases where the tumor spreads to the heart sac (pericardium). Similarly, peripheral cancer of the middle lobe of the right lung is no different from peripheral cancer of the lower lobe of the right lung.

The usual route of metastasis is lymphogenous: to neighboring lobes, to neighboring lungs, to the pleura.

Suspicion should be raised by frequent pneumonia that poorly responds to antibiotic therapy. Plain radiography, magnetic resonance imaging (MRI), and computed tomography (CT) will help confirm the diagnosis and determine the location of the tumor. Fiberoptic bronchoscopy is not very informative, since peripheral cancer develops far from the large bronchi. Laboratory tests include a cytological analysis of sputum for atypical cells and a blood test for tumor markers.

Main method lung cancer treatment surgical intervention remains. The extent of intervention depends on the size of the tumor, location and extent of spread. Depending on the stage of the malignant process, radiation and chemotherapy are added to surgery. In inoperable cases, combined

The main prevention of lung cancer is considered to be smoking cessation as the main factor, and passive smoking should also be taken into account. All possible irritants should be eliminated, therefore, when working with carcinogenic substances (asbestos, diesel, chromium, cadmium, etc.), protective equipment (respirators, masks, etc.) should be used.

Also, the disease prevention strategy includes periodic examinations - screening. As a screening for people over 45 years of age, it is proposed to undergo fluorography annually. Regular screening is especially important for smokers, because their risk of developing cancer is 10 times higher. In the Russian Federation there are no recommendations for screening for lung cancer, but fluorography can be performed as part of the standard free medical examination of the population.