Lung Cancer (Pulmonary Carcinoma)

Lung cancer is one of the most common and deadliest types of cancer worldwide. Each year, approximately 2.2 million people are diagnosed with lung cancer, and the disease is responsible for around 1.8 million deaths. Men are generally affected more frequently than women, but particularly due to increasing tobacco consumption worldwide, the number of women affected is also rising. Smoking is by far the biggest risk factor, as about 85-90% of all lung cancer cases can be attributed to it. The risk of developing lung cancer increases especially with the number of cigarettes smoked and the duration of smoking. Heavy smokers have a comparatively up to 30 times higher risk of developing a carcinoma in the lung.

But how does lung cancer actually develop? Lung cancer occurs when healthy lung cells are damaged by carcinogenic substances, particularly carcinogens such as those found in tobacco smoke. These damages can lead to genetic mutations, causing cell growth to become uncontrolled. In most cases, the carcinoma develops in the bronchi, but it can also develop directly in the lung tissue. Due to the strong blood flow in the lungs and the venous connection from the vena cava to the heart, from where it subsequently reaches the lung, it is a preferred site for metastases from other types of cancer. Tumors of the breast (breast cancer), kidney (kidney cancer), colon (colorectal cancer), or prostate (prostate cancer) particularly often metastasize to the lung. Melanomas, or malignant skin tumors, can also form lung metastases as they quickly establish connections to the blood or lymphatic system.

Lung cancer can occur in various forms, which differ in their origin and development. Broadly, lung carcinomas can be divided into two main types: small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC). Non-small cell lung carcinoma is the most common form. Within NSCLC, there are further subgroups, including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Additionally, a distinction can be made between hormone-producing and non-hormone-producing types of lung cancer. They differ in their biological activity and their impact on the body. In the following sections, we will explain these different types of lung cancer in more detail.

Small cell lung carcinoma (SCLC) is a highly aggressive form of lung cancer, accounting for approximately 15% of all lung cancer cases. SCLC is characterized by rapid growth and often early metastasis, particularly to the brain, liver, adrenal glands, and bones. Since SCLC originates from neuroendocrine cells, it can produce hormone-active substances, causing paraneoplastic syndromes such as SIADH (Syndrome of Inappropriate ADH Secretion) or Cushing’s syndrome.

The primary cause of SCLC development is smoking. Over 90% of affected individuals are or were heavy smokers. Due to its particularly aggressive course, SCLC has in most cases already spread beyond the lungs at the time of diagnosis. Surgical removal is therefore rarely possible. Instead, treatment consists of a combination of chemotherapy and radiation therapy.

Non-small cell lung cancer (NSCLC) is the most common form of lung cancer. Approximately 80-85% of cases are NSCLC. It includes various subtypes: adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. Compared to small cell lung cancer, NSCLC typically grows significantly slower and metastasizes later. Therefore, treatment depends on the stage of the disease. For early detected tumors, surgical removal is often still possible. In more advanced stages, chemotherapy, immunotherapy, and targeted therapies are used as complementary treatments. These are frequently applied for genetic mutations such as EGFR or ALK alterations.

Adenocarcinoma is the most common form of non-small cell lung cancer. A distinctive feature of adenocarcinoma is that, unlike most other lung cancers which are primarily caused by smoking, it frequently occurs in non-smokers and women. As the name suggests, adenocarcinoma develops from the mucus-producing glandular cells of the lung tissue. It tends to develop in the peripheral regions of the lung. Due to this location, it often remains undetected for a long time until symptoms such as chronic cough, shortness of breath, or chest pain appear.

Unlike other types of lung cancer, adenocarcinoma is frequently associated with genetic mutations such as EGFR or ALK mutations. These facilitate the use of targeted therapies specifically directed against these mutations, which can work more selectively. However, treatment still depends on the stage of the disease. In early stages, surgical removal is the best option, while in advanced cases, chemotherapy, immunotherapy, or targeted medications are used.

Squamous cell carcinoma of the lung develops through a process known as metaplastic transformation. This involves the transformation of glandular cells into squamous epithelial cells, a process frequently triggered by chronic inflammation and irritation, particularly from smoking. This type of cancer constitutes a large proportion of non-small cell lung carcinomas and is strongly associated with long-term tobacco use. Unlike adenocarcinoma, squamous cell carcinoma typically originates in the central airways, especially in the main or segmental bronchi. As a result, symptoms appear early due to tumor growth. Typical symptoms include chronic cough, hemoptysis (coughing up blood), shortness of breath, or recurrent infections. Therapeutically, surgical removal is recommended for locally confined tumors, supplemented by radiation therapy or chemotherapy if complete resection is not possible. In more advanced stages, immunotherapies such as PD-L1 inhibitors are also used to inhibit tumor growth.

Large cell carcinoma is the rarest form of non-small cell lung cancer, accounting for only about 5-10% of cases. Characteristic of large cell carcinoma is the absence of specific histological features that are typical of other NSCLC subtypes. These include glandular structures as found in adenocarcinoma or keratinization in squamous cell carcinoma. The tumor cells are relatively undifferentiated and typically appear large and round under the microscope. Due to this lack of differentiation, large cell carcinoma is more difficult to classify into a specific type, which is why it is used more as an umbrella term for NSCLC tumors that cannot be more precisely classified. Large cell carcinoma usually grows very aggressively and typically metastasizes early. Therefore, at the time of diagnosis, the tumor has usually already spread to other organs, which complicates the prognosis. In large cell carcinoma, the tumor is located in both the central and peripheral lung and often causes symptoms only late in the disease. The most common complaints here also include chronic cough, chest pain, shortness of breath, unexplained weight loss, and general fatigue. Due to its tumor progression, treatment in the case of large cell carcinoma depends significantly on the stage. In early stages, surgical removal is one of the preferred treatment options. However, since large cell carcinoma is often diagnosed only in advanced and already metastasized stages, chemotherapy and radiation therapy are usually employed. In recent years, immunotherapies, particularly checkpoint inhibitors, have also been used as treatment approaches to specifically activate the immune system against the tumor cells.

Although the following forms of lung cancer are diagnosed significantly less frequently than common variants such as adenocarcinoma or squamous cell carcinoma, they still play an important role. Their progression is often more aggressive, which is why special treatment approaches and a better understanding of these rare tumor types are necessary to facilitate early detection, more targeted therapies, and improved prognosis for those affected.

Carcinoids are rare neuroendocrine tumors of the lung that grow relatively slowly compared to other, more common types of lung cancer. They typically originate in the central airways, particularly in the bronchi, where their size or location can narrow the airways and lead to symptoms such as shortness of breath. Despite their often benign or less aggressive growth pattern, carcinoids can be malignant in some cases and form metastases. A distinctive feature of these tumors is their ability to produce hormonally active substances. This frequently results in systemic symptoms such as skin flushing or diarrhea. This phenomenon is known as carcinoid syndrome, though it occurs less frequently in lung carcinoids compared to carcinoids of the digestive tract.

The preferred treatment for carcinoids is surgical removal, as many carcinoids are well-defined, making complete resection often possible. In cases where surgery is not feasible or metastases are already present, chemotherapy, radiation therapy, or modern targeted therapies may also be considered to more precisely control tumor growth.

Adenosquamous carcinoma is also one of the rare forms of lung cancer. It is an aggressive mixed type of non-small cell lung cancer that exhibits characteristics of both adenocarcinoma and squamous cell carcinoma. Therefore, the tumor is particularly complex in its structure and behavior. Clinically, adenosquamous carcinoma is often characterized by aggressive growth with a high tendency to metastasize and an overall rather unfavorable prognosis. The symptoms are often non-specific and similar to those of other lung carcinomas. Treatment is therefore primarily based on the tumor stage and consists mainly of surgical removal and, due to its high aggressiveness, supplementary chemotherapy, radiation therapy, or immunotherapy. This combination of therapeutic approaches offers the possibility to control tumor growth and minimize recurrence.

Sarcoid carcinoma is an extremely rare and highly malignant form of lung cancer that originates from the cells of connective tissue. Unlike the more common epithelial tumors of the lung, sarcoid carcinoma exhibits characteristics of both carcinoma and sarcoma. This characteristic makes this form of lung cancer particularly aggressive. Additionally, sarcoid carcinoma typically demonstrates rapid and invasive growth, which often leads to early metastasis to other organs such as the liver, bones, or brain. Due to its rare diagnosis, there is limited data on optimal therapy. In most cases, however, a multimodal treatment approach is pursued, consisting of surgical removal of the tumor, chemotherapy, and possibly radiation therapy.

Mesothelioma is a rare but highly aggressive form of cancer that affects the pleural lining of the lungs. In most cases, it is attributed to long-term asbestos exposure, which puts certain occupational groups at higher risk, particularly construction workers and industrial laborers. A notable characteristic is the extended latency period: often decades pass between asbestos exposure and the onset of initial symptoms. The most common symptoms include shortness of breath, chest pain, and pleural effusion—an accumulation of fluid in the pleura that further complicates breathing. Due to its diffuse growth pattern and early spread to surrounding tissues, the prognosis is generally unfavorable. Treatment typically involves a combination of surgery, chemotherapy, and radiation therapy. In advanced stages, modern treatment approaches such as immunotherapy are increasingly being utilized to slow the progression of the disease.

The classification of lung cancer into specific stages plays a crucial role in therapy selection and prognosis. It describes how far the tumor has already spread in the respective tissue. Therefore, one can distinguish between early, locally limited disease and advanced stages with metastases in other organs. Particularly important is the distinction between non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), as they differ significantly in their growth patterns and treatment options.

While tumors in early stages can often still be surgically removed, chemotherapy, radiation, or modern immunotherapies are necessary in more advanced stages. Once lung cancer metastasizes to lymph nodes or other organs, the prognosis deteriorates considerably. In the following, we want to explain the individual stages in more detail.

In stage 1 lung cancer, the cancer remains localized within the lung, with tumors measuring up to 4 centimeters. At this early developmental stage, cancer cells have not yet spread to lymph nodes or metastasized to other organs. Since cancer at this stage usually causes no or only non-specific symptoms, it is often discovered by chance, for example during a routine examination or imaging. The prognosis for patients with stage 1 lung cancer is comparatively good, as the tumor can be completely removed surgically in many cases. Depending on the tumor type and individual situation, the 5-year survival rate is between 60 and 80%. In certain cases, additional treatment with radiation or chemotherapy may be considered to further reduce the risk of recurrence. However, early diagnosis is crucial for successful treatment.

In stage 2 lung cancer, the tumor has extended beyond the lung, but remains absent from distant organs and lymph nodes. This stage is divided into Stage 2A and Stage 2B, depending on how far the tumor has progressed:

In this stage, survival rates can vary significantly depending on treatment, with the 5-year survival rate approximately 30-60%. However, it should be noted that this can fluctuate depending on the patient’s age, general health condition, and response to therapy. Treatment in stage 2 typically includes a combination of surgery, chemotherapy, and possibly radiation therapy, depending on tumor location and extent of spread.

In lung cancer stage 3, the tumor has already spread further, but not yet to distant organs. This stage is also divided into stage 3A and stage 3B, depending on the tumor infiltration and lymph node involvement:

The 5-year survival rate for stage 3 lung cancer is generally about 15-30%. However, it varies depending on tumor size, age and health condition of the patient, and response to treatment. Stage 3 is often more difficult to treat because the tumor has already expanded significantly and has partially spread to lymph nodes or adjacent tissues. Treatment often involves multiple options, including surgery, chemotherapy, radiation therapy, and increasingly immunotherapy and targeted therapies. In many cases, chemoradiotherapy is already used to more specifically shrink the tumor and alleviate symptoms.

In stage 4 lung cancer, also known as the terminal stage, the tumor has already spread to distant organs, including the liver, brain, bones, and other tissues. The most common symptoms at this stage include severe back pain, shortness of breath, coughing, significant weight loss, fatigue, and blood in coughed-up sputum. Additional symptoms may also be caused by metastases.

Life expectancy in the terminal stage varies greatly, depending on the patient’s overall health, the spread of metastases, and response to treatments received. On average, the 5-year survival rate for stage 4 lung cancer is approximately 5-10%, which means that in most cases, the tumor is difficult to control.

Therefore, palliative treatment is the primary focus, aimed at alleviating symptoms and improving quality of life, without curing the cancer. Options include therapies for pain relief, respiratory support, but chemotherapy and immunotherapy may also be used in individual cases. In advanced stages, targeted therapies or radiation therapy are also employed to relieve symptoms and control metastases.

Palliative care focuses on psychosocial support and comfort care in the final phases of life. This includes support from caregiving staff and the integration of hospice services to accompany patients and their families during this difficult time.

Lung cancer is one of the most common types of cancer worldwide, and its development is influenced by a variety of risk factors. These factors can be divided into exogenous and endogenous causes. Exogenous risk factors such as smoking, air pollution, or chemical exposure significantly contribute to the development of lung cancer. However, endogenous factors, which often represent less obvious causes, also play a central role. These include physical imbalances that can provide a foundation for cancer development over years. Examples include chronic but often undetected inflammations, hidden infections, or metabolic disorders that weaken the body and increase the risk of cancer. Micronutrient deficiencies and chronic toxin exposure from environmental pollutants or unhealthy lifestyle habits also negatively affect the immune system and promote oxidative stress, which in turn damages cells and can promote cancer growth.

Exogenous risk factors refer to external influences that increase the risk of cancer and thus play a decisive role in the development of lung cancer. These factors include both lifestyle and environmental factors that damage the lungs over extended periods. The following are among the most important exogenous risk factors for lung cancer:

• Smoking: The duration and amount of consumption are decisive. Smokers have a significantly higher risk of developing lung cancer. The risk increases with the number of cigarettes smoked and the duration of smoking.
• Passive smoking: Non-smokers who regularly inhale secondhand smoke are also exposed to an increased risk of lung cancer.
• Occupational and environmental factors:
  • Metals: Exposure to metals such as nickel, chromium, or arsenic can increase the risk of lung cancer.
  • Quartz dust: Occupations that involve contact with quartz dust also have an increased risk of developing lung cancer.
  • Fine particulate matter: Long-term exposure to fine particulate matter from air pollution promotes the development of lung cancer.
  • Asbestos: One of the most well-known and important causes of lung cancer, especially when asbestos fibers are inhaled.
  • Industrial and traffic emissions: Air pollution from vehicle and industrial plant emissions increases the risk of lung cancer, particularly in urban areas.

Endogenous risk factors are internal, mostly genetic or health-related causes that can contribute to the development of lung carcinoma. These factors can either increase the risk by altering genetic predisposition or the condition of the body, or they can amplify the effects of exogenous influences. The most important endogenous risk factors for lung cancer are:

• Genetic Disposition: A familial clustering of lung cancer often indicates a genetic predisposition. Certain hereditary diseases or genetic alterations, such as mutations in specific tumor suppressor genes, can increase the risk for lung cancer. A typical mutation commonly occurs in the tumor suppressor gene p53.
• Pre-existing Lung Conditions: Chronic inflammatory lung diseases or scarring that develops from repeated infections or inflammations increase the risk for lung cancer. An example of this is tuberculosis, which can cause long-term inflammation and changes to lung tissue. Chronic obstructive pulmonary diseases such as COPD can also contribute to an increased risk of lung cancer.

Lung cancer often remains undetected for a long time because early symptoms are quite non-specific and can easily be confused with other respiratory diseases. Many complaints only occur when the tumor is already advanced and causes symptoms due to its size and spread. Nevertheless, there are some warning signs that may indicate lung cancer. Smokers and people with lung diseases in particular should watch out for persistent or worsening symptoms:

• Chronic cough
• Chest pain
• Bloody sputum (hemoptysis)
• Shortness of breath and breathing difficulties
• Exhaustion and fatigue
• Loss of appetite
• Unintentional weight loss
• Swelling in the face and neck
• Difficulty swallowing
• Hoarseness
• Pain in the shoulder blade area

However, many of the symptoms mentioned above also occur with conditions such as COPD, asthma, or pneumonia. While inflammatory lung diseases often involve fever, increased sputum, or improvement with medication, lung cancer symptoms do not improve or worsen over time. COPD and asthma, on the other hand, are chronic lung diseases typically associated with shortness of breath, cough, and reversible or progressive airway narrowing. In contrast, lung cancer symptoms usually develop more gradually and are often non-specific, including chronic cough, bloody sputum, persistent chest pain, and unexplained weight loss. While inflammatory or allergic processes are often the cause of symptoms in COPD and asthma, lung cancer can also cause abnormalities due to tumor growth-related mechanical airway narrowing or metastases.

Certain changes in the hands and fingers can indicate lung cancer, especially in advanced stages. A typical sign is the formation of clubbed fingers, where the fingertips significantly thicken and the nails increasingly curve outward. This often occurs as part of hypertrophic pulmonary osteoarthropathy syndrome, which is characterized by excessive bone formation and pain in the long bones. These changes usually develop due to paraneoplastic syndromes, which are indirect effects of the tumor on the body. Not only lung cancer, but also other serious conditions such as heart defects or chronic lung diseases can lead to these symptoms.

Lung cancer can also manifest through changes in the face, especially when the tumor affects certain nerves or blood vessels in the chest area. A typical sign is superior vena cava syndrome, which involves compression of the superior vena cava, leading to swelling in the face, neck, and arms, as well as visible, dilated veins. Additionally, Horner’s syndrome may occur. This involves damage to the sympathetic nervous system in the chest area, which typically manifests as a drooping eyelid on one side, a smaller pupil, and retraction of the eyeball. Less specific signs such as pale or reddened skin, increased wrinkles, or noticeable redness may also appear, caused by chronic oxygen deficiency states.

Persistent throat clearing can be an early sign of lung cancer, especially when accompanied by a persistent cough or changes in voice. The tumor can affect mucus production in the airways or put pressure on nerves and structures in the laryngeal area, triggering persistent throat clearing or chronic irritation cough. Typical for lung cancer is a cough that persists for weeks and changes in intensity. However, it is often a rather dry cough with occasional phlegm.

Furthermore, altered sputum can be an important additional indicator of lung cancer. The tumor or inflammatory reactions it causes can change mucus production in the airways, leading to unusual sputum. Whitish or clear mucus often appears in early stages, while yellowish or brown sputum may indicate accompanying infections or tissue degradation. Particularly alarming is bloody sputum, which results from damaged blood vessels in the bronchi and may already point to advanced tumor development. Bad breath caused by necrotic tissue or bacterial infections in the damaged lung areas can also be an accompanying symptom of lung cancer. However, any persistent change in sputum should be medically evaluated immediately.

Breathing difficulties and shortness of breath are among both the early and advanced symptoms of lung cancer. Initially, shortness of breath often occurs only during physical exertion, but as the disease progresses, it may become noticeable even at rest. The advancing tumor growth, fluid accumulation in the pleura, or narrowing of the airways due to the tumor can significantly impair breathing mechanics. This can lead to specific breathing changes such as wheezing or whistling breath sounds. If these or similar symptoms occur, especially without an apparent cause, medical evaluation should be sought.

The differences in lung cancer symptoms between men and women can be explained by biological differences in lung structure, immune response, and hormonal balance. Studies show that estrogen may play a role in the development and growth of certain lung cancer types, particularly adenocarcinoma. This could explain why women are more likely to develop this form of lung cancer. Additionally, women often show a stronger immune response, which manifests in more pronounced B symptoms. Consequently, fatigue, weight loss, and night sweats occur more frequently and intensely, as the immune system reacts more strongly to tumor cells. Environmental and lifestyle factors also contribute to the differences between genders. While smoking is the main trigger for lung cancer, women are more likely than men to develop lung cancer despite never having smoked. This suggests a greater susceptibility to other risk factors such as air pollution, passive smoking, or genetic predisposition. Nevertheless, lung cancer in women is often detected late, as the non-specific symptoms are initially not associated with cancer.

A crucial step for proper treatment and therapy planning of lung carcinomas is thorough diagnostics. To detect the tumor early, various diagnostic procedures are necessary, as symptoms often become noticeable only in advanced stages. An accurate diagnosis is essential for determining the type of tumor, its stage, and individualized treatment methods.

Physical examination is vital in early lung cancer diagnosis, although not definitive by itself. Auscultation with a stethoscope can detect abnormal breathing sounds or crackles that may signal lung changes. Blood tests can identify potential lung cancer indicators, including elevated non-specific inflammatory markers like C-reactive protein (CRP) and tumor markers such as CEA (Carcinoembryonic Antigen) or SCC (Squamous Cell Carcinoma Antigen). However, these markers aren’t exclusive to lung cancer and may appear in other cancers like colorectal or cervical cancer. Additional examinations are essential for accurate diagnosis, as blood values alone cannot definitively confirm lung cancer but serve as valuable supplementary tools in the diagnostic process.

Bronchoscopy, also known as lung endoscopy, is a diagnostic procedure in which the airways and lungs are examined in detail using a special instrument called a bronchoscope. The bronchoscope is a thin, flexible endoscope that is inserted through the trachea into the bronchi and lungs. Bronchoscopy allows direct visualization of the inner walls of the airways via a camera and detection of abnormalities such as tumors, inflammations, or bleeding. Additionally, the procedure can be used to collect tissue samples for microscopic examination. Bronchoscopy is frequently performed when lung cancer is suspected, especially when the tumor is located in the larger airways. This enables the precise origin of the tumor to be determined and, if necessary, allows for early treatment.

Imaging is another crucial component in lung cancer diagnostics, as it helps to more precisely identify tumors, determine their size and location, and detect metastases. Initially, a chest X-ray is often performed to visualize irregular densities or nodules in lung tissue. This procedure is frequently the first step in examining patients with symptoms, however, it may be insufficient in early stages of a tumor. In such cases, further examination follows, usually through computed tomography (CT). This provides a more detailed view of the lungs and enables more precise localization of tumors as well as assessment of adjacent structures such as lymph nodes and blood vessels. CT also allows for early detection of metastases and lymph node enlargements, which provides important information for treatment planning and prognosis. Although CT makes a significant contribution to diagnosis, magnetic resonance imaging (MRI) is also used in certain cases. This is primarily utilized when metastases are suspected in soft tissues such as the brain or spinal cord. Another important method for evaluating lung cancer is positron emission tomography (PET), which is performed in combination with CT. By using radioactive markers, PET can visualize tumors with high metabolic activity, which is particularly helpful in recognizing the spread of cancer and visualizing metastases in other areas of the body.
Overall, these various imaging techniques play a central role in establishing a precise diagnosis, determining the tumor stage, and planning appropriate therapy.

The treatment of lung cancer is generally based on the type of tumor, the stage, and the patient’s overall health condition. The main pillars are surgery, chemotherapy, and immunotherapy, which are often combined. Surgery is usually an option in earlier stages to completely remove the tumor. Chemotherapy is used to combat cancer cells throughout the entire body, particularly in more advanced stages of lung cancer. Immunotherapy strengthens the immune system to target tumor cells more effectively. In the following, we will explain the individual therapeutic approaches to you in more detail.

Surgery is one of the most important treatment options for lung cancer, particularly in early stages (Stage I and II) and for locally confined tumors. The goal is to completely remove the tumor, usually through a lobectomy (removal of a lung lobe) or a pneumonectomy (removal of an entire lung). However, the type of surgery performed depends on the size and location of the carcinoma. Survival rates after surgery vary according to the tumor stage and the patient’s general condition. In early stages, the 5-year survival rate after successful resection can be over 60-80%. After surgery, chemotherapy or immunotherapy may be necessary to combat remaining cancer cells and reduce the risk of recurrence.

Radiation therapy is another important treatment method for lung cancer, especially when surgery is no longer possible or as a complementary therapy after tumor resection. High-energy rays are targeted directly at the tumor to destroy cancer cells or inhibit their growth. Life expectancy after radiation depends on various factors, including accompanying therapies. In early stages, the 5-year survival rate can still be over 50%, while it is significantly lower in advanced stages. Possible side effects of radiation therapy include inflammation of the lungs, skin irritation, or difficulty swallowing, depending on the radiation field.

Chemotherapy is primarily used for small cell lung cancer (SCLC) and in advanced stages of non-small cell lung cancer (NSCLC). It aims to combat cancer cells throughout the body and inhibit their growth. Depending on the individual case, chemotherapy can be applied in different ways. Neoadjuvant therapy is used before surgery or radiation to reduce tumor size, while adjuvant therapy is administered after surgery to destroy remaining cancer cells. It can also serve as primary therapy when surgery is no longer possible. In advanced stages, chemotherapy may also be used for palliative treatment, with the goal of relieving symptoms and improving quality of life.

Platinum-based agents are commonly used, often combined with other medications. Especially in SCLC, which grows very aggressively, chemotherapy initially shows good response, but relapses are common. For NSCLC, it is frequently combined with other modern therapies such as immunotherapy or targeted treatments to increase effectiveness. Despite its efficacy, chemotherapy can be accompanied by side effects such as nausea, hair loss, fatigue, and increased susceptibility to infections, as it also attacks healthy cells. Many of these side effects can be managed with supportive measures, such as acupuncture, making the therapy more tolerable for patients.

Immunotherapy has proven to be a promising treatment option for lung cancer in recent years, particularly for patients with non-small cell lung carcinoma. It utilizes the body’s immune system to specifically target cancer cells. Checkpoint inhibitors, such as PD-1 or PD-L1 inhibitors, play a central role in this treatment. By removing the natural immune brake, T-cells can be activated to attack the tumor. Immunotherapy can be used in various stages of lung cancer. It is typically applied adjuvantly after surgery to reduce the risk of recurrence, neoadjuvantly before surgery, or as a primary therapy. Patients with high PD-L1 expression especially benefit from this form of therapy, as their tumors are particularly sensitive to the immune response.

Although immunotherapy is often better tolerated than traditional chemotherapy, it can still cause side effects such as autoimmune reactions, as the immune system may also attack healthy tissue.

In addition to conventional therapy, complementary medical treatments are often used to alleviate the side effects of cancer therapy, support the immune system, and improve the overall well-being of patients.

Complementary medical approaches can make an important supportive contribution to cancer therapy by alleviating symptoms and enhancing well-being. Nevertheless, they should always be undertaken in close consultation with the treating physician to avoid risks or interactions with conventional therapy.

A lung cancer diagnosis is often a significant psychological burden for many patients. Anxiety, depression, and stress are therefore common accompanying symptoms that can severely impair quality of life. Psycho-oncological support aims to emotionally support patients and their families, accompany them through their journey, and help them cope with the disease. Among the most important approaches are talk therapies, where affected individuals can process their worries and fears. Relaxation techniques such as meditation or breathing exercises can also help reduce stress and restore emotional balance. Additionally, psycho-oncological specialists offer individual counseling that teaches strategies for coping with illness and helps facilitate acceptance of the diagnosis. This form of support can make an important contribution alongside therapy to strengthen mental health and improve quality of life despite the disease.

The curability of lung cancer depends significantly on the stage of the disease at the time of diagnosis. In earlier stages, when the tumor is still locally confined, there are good chances of cure through surgery or a combination of radiation and chemotherapy. In more advanced stages, especially when metastases have already developed, complete cure is rare. However, modern therapies can often effectively control the disease and extend life expectancy. A central concept in this context is the remission rate, which describes the extent to which cancer can be suppressed through therapy. A distinction is made between complete remission, where no more cancer cells are detectable, and partial remission, where the tumor is reduced but not completely gone. Even though lung cancer is not curable in many cases, those affected can often significantly improve their quality of life through innovative therapeutic approaches.

A lung cancer diagnosis represents a profound life change for most affected individuals. In addition to the challenging physical burdens caused by the disease and its treatment, emotional difficulties such as anxiety, uncertainty, and depressive moods often arise. Therefore, psychosocial support, self-help groups, and psycho-oncological care play a crucial role. Another important aspect is symptom control to best alleviate typical complaints like shortness of breath, pain, or fatigue. Both conventional medicine and complementary approaches are used for this purpose. Follow-up care is equally important, comprising regular examinations for the early detection of possible recurrence. Furthermore, measures regarding relapse prevention, such as smoking cessation, healthy nutrition, and physical activity, can contribute to improving the prognosis.

Note: The following section contains information about the progression of end-stage lung cancer that may be distressing for some readers.

In the end stage of lung cancer, stage 4, the tumor has often spread to other organs such as the brain, liver, or bones. This leads to a significantly reduced life expectancy, usually only a few months. The metastases can cause additional complications, including severe pain and shortness of breath. The body increasingly fails due to the advanced disease and organ involvement. Treatment in the end stage is primarily palliative, meaning it focuses on alleviating symptoms and maintaining quality of life. Palliative care therefore includes pain relief measures, support for breathing difficulties, and psychological care to help patients cope with their situation. Life expectancy for patients in the end stage varies depending on the individual disease progression. Death usually occurs due to respiratory insufficiency caused by lung failure or metastatic tumors, or through multiple organ failure.

In the following, we want to address your questions about lung cancer in more detail.

The information listed contains relevant topics and serves to improve understanding.