Your cancer

Living with the disease

Lung cancers

What is it ?

Lung cancer (also known as bronchial cancer)

affects more than 2.2 million people a year.

Patient Testimonial

Jean-François, 75 years old, retired farmer, tells us about his fight against lung cancer, which he discovered just before the pandemic. 

Nadia, 50 years old, shares her story about her lung cancer, from its discovery to its treatment.

Discover her testimony and her advice in this fight against cancer.

Types of cancer

There are two types of lung cancers,
which differ in appearance and recommended treatment:

Non-small cell lung cancer (NSCLC)

Within this category, the 3 most common subtypes are:
- Adenocarcinoma
- Squamous cell carcinoma
- Large cell carcinoma

Small cell lung cancer (SCLC)

.

Rapid progression

Lung cancer can progress rapidly. It is therefore recommended that start treatment within 6 weeks of your diagnosis.

A wide range of treatments

Many treatments are now available, including local therapies (surgery, radiotherapy, radiofrequency, cryotherapy) and drug treatments

(chemotherapy, immunotherapy, targeted therapies, some of which are taken as tablets).

These treatments are combined in different ways depending on the type, stage and location of the cancer. 

Personalized treatment

Particularly in the case of metastatic cancer, the health care team will determine the best therapeutic strategies per the exact cancer subtype based on the biopsy’s histological results and molecular biology (the study of cancer cell DNA). 

If a DNA mutation is found, targeted oral therapy will be suggested. If the PD-L1 protein is present on the majority of cancer cells, immunotherapy will usually be recommended. If the PD-L1 protein is rare, a combination of chemotherapy and immunotherapy is considered best practice. Treatment is also personalized per the patient's overall condition, taking into account other health problems.

Early supportive care

In metastatic cancer (stage IV), early supportive care has been shown to improve both quality of life and life expectancy.

Supportive care includes the treatment of the patient's symptoms and general well-being and may include psychological and social care.

Sometimes, the patient is brought to meet with a team specialized in supportive care. There is still much progress to be made, particularly at early and advanced stages of the disease, and patients should be encouraged to participate in clinical trials whenever appropriate. 

The symptoms

The most common symptoms of lung cancer include both respiratory problems and an unexplained deterioration of the patient’s general health.
They can be :

Persistent cough

Shortness of breath

Hoarseness or lowering of the voice

Unusual and persistent fatigue

Presence of blood in the sputum (coughing up blood)

Loss of appetite

Fever

Unexplained weight loss

Respiratory tract infection

Unexplained severe acute or chronic pain

Diagnostic Process

Different diagnostic exams will be performed depending on the cancer’s:

- location
- histological type (the type of cells involved)
- stage (degree of extension)

In order to have a complete diagnosis, further examinations to determine the cancer’s characteristics will be required, such as:

An imaging workup with X-ray, chest CT, brain CT or MRI and PET scan.

Histological diagnosis: following a biopsy, the anatomopathologist will determine the cancer’s histological type and subtype, highlight any biological markers and forecast treatment response (PDL1..). The biopsy can be done by fibroscopy, by CT-scan-guided biopsy or by surgical technique. 

Molecular analysis to identify cancer cells’ DNA mutation that could guide treatment.

Risk factors

There are many different risk factors for lung cancer.

The most important is the use of tobacco.

Environmental or occupational factors have an impact on the development of bronchial cancers. These include asbestos, diesel exhaust, hydrocarbons, etc. 

There is no hereditary risk associated with lung cancer.

Treatments

It is highly recommended that lung cancer patients who smoke, stop immediately.

Treatments are determined by:

  • The type of cancer: Non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC)
  • The stage of the disease: Stage I, Stage II, Stage III, Stage IV
  • If the patient is operable
  • If the tumor is resectable (i.e., can be removed by surgery)
  • Specific molecular alterations: ALK, EGFR, ROS1
  • The patient's general health and other health issues

Therapeutic strategies for "non-small cell" bronchial cancers may include surgery, chemotherapy, radiotherapy, targeted molecular therapy, and immunotherapy.

Surgery is rarely performed for small-cell bronchial cancer; chemotherapy, radiotherapy and immunotherapy are more commonly recommended.

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