General information

The primary malignant diseases of the chest are lung carcinoma (lung cancer). With an estimated number of 55,000 new cases each year in Germany, it is the fourth most common cause of death and the most common cause of death from cancer.

There are no distinctively characteristic (pathognomonic) symptoms of bronchial carcinoma. Besides a dry cough, breathlessness and the coughing up of bloody phlegm, chest pain symptoms may be indicative; furthermore, metastases can cause the following symptoms: impairment of brain function or headaches (brain metastasis), fatigue or tiredness (metastasis in the liver or in other organs), bone pain (bone metastasis).

By taking a tissue sample (biopsy) from the tumor, the diagnosis of lung cancer can be made reliably. In accordance with pathological tissue diagnostics, differentiation is made between small cell and non-small cell bronchial carcinoma (squamous cell carcinoma, adenocarcinoma, ...), differing fundamentally in prognosis and therapy.

For non-metastatic non-small cell lung cancer, surgery as a local therapy is one of the main pillars of therapy.

If metastases develop or if small cell lung cancer is more aggressive, chemotherapy is necessary. Oftentimes, a combination of different forms of treatment (surgery, chemo / immunotherapy, radiation therapy) is performed.

Additionally, so-called molecular diversification is gaining importance (for example, EGF-receptor mutations; EML4-ALK translocation; and–in a study context–mutations of K-RAS, DDR2, B-RAF; and ROS-1 translocation). Therapeutic approaches developed from this can have a positive influence on the course of the disease and treatment of lung cancer.

An overview of the available treatment modalities for lung cancer:

  • Surgery
  • Radiation therapy
  • Interventional tumor ablation (e.g. radio frequency ablation, microwave ablation)
  • Chemotherapy
  • Targeted therapy (e.g. tyrosine kinase inhibitors, antibody therapy ...)
  • Immunotherapy
  • Combination therapies as part of studies