Suomeksi

Lung Cancer

Lung cancer is the second most common form of cancer among men and it is becoming more common among women too. Often, lung cancer shows little symptoms in the early stage and the patient does not seek medical help until he/she shows a decline in general condition, weight loss and severe lung symptoms. By that time, the cancer manifestations are usually extensive.

The majority of lung cancer is caused by smoking. Work- and environment-related lung cancer is also caused by exposure to asbestos, chrome, rock dust or radon.

Lung cancer remains a difficult one to treat. It is a serious disease and causes a significant portion of cancer deaths among Finns. The five-year survival rate of all lung cancer patients has been only approximately 15%, but has slightly improved over the last years due to advanced surgical procedures, a combination of different treatment methods and new cancer pharmacotherapy.

Referral and examinations at Tays

An occupational health care doctor or general practitioner, for example, may perform a clinical examination on the patient or order a lung X-ray. If these give cause to suspect lung cancer, the doctor refers the patient urgently to Tays for further examinations.

At Tays, we perform the examinations primarily at the outpatient clinic. In the case of patients in poor condition and coming in for special procedures, we perform the examinations at the ward.

The primary examination is a bronchial endoscopy performed by a lung disease specialist. In connection with the endoscopy, biopsies of the possibly visible tumour and diverse samples are taken for diagnostic purposes. Sometimes the sample must be taken via the bronchi either surgically or through the skin under imaging guidance.

As an examination of the spread, the pulmonologist usually orders a CT scan of the thoracic cavity and upper abdomen. Sometimes, a PET scan or surgical thoracic endoscopy may also be necessary in order to determine the spread.

Based on the symptoms, other examinations may also be ordered, such as a bone scan.

Treatment of lung cancer

When the lung cancer diagnosis has been confirmed, we assess the scope of the disease, its tissue type and the overall situation of the patient in the specialist meeting of the cardiothoracic surgeons, pulmonologists, oncologists, radiologists and pathologists. This is especially important in the case when surgical treatment of a local tumour may be possible.

The primary treatment of non-small cell lung cancer, i.e. squamous cell carcinoma, adenocarcinoma and large cell anaplastic carcinoma, is curative radical surgery. Small cell lung cancer is most often treated with chemotherapy.

In radical surgery, all discovered tumorous mass is removed. The preconditions of surgery include the patient’s sufficient general condition to withstand the strain of the surgery and sufficient lung operation after the surgery, which is measured with the help of lung function tests, such as spirometry. Surgical treatment is ensured by the cardiothoracic surgeons of Heart Hospital of Tays.

If surgery is not an option, but the condition of the patient is good, the oncologists plan a treatment option that includes either cancer pharmacotherapy or radiation therapy, sometimes both. A requirement of curative radical radiation therapy is that the whole tumorous mass can be included in the target area.

If the cancerous tumour is very widely spread and the patient’s overall condition has weakened considerably, the focus is on symptom-relieving care, i.e. palliative care.

Specialised workers also participate in the treatment according to individual needs. Most often, services of physiotherapists, dieticians and social workers are needed.

Monitoring

The monitoring of a lung cancer patient is planned according to the individually performed treatment procedures and the disease prognosis. Monitoring includes doctor’s appointments, laboratory tests and imaging.

After surgery, the patient is monitored at the lung disease outpatient clinic, if he/she has not needed any adjuvant therapy. If the patient has received cytostatic or radiation therapy as adjuvant therapy, he/she is monitored at the cancer outpatient clinic for approximately two years.

Patients suffering from advanced lung cancer are treated and monitored at the cancer outpatient clinic. Patients in fully symptomatic treatment are monitored at either the palliative unit of Tays or in primary health care.

Division of work between the hospitals

Patients in the areas of Seinäjoki, Hämeenlinna and Lahti are examined and, with regard to cancer pharmacotherapy, also treated at their own central hospitals.

Patients of the Lahti area receive radiation therapy at the radiation therapy unit of Päijät-Häme Central Hospital, and patients of the Seinäjoki area in the radiation therapy unit of Vaasa Central Hospital. Other patients receive radiation therapy at the radiation therapy unit of Tays Central Hospital.