Lung cancer: chances of recovery & life expectancy

Quick overview: Frequently asked questions and answers

What are the chances of curing lung cancer? The prognosis depends on the type of bronchial carcinoma and the stage of the disease, but overall it is rather poor.

Where does lung cancer spread first? Lung cancer can spread throughout the body via the blood and lymph vessels. It usually spreads from one lung to the other.

How long do you have left to live if you have lung cancer? More than half of those affected die within one year of being diagnosed with bronchial carcinoma; the five-year survival rate is less than 20 percent.

Article contents at a glance:

What is lung cancer?

Lung cancer (bronchial carcinoma, lung carcinoma) is a malignant change in the tissue in the lungs or bronchi. A carcinoma can develop in all parts of the lungs, but most commonly in the upper parts of the lungs. This is because these regions are more ventilated during breathing and are therefore exposed to more harmful substances.

Experts distinguish between two main forms of lung cancer based on the appearance of the tumor cells under the microscope:

• non-small cell lung cancer (NSCLC): About 80 out of 100 people with lung cancer have this form. Non-small cell lung cancer develops either from cells in the alveoli (adenocarcinoma) or from the lining of the lungs and bronchi (squamous cell carcinoma). This form of cancer grows more slowly than small cell lung tumors.

• small cell lung cancer (SCLC): This form is particularly malignant because it spreads very quickly throughout the body and forms metastases. Small cell lung cancer is often only discovered at an advanced stage, which makes the prospects for a cure difficult.

Good to know: Lung cancer is one of the most common types of cancer in Germany. Almost 60,000 people are diagnosed with it every year. Bronchial carcinomas mostly occur after the age of 40, with the risk increasing with age. On average, those affected are around 70 years old.

Symptoms of lung cancer

Lung cancer often develops slowly and rarely causes symptoms in the early stages. This is why it is often only discovered at an advanced stage. However, there are certain symptoms that can indicate bronchial carcinoma and should be checked by a doctor:

In later stages of the disease, metastases (secondary tumors) can occur, causing further symptoms. Metastases can develop in the brain, particularly in the case of small cell bronchial carcinoma – these are noticeable through:

Reading tip: More about early warning signs, symptoms and complaints of bronchial carcinoma

Causes and risk factors for lung cancer

Lung cancer is caused by various factors that increase the risk of developing the disease. Around 85 percent of all cases are caused by smoking. People who started smoking at a young age and smoke a lot of cigarettes over a long period of time are particularly at risk. If harmful substances act on the mucous membranes of the lungs over a longer period of time, this promotes the formation of tumor cells.

Passive consumption, i.e. the inhalation of tobacco smoke by non-smokers, is also dangerous: experts estimate that around 300 people in Germany die of lung cancer every year because they have been passively exposed to smoke.

Other risk factors include:

• occupational risks: Some pollutants inhaled at work can cause lung cancer. These include asbestos, arsenic and polycyclic hydrocarbons. People who work in the construction or textile industries are particularly at risk.

• Lung diseases: People with chronic lung diseases such as tuberculosis, pulmonary fibrosis or chronic obstructive pulmonary disease (COPD) have an increased risk of developing lung cancer.

• Environmental influences: Environmental risk factors include fine dust from industry or diesel vehicles as well as the naturally occurring noble gas radon.

• hereditary factors: Genetic predispositions also play a role in the development of lung cancer, albeit to a lesser extent.

Lung cancer: examinations and diagnosis

If lung cancer is suspected, the patient is first questioned in detail about symptoms and possible risk factors such as previous illnesses (anamnesis). This is followed by a thorough physical examination, in which the heart and lungs are listened to and a lung function test is carried out.

If the suspicion that lung cancer is present is confirmed, further tests are ordered:

• Laboratory tests: Blood and sputum are examined in the laboratory. Tumor markers in the blood can indicate the presence of bronchial carcinoma, and abnormal cells that indicate a tumor can possibly be detected in the coughed-up mucus (sputum).

• Bronchoscopy: During this examination, a flexible tube is inserted through the nose and trachea into the bronchi. An optical device at the end of the endoscope allows the mucous membranes to be examined and secretions and tissue samples (biopsies) to be taken.

• Feinnadelbiopsie: If the suspicious area is not accessible for bronchoscopy, a fine needle biopsy is performed. A long, thin needle is inserted through the chest into the suspicious area and tissue is removed. This is usually done under ultrasound or CT guidance.

• imaging techniques: X-rays, ultrasound, computer tomography (CT), magnetic resonance imaging (MRI), bone scintigraphy and/or positron emission tomography (PET) are used to determine the extent of the tumor and to search for any metastases that may be present.

Stages of lung cancer

The treatment plan depends on the stage of the tumor. The stages are classified according to the so-called TNM system.

• “T” for the size of the tumor,
• “N” for number and location of affected lymph nodes and
• “M” for distant metastases in other organs.

A distinction is made between T1-4, N0-3 and M0-1. For example, T1 N0 M0 means: small tumor, no lymph nodes affected and no distant metastases present.

Treating lung cancer

The treatment of bronchial carcinoma depends largely on the type and stage of the disease. A combination of different therapies is often used to achieve the best possible results.

In addition, it is important to relieve accompanying symptoms such as shortness of breath, cough and pain and to treat chronic bronchitis, which is often present.

Therapy of non-small cell lung carcinoma

The first choice for treating non-small cell lung cancer is surgical removal of the tumor. Unfortunately, such an operation is only possible for around 25 percent of those affected – for everyone else, the tumor is often already too large. In addition, the procedure can only be performed if the patient’s general health is good and the rest of the lungs can take over respiratory function.

If surgery is not possible or the tumor grows into vital organs, radiation therapy and/or chemotherapy are performed. These therapies can also be carried out after surgery to destroy remaining tumor cells or at least inhibit their growth.

Treatment of small cell lung carcinoma

Small cell bronchial carcinoma grows very quickly and forms metastases early on, which is why it is rarely possible to operate on it. Chemotherapy and radiation are the main treatments here. Sometimes the skull is also irradiated to prevent the formation of metastases in the brain. However, experts do not agree on whether such preventive radiation, with its serious side effects, is always advisable.

In some cases, immunotherapy is also carried out: it supports the body’s own immune system in recognizing and fighting the cancer cells. Although immunotherapy cannot cure lung cancer, it can improve the patient’s quality of life and chance of survival.

Lung cancer: course until death

Overall, lung cancer has a rather poor prognosis because this type of cancer can spread to other organs early on and is usually diagnosed late. Small cell lung cancer in particular grows very quickly and spreads rapidly to other areas of the body via the blood and lymphatic system.

More than half of patients die within a year of being diagnosed with bronchial carcinoma. However, if discovered early and treated with surgery, chemotherapy and/or radiotherapy, some patients can survive long-term.

Those affected without any prospect of a complete recovery often have to learn to deal with symptoms such as pain, breathing difficulties, exhaustion and anxiety. However, these can be alleviated in close coordination with the treating doctors.

How can lung cancer be prevented?

The most effective method of preventing bronchial carcinoma is to stop smoking. Passive smoking in smoky rooms should also be avoided at all costs. Even after many years of smoking, it is worth quitting: This significantly reduces the risk of lung cancer and improves the prognosis if the disease is already present.

Anyone who comes into contact with carcinogenic substances at work should strictly observe the safety precautions. Respiratory protection devices and filters can reduce the risk. A healthy, vitamin-rich diet with lots of fruit and vegetables also appears to have a protective effect against lung cancer: the antioxidants contained in these foods can prevent damage to cells and thus reduce the risk of cancer.