Causes of lung sarcoma. Poor prognostic factors include: Therapy and prognosis

Lung sarcoma is a malignant disease characterized by an aggressive course. Organs respiratory system This tumor rarely affects - only 1% of cases among all oncological processes in the lungs. But, despite such exclusivity, pathology entails serious consequences. We invite you to learn about its features and treatment.

Features of the disease

Lung sarcoma is a rare but dangerous disease, often resulting in inevitable death. Of all cases of malignant lung disease, 97-99% are cancer and only 1-3% are sarcoma.

This tumor can be primary, when the tumor site appears in the respiratory tract, or secondary - the pathology develops as a result of metastases from neighboring organs. Atypical cells can penetrate into the lung tissue both through the general bloodstream and through the lymphogenous system.

Externally, lung sarcoma looks like a node - on late stages disease, it reaches impressive sizes, occupying most organ or affecting it entirely. The neoplasm, as a rule, is limited from healthy cells by the capsule, but sometimes it grows in an infiltrative manner, penetrating the parenchyma and bronchi.

Disease code according to ICD-10: C78.0 Malignant neoplasm of the lung.

Difference between lung sarcoma and cancer

The difference between these diseases is that a cancerous tumor is formed from epithelial cells that line the organ from the inside, and sarcoma is formed from the connective tissues that cover the lungs from the outside.

Classification, stages

According to the histological nature, sarcoma affecting the respiratory organs is of two types:

• highly differentiated (G1)- has low malignancy: division of atypical cells is rare, the concentration of oncoelements among healthy ones is insignificant;
• low-grade (G2)– characterized by high malignancy: cancer cells divide with high speed, the network of vessels is well developed, there are foci of necrosis;
• undifferentiated (G0)– formed from polymorphic cells, round and spindle cell structures.

By morphological classification Lung sarcoma varies into the following tumors:

• angiosarcoma is a common, highly differentiated tumor that affects the walls of blood vessels;
• pulmonary fibrosarcoma- originates from the connective tissue of the bronchi and alveoli;
• fibrolymphosarcoma- develops from lymphoid cells;
• lymphosarcoma - formed from regional lymph nodes;
• neurosarcoma - originates from the nerve plexuses of the lungs;
• chondrosarcoma - affects the cartilage of the bronchial tree;
• leiomyosarcoma - develops from smooth and striated muscles.

It is also customary to distinguish between the stages of the oncological process. This classification depends on the degree of malignancy of the tumor and its spread throughout the body. Let's look at them in the following table.

Stages of lung sarcoma	Description
FIRST	The neoplasm is up to 3 cm in size. There are no metastases. Symptomatic picture missing or blurred.
SECOND	The tumor grows up to 3-6 cm. Usually the first signs of the disease appear. Metastases are single, mainly in regional lymph nodes.
THIRD	The neoplasm exceeds 6 cm in diameter. In addition to damage by metastatic changes in the lymph nodes, invasion occurs into the pleural tissue.
FOURTH	The tumor reaches any size, and its disintegration is possible. Metastases occur in distant organs. The prognosis for survival is poor.

Causes

Experts are still figuring out the causes of lung sarcoma, and today they have their own theory on the development of this disease. Negative factors, predisposing to oncological damage to the respiratory system are:

• ionizing radiation;
• ultraviolet irradiation;
• food and household chemicals;
• smoking;
• air pollution and smoke.

Also, the causes of sarcoma may be associated with uncontrolled use of various medications and an unhealthy diet, for example, if the diet is dominated by dishes with an excess of potential carcinogens, but there are practically no fruits, greens, etc.

Who is at risk?

Most often sarcoma lung tissue found in heavy smokers. Chemical carcinogens, contained in excess in tobacco smoke, contribute to the development of malignant lung tumors, including provoking the formation of sarcoma. Both active and passive smoking are considered to be the culprits of the disease.

Promoting a healthy lifestyle and giving up this addiction will protect the smoker and his loved ones from the unnecessary risk of cancer.

Also at risk are people working in hazardous industries and those with unfavorable heredity for cancer.

Symptoms

The clinical picture of lung sarcoma is practically no different from cancer of the same location. The intensity of symptoms directly depends on the size of the tumor, its histological nature and the degree of the oncological process. At the first stage, the disease usually does not cause any symptoms.

So, we list the main symptoms of lung sarcoma:

• Signs of intoxication: weakness, increased sweating, headaches, lack of appetite.
• Shortness of breath and cardiac dysfunction associated with stagnation of blood in the organ (most often with sarcoma, the left lung is affected).
• Frequently recurring bronchitis and pneumonia, difficult to treat.
• Dry nonproductive cough of a constant nature, eventually ending in hemoptysis.

• Chest pain.
• Dysphagia is a swallowing disorder associated with metastases affecting the esophagus.
• Hoarseness of voice.
• Convulsive syndrome.
• Increased body temperature.

Diagnostics

The insidiousness of malignant tumors lies in the difficulties of early detection, since at the initial stage there are no signs of their presence in the body. As a result, a person consults a doctor after the disease has entered one of the last stages of the oncological process and curing it is quite problematic.

Lung tumors are accidentally diagnosed during routine examinations or routine X-rays of the respiratory tract, but this falls into the category of a lucky accident.

To confirm the diagnosis of sarcoma, it is necessary to carry out the following laboratory and instrumental studies:

• General and biochemical blood test. Reveals indirect signs of a tumor process in the body due to increased ESR indicators and decreased hemoglobin.
• CT and MRI. The presence, exact location, size and shape of the neoplasm are determined.
• Radiography. Specifies the parameters of the tumor, the degree of damage to the lung.
• Videothoracoscopy. It establishes not only the type of sarcoma and its spread to other organs and systems, but also allows you to obtain a sample of biomaterial for further histological examination.
• ECG. Indicates changes in the functioning of the heart.
• Biopsy. Confirms or denies the malignancy of the neoplasm, determines the type of tumor.

Treatment

Therapy for lung sarcoma can be successfully carried out using an integrated approach that combines surgery, radiation and chemotherapy.

The main role in the treatment of this disease is played by surgery. Depending on the stage of the oncological process, age characteristics and general well-being of the patient, the doctor chooses one of three types of surgical intervention:

• Lobectomy - removal of a lobe of the lung.
• Pneumonectomy - resection of the entire lung.
• Segmentectomy is resection of one of the segmental sections of an organ.

If a person is in in serious condition or he has contraindications for surgery, the tumor is removed using a radiosurgical method, the so-called CyberKnife. This is a remote treatment option for sarcoma; its integrity does not suffer skin And healthy cells, only oncoelements are affected. Unfortunately, this method is effective for small malignant lesions - in the later stages of the disease, it can only be used to stop the growth of the tumor, reduce its size, but not affect the disease itself.

Chemotherapy is recommended before and after surgery. The patient is prescribed a regimen of cytostatics - medications aimed at destroying atypical elements in the body. If we are talking about the inoperable stage of lung sarcoma, chemotherapy becomes one of the main methods of treatment - even if there is no 100% effect, it improves the patient’s quality of life.

Radiation therapy is often used in conjunction with chemotherapy. In addition to its targeted effect on lung sarcoma, it also works against its metastases. Both methods complement each other perfectly, enhancing the effectiveness of the treatment.

If the severity of the disease refers to the fourth stage of the oncological process, the methods listed above often turn out to be powerless and even dangerous for the patient, especially when it comes to children and the elderly. On last stage It is no longer possible to destroy the sarcoma tumor. Therefore, doctors resort to palliative medicine - symptomatic care that improves the patient’s quality of life. For this purpose, methods such as oxygen therapy, pain relief, feeding through a tube and much more are used.

Is it possible for both lungs to be affected at the same time?

Yes, this situation occurs, mainly in the last stages of the oncological process. According to observations, the primary cancer focus most often forms in the left lung, but due to the active growth of the sarcoma over time, the lesion can completely cover both organs. In this case, radical treatment in the form of surgery does not make sense, because a person cannot live without the main structural elements of the respiratory system. In order to improve the clinical picture, such a patient is prescribed chemotherapy and radiotherapy and palliative support.

Is a lung/lung transplant done for cancer?

Respiratory organ transplantation is a severe operation aimed at completely or partially replacing damaged lungs. incurable disease, using donor material. This method allows you to prolong and improve a person’s quality of life, despite the difficult recovery period.

But in cases of cancer, a transplant of one or both lungs is not performed. The fact is that after surgery, therapy with immunosuppressants is necessary - drugs that temporarily suppress a person’s immune system so that donor organs are not rejected. Unfortunately, this moment becomes the reason for the progression of sarcoma.

Traditional treatment

Any means of informal medicine for malignant processes should be used with prior agreement with a doctor. Lung sarcoma is characterized by aggressiveness and rapid growth and development, so the use of medicinal herbs and other products with unproven effectiveness and delaying a visit to a specialist can lead to a loss of time, which would be enough to carry out the operation and save the patient’s life.

In addition, the tumor has a different histological picture, and choosing a specific folk recipe to combat it is an almost impossible task. Of course, it would be wrong to completely doubt the success of unofficial medicine in the fight against oncology, but this method cannot become the only one in the treatment of lung sarcoma.

Recovery process

When the therapeutic manipulations are considered complete, the patient is transferred under the supervision of specialists from a medical institution. On postoperative stage he is prescribed such studies as:

• CT scan;
• radiography;

During the first year after treatment, the patient will have to visit the doctor regularly every 2 months. Thanks to frequent monitoring, it is possible to timely detect a recurrence of the oncological process and take the necessary therapeutic measures.

Diet

Organization of nutrition for lung sarcoma, both during and after treatment, is of no small importance. Balanced diet can alleviate the painful clinical manifestations of a malignant tumor and improve the condition of the immune system.

Persons diagnosed with pulmonary tissue sarcoma are necessarily recommended to eat small, frequent meals up to 6 times a day, which allows them to maintain all the vital functions of the body in a certain tone.

So, patients with this cancer should include in their daily menu:

• wholemeal bread and pasta, cereals, pork and nuts. Saturate the body with vitamin B, which improves resistance to infectious agents and restores the functional activity of all internal organs and systems;
• fresh vegetables and fruits, butter, chicken and beef liver, milk and products based on it. All of the listed dishes contain a huge amount of vitamin A, which, as an antioxidant, neutralizes dangerous radicals and accelerates the regeneration of damaged cells;

• black currants, viburnum, rose hips, kiwi, bell peppers, citruses, herbs. These products are enriched with vitamin C, a component that is directly involved in the construction of connective tissue and is also responsible for removing waste and toxins from cells.

The following dishes are contraindicated for pulmonary sarcoma:

• flour, sweet, confectionery. Carbohydrates, which this food is rich in, enhance tumor growth and increase the likelihood of oncological processes;
• fatty, fried and smoked. Contain dangerous components that increase the risk of malignant tumors.

To prevent the development of sarcoma, you should also adhere to the listed principles, organizing your diet according to the rules of a healthy lifestyle.

Complications

The only serious complication of lung sarcoma is death. Unfortunately, statistics claim that a small percentage of people who were diagnosed with the disease at an early stage of the oncological process have a chance of a complete cure.

The consequences also include deterioration in the functioning of organs where the primary tumor site and metastases are localized. With the development of lung sarcoma, the patient’s quality of life only worsens.

Relapse

Relapses make themselves felt in at least 80% of cases, which negatively affects the five-year survival prognosis of such patients. Most often, the secondary development of pathology is noted already in the first 2 years of a person’s life, despite previous successful treatment.

Recurrent tumors behave more aggressively than the primary tumor lesion, so such patients usually fall into the category of inoperable patients, and the situation ends in death.

Course and treatment of the disease in children, pregnant and lactating women, the elderly

Children. In childhood, there is active growth of connective, muscle and bone tissue, therefore, when a child’s lungs are affected by sarcoma, aggressive tumor growth is observed with frequent relapses. The disease in such young patients is caused by heredity, mutations in tissues due to the influence of unfavorable external factors, weak immune system and associated respiratory pathologies. Clinical manifestations, treatment and prognosis of lung sarcoma in children are typical, as for an adult.

Pregnant and lactating women. Expectant and nursing mothers also experience cancer, the detection of which requires urgent intervention, taking into account the unfavorable course and outcome of the pathology. If a tumor is detected in the first half of gestation, doctors will insist on immediate termination of pregnancy and appropriate treatment. From the 20th week, specialists try to preserve the life of the fetus by prescribing special therapy that accelerates the development of the unborn child’s lungs and induces premature labor. A patient with pulmonary sarcoma should refuse breastfeeding due to upcoming treatment associated with radiation and other negative factors.

Advanced age. In older people, sarcoma is often diagnosed in the last stages of cancer, and surgical intervention in such patients is usually contraindicated due to the presence of concomitant somatic pathologies. The prognosis is extremely unfavorable.

Treatment of lung sarcoma in Russia, Israel and Germany

Treatment of lung sarcoma is carried out in any country in the world. The methods of therapeutic approach in them may differ depending on the level of medicine. Clinics in our and foreign countries use modern diagnostic and treatment protocols. Russian doctors diligently adopt the experience of foreign specialists and successfully implement it. It should also be noted that prices for cancer therapy are several times lower than in Israel and Germany.

Treatment in Russia

The fight against lung sarcoma in our country is due to an integrated approach to solving the problem. A treatment program is developed individually for each patient by a whole group of doctors - morphologists, oncologists, surgeons and chemotherapists. With its help, specialists strive to achieve an effective result in relation to the tumor.

Let's look at the clinics where you can go with lung sarcoma.

• Moscow Research Oncology Institute named after P.A. Herzen. The first institution of this type in Russia with a century-old history.
• Clinical Hospital No. 85 FMBA, Moscow. A modern center providing its patients with a full range of services.
• National Medical Research Center for Oncology N.N. Petrova, St. Petersburg.

We invite you to find out what reviews these medical institutions have.

Nadezhda, 35 years old. “Lung sarcoma was discovered quite early in my grandfather at the age of 67. At the Petrov Oncology Research Institute, surgery and chemotherapy were performed. Everything is absolutely free, the staff is friendly, there are no complaints about the medical institution. After treatment, he lived for about two more years, and a relapse occurred.”

Marianna, 40 years old. “With a diagnosis of left lung sarcoma, my husband was sent to the Research Institute named after. Herzen. There, additional examination and complex treatment were carried out. The husband stayed in the hospital for several months. During this time, he was provided with proper care, daily visits and walks around the hospital grounds were allowed. The operation and radiation therapy were completed successfully. A year has passed since discharge, and I am constantly being monitored by an oncologist at my place of residence.”

Treatment in Germany

The fight against lung sarcoma in Germany is characterized by certain successes and effectiveness. German clinics treating cancer patients are equipped with high-precision diagnostic methods, which guarantees positive result treatment performed.

Where can you get help in Germany with lung sarcoma?

• Helios Clinic Berlin-Buch (HELIOS-BUCH), Berlin. Provides patients with high-quality oncology services.
• University Hospital of Geldeiber, Geldeiber. Oldest medical institution in Germany, specializing in the treatment malignant diseases.
• University Hospital Essen, Essen. One of the leaders in the field of high-precision diagnostics and modern treatment of sarcomas.

Now let's look at the reviews about some of them.

Galina, 56 years old. “The service and assistance provided at the Essen Clinic is beyond praise. There were a lot of hopes placed on her, because with sarcoma, every minute counts. I was one of the lucky ones - everything went well, I’ve been at home in Russia for 2 years now and there are no relapses of the tumor. I still keep in touch with doctors via the Internet, I am very grateful to them.”

Olga, 47 years old. “My mother underwent surgery at the Helios-Berlin-Buch clinic, it was successful, there were no metastases. I liked the attitude of the medical staff, the care and rehabilitation after treatment. At discharge, recommendations for follow-up were given. Six months have passed, everything is fine.”

Treatment of lung sarcoma in Israel

The successful fight against malignant sarcomas in Israel is reliable in modern oncology. Specialists provide the necessary diagnostic and treatment services to both their own and foreign citizens at the highest level.

So, where can you get treatment for lung sarcoma in Israel?

• Medical Center "Ramat Aviv", Tel Aviv. The institution is licensed by the Ministry of Health and enjoys its support.
• Meir Clinic, Kfar Saba. One of the most modern and largest in Europe.
• Assuta Medical Center, Tel Aviv. The most famous Israeli complex offering advanced technologies in the fight against sarcomas in the world.

Let's consider reviews about the listed medical institutions.

Marina, 35 years old. “On the advice of friends, in September we went to Tel Aviv, the Ramat Aviv medical center, which now belongs to the Russian businessman M. Prokhorov. Here, my mother had a sarcoma of the left lung removed and several sites of metastases were treated with radiotherapy and chemotherapy. I can say that everything went well, although it is too early to talk about the results - experts warned that tumor relapses occur in almost 90% of cases. We hope for a miracle, but it already exists, my mother is alive.”

Vladimir, 37 years old. “My father, a heavy smoker with 40 years of experience, was diagnosed with lung sarcoma. They decided to undergo treatment in Israel, placing all their hopes on foreign doctors. We contacted the Meir clinic, received a call, but the operation upon arrival was canceled due to the advanced state of the oncology, damage to both lungs and the inappropriateness of the surgical approach. They performed radiotherapy and chemotherapy and gave recommendations for home treatment. Father lived another 8 months.”

Relationship between lung sarcoma and asthma

These two pathologies are not related to each other. It cannot be argued that chronic obstructive pulmonary disease, in particular, bronchial asthma, eventually turns into sarcoma or cancer - they are not a complication of COPD. Such studies have been conducted, but no relationship between them has been identified.

Breathing exercises for sarcoma

Therapeutic gymnastics, exercise therapy activities, breathing exercises help to partially get rid of inflammation and pain in the lung area, but it is impossible to cope with their help against a malignant neoplasm. Such methods are usually used at the stage of recovery of the body after surgical therapy. It is strictly prohibited to carry them out without the appointment and supervision of a specialist.

Metastases

Metastases are secondary cancer foci formed as a result of the separation of an atypical cell from a primary tumor, which ends up in a blood or lymphatic vessel and moves throughout the body, lingering anywhere and developing into a new malignant process.

The clinical manifestations of metastases depend on the location of the tumor. In lung sarcoma, the nearby lymph nodes are first affected, followed by the liver, brain and skeletal system.

Survival prognosis

Lung sarcoma is a dangerous disease characterized by the highest mortality rate. The tumor is aggressive and prone to frequent relapses, so even with early diagnosis and timely treatment, no more than half of the patients remain alive after 5 years, even under such favorable conditions.

We propose to consider in the table how many chances of life a sarcoma of the lung tissue gives, depending on the stage of the oncological process.

Stages	Success rate
FIRST	50,00%
SECOND	30,00%
THIRD	20,00%
FOURTH	0,00%

As can be seen from the table, people with last stage The disease has virtually no chance of recovery and survival - most of them, even with treatment, die within 3-4 months after diagnosis. Death is usually associated with pulmonary embolism, respiratory failure, metastases and secondary infections.

The five-year survival prognosis for all patients with this diagnosis is 3-17%.

Prevention

Primary measures to prevent cancer are aimed at eliminating unfavorable factors that increase the likelihood of lung sarcoma. These include:

• promoting a healthy lifestyle, in particular, quitting smoking;
• carrying out work to clean the surrounding atmosphere, for example, air filtration in hazardous industries.

Secondary measures are based on a routine preventive examination of the lungs, timely treatment of infectious and inflammatory diseases of the respiratory tract, and increasing human immunity.

If a patient has undergone surgery to remove sarcoma in the past, he should be careful about his own health. If symptoms such as fever, nausea and vomiting, signs of swelling and infection appear, you should consult a doctor as soon as possible. Timely contact with a specialist will help prevent the development of relapse and positively affect the patient’s life expectancy.

Are you interested in modern treatment in Israel?

One of malignant neoplasms, developing from immature cells of connective tissues, is sarcoma of the lungs and bronchi. Main feature This pathology is characterized by a large number of malignant elements and a high degree of aggressiveness. In cases of primary sarcoma, the neoplasm immediately affects the mesodermal layer of the pulmonary system (interalveolar septa and connective tissue of the bronchial walls). Secondary damage occurs due to metastases of the tumor, which develops from the connective tissues of other organs.

The most common location of the tumor is the peripheral parts of the upper lobes of the lung, but sometimes the tumor affects the entire organ. In rare cases, the tumor affects large bronchi and appears as polyps. Basically, the neoplasm is a massive node with a polycyclic or round shape. The consistency of the tumor is soft, and when cut it has a pale pink tint. Oncopathology spreads more often through the bloodstream (hematogenous route).

The development of the disease is more often observed in men aged twenty to forty years. Moreover, this pathology accounts for only one percent of all types of lung cancer. The disease sarcoma progresses with symptoms such as shortness of breath, cough, pleurisy, pericarditis, pneumonia, and fever. Treatment methods and prognosis depend on which of the four stages the disease is detected at. To make a diagnosis, X-rays, bronchoscopy, biopsy and others are performed. diagnostic measures. Early diagnosis in pulmonology can improve the effectiveness of operations in thoracic surgery.

Any person, especially if he is at risk, needs to know what lung sarcoma is, and also why it can develop. The exact causes of sarcoma have not been established by doctors, but according to statistics, the pathology most often occurs in people who are exposed to ultraviolet radiation, ionizing radiation, and exposure to chemicals. A lot of cases of sarcoma are recorded in areas with polluted and smoky air. Under the influence of these factors, changes occur in the lung tissues, leading to pathological and uncontrolled cell division.

People who smoke or work in hazardous industries with carcinogenic substances such as asbestos, aniline dyes, and pesticides are at risk. People who abuse sunbathing and tanning in solariums are more susceptible to sarcoma. Several times more often, the pathology occurs in those whose family already had cases of sarcoma (genetic predisposition). Secondary view The disease can occur in the chest, soft tissues, and mediastinum.

Stages

The stages of development of lung sarcoma are determined by the size of the tumor and metastasis to other organs. Treatment methods and prognosis of pathology depend on the degree of development of the oncological process. There are four stages of lung tissue sarcoma:

1. At the first stage, a single limited node no more than three centimeters in diameter is present in the lung;
2. At the second stage, the neoplasm reaches six centimeters in size and metastasizes to the lymph nodes of the root of the organ and to the peribronchial nodes;
3. At the third stage, the tumor size exceeds six centimeters, metastases occur in the intrathoracic lymph nodes and grow into the pleural tissue;
4. The fourth stage is characterized by a tumor of any size and metastasis to any near and distant organs.

The sooner the patient visits a doctor after the onset of the pathology, the greater the chance of recovery, since this type of cancer progresses very quickly. Unfortunately, early diagnosis is often difficult, since in most cases only at stage 3 the first significant signs appear.

Symptoms

With lung sarcoma, symptoms may appear when the pathology has already reached the third stage. If the tumor grows inside the bronchus, the patient experiences obstruction. With this disease, the symptoms also depend on the stage of development of the pathology. In most cases, sick people experience typical symptoms:

• shortness of breath;
• painful sensations in the chest;
• cough with sputum and bloody streaks;
• increased body temperature;
• increased sweating, especially at night.

When making a diagnosis, the doctor sees foci of necrosis on an x-ray. There is also a disturbance in the general condition of the patient - constant increasing weakness, rapid fatigue, decreased performance, lack of appetite, loss of body weight. If the tumor grows into the esophagus, dysphagia (problems with swallowing) occurs. When the tumor begins to exert compression on the venous trunks, superior vena cava syndrome develops. When infiltrating into the pleura, the patient is faced with hemorrhagic pleurisy, and into the outer layer of the heart - with hemorrhagic pericarditis.

Diagnostics

Since a neoplasm in the early stages almost never reveals itself as a clinical picture, diagnosis can be difficult. In rare cases, a tumor is discovered by chance during a routine examination or during routine fluorography. In order to make a diagnosis of lung sarcoma, it is necessary to conduct the following studies:

• general and biochemical blood test;
• computer and magnetic resonance imaging in pulmonology;
• X-ray examination of the lungs or fluorography;
• videothoracoscopy of the chest;
• heart electrocardiogram;
• radioisotropic research;
• contrast angiography;
• fine needle biopsy;
• histological and cytological examination biopath.

Only after carrying out the above measures can the doctor prescribe pulmonary therapy, depending on the stage of the oncological process, the age of the patient and his general condition.

Treatment of the disease

Sarcoma treatment is carried out using a comprehensive approach, including immunotherapy, surgery, chemotherapy and radiation therapy. The most effective is surgical intervention, during which the sarcoma cells and the entire affected segment are removed (segmentectomy). If the tumor is of a significant size, part of the lung lobe may be removed (lobectomy), the entire lobe, or the entire organ (pneumonectomy). In cases where the patient is in serious condition or surgery is contraindicated for him, the tumor is removed using a cyber knife (radiosurgery method of treatment).

Before surgery, it is necessary to take high doses of cytostatic drugs, this will help reduce the size of the tumor. For inoperable sarcoma, chemotherapy is performed as palliative treatment. Radiation therapy before surgery complements the effect of chemical drugs, and after tumor removal helps get rid of metastases and residual cancer cells, which reduces the risk of relapse. Treatment and prognosis of sarcoma are closely interrelated; much depends on what therapy was given to the patient and how his body responded to it.

Prognosis and prevention

Oncology sarcoma is aggressive and very dangerous disease, in which a very high percentage of deaths is recorded. How long people live with this disease depends on the stage at which it was discovered. This cancer pathology is so severe that even if the doctor detects it at the first stage and carries out appropriate treatment, only half of the patients can count on five-year survival. When diagnosed in the second stage, only thirty percent of patients survive.

If a person does not pay attention to the first signs of the disease and consults a doctor already at the third stage, then he has only a five percent five-year survival rate.

The fourth stage is fatal. A person who has advanced the disease to this extent dies within three or four months. The same thing awaits patients with secondary lung damage. There is no specific prevention for this pathology, but there are simple rules that can reduce the risk of its development:

1. Quitting smoking and other bad habits;
2. Wearing a respirator when working with hazardous substances;
3. Annual fluorographic examination or x-ray.

Unfortunately, this will not give a 100% guarantee of preventing the disease, but by identifying sarcoma early stage, a person has a greater chance of successful treatment of the pathology.

Lung sarcoma is a malignant neoplasm that affects lung tissue and metastasizes to other organs. Consider the features of this disease, diagnostic methods, treatment methods, as well as survival prognosis.

Unlike other types of cancer, sarcoma manifests itself by its increased aggressiveness, rapid growth and division of mutated cells.

As a rule, lung sarcoma is a tumor lesion of the mesoderm, that is, connective tissue. Unlike other malignant diseases, it is characterized by very rapid growth and distant metastases. Sarcoma has two types, which determine the degree of malignancy of the tumor:

• Low degree of malignancy - such neoplasms arise from highly differentiated cells that divide slowly. The neoplasm contains few malignant elements and a lot of stroma.
• High degree of malignancy - sarcoma occurs from poorly differentiated cells that divide quickly and frequently. Such cells contain many malignant elements and little stroma. The tumor is characterized by a well-developed vascular network and the presence of necrotic foci.

Lung sarcoma is characterized by a high degree of malignancy, although the neoplasm itself is quite rare disease. Thus, according to medical statistics, for one lung sarcoma there are about 100 cases of lung cancer. That is, it occupies 1% of all malignant lung lesions, but is highly malignant. As a rule, sarcoma originates from the connecting interalveolar septa or bronchial walls. Most often, the upper lobes are affected (part of a lobe or the entire lobe), but complete damage to the lung is also possible.

The lung consists of many structures and elements and has connective tissue. Lung sarcoma combines many other types of neoplasms, which are divided according to the degree of differentiation.

Highly differentiated:

• Angiosarcoma - affects the blood vessels pulmonary vessels, its different layers and walls. It is the most common neoplasm.
• Chondrosarcoma - originates from cartilaginous tissue, usually develops from the third germinal layer of the lung.
• Fibrosarcoma - can develop from the connective tissue of the bronchi or surrounding tissue. In second place in terms of frequency of occurrence.
• Neurosarcoma - develops from connective tissue, which is part of the nerve trunks.
• Hemangiopericytoma - originates from the cells that surround blood vessels - pericytes.
• Lymphosarcoma, the third most common neoplasm, develops from the tissue of the lymph nodes.
• Liposarcoma is rare and originates from adipose tissue.
• Rhabdomyosarcoma and leiomyosarcoma are neoplasms of striated muscle and smooth muscle tissue of the lungs.

Undifferentiated sarcomas are the cells from which they develop at different stages of development, so their further functions are not defined. That is, one cell can become part of muscle tissue or become part of a tendon. Undifferentiated cancers behave unpredictably, quickly and often metastasize; metastases spread hematogenously, that is, through the bloodstream. Typically, spindle cell, round cell and polymorphic cell sarcomas are found.

ICD-10 code

C78.0 Secondary malignant neoplasm of the lung

Causes of lung sarcoma

The causes of lung sarcoma are not fully understood, but there are a number of factors that provoke the appearance of a neoplasm and other malignant neoplasms.

• Air with a high content of carcinogens (gas, soot, exhaust) is the main cause of lung sarcoma.
• Heredity – lung sarcoma can develop in childhood. Predisposition to malignant neoplasms and the influence of provoking factors lead to the appearance of a tumor.
• Bad habits, especially smoking.
• Poor ecology and high doses of radiation negatively affect not only the lungs, but also the overall functioning of the body.

Quite often, lung sarcoma appears as if out of nowhere, for no apparent reason, spontaneously. The etiology of this disease is sometimes difficult to identify. But still, the most promising reasons can be voiced:

• Burdened heredity. A person whose family has already had cases of this disease needs to undergo preventive examinations more often, since there is a high risk of cancer in other blood relatives.
• Chemical carcinogens: minimize the use of household chemicals at home, avoid toxic gases that can enter the respiratory tract.
• Take medications with caution. Do not self-medicate.
• Limit ionizing radiation: prolonged exposure to the scorching rays of the summer sun, limited visits to the solarium.
• Bad habits, and, in particular, smoking.
• Environmental pollution.
• Receiving significant doses of radiation.

Symptoms of lung sarcoma

Lung sarcoma can appear at any age, but, as observations have shown, this pathology is more common in white-skinned people. In this case, the age of risk is after forty years.

So what are the symptoms of lung sarcoma?

• A person begins to quickly lose strength, and the body’s fatigue increases. Shortness of breath appears, caused by hypertrophy of the right heart.
• Dysphagia. There are difficulties when swallowing food and liquids. Metastasis also penetrated into the esophagus.
• Nausea and vomiting.
• Headache and dizziness.
• Cramps.
• Hoarseness of voice.
• Increase in the size parameters of the tumor neoplasm.
• Pathology of the pulmonary (pulmonary) circulation appears as a consequence of stagnant processes occurring in the lungs.
• Pleurisy. There is a frequent manifestation of inflammatory processes in the pleura, both of a cold and infectious nature.
• There is a syndrome of compression of the superior vena cava, which occurs under the influence of a growing tumor, or due to an increase in the size of the heart muscle.
• The patient constantly complains of signs of a cold (long-term, persistent pneumonia), which do not go away even when taking medications.
• As a result of tumor growth and its metastasis to neighboring organs, the symptoms of lung sarcoma can be further supplemented based on which organ has been affected pathologically.

The symptoms are practically no different from clinical symptoms lung cancer. The intensity of the symptoms that appear depends on the size of the neoplasm, its location and stage of development. As a rule, patients complain of fatigue, shortness of breath, difficulty swallowing food, and pleurisy. Hypertrophy of the right side of the heart is possible due to stagnation of blood in the lungs. The growth and development of sarcoma causes compression of the superior vena cava. Patients may experience long-term pneumonia that cannot be treated. In later stages, symptoms become generalized, cause cachexia and metastasize.

Lung sarcoma is very rare, but appears more often in older men than in women and, as a rule, affects the left lung. According to medical statistics, the most common cause of neoplasm is work related to occupational hazard(finger, chemicals, radiation exposure) and bad habits, namely smoking.

Lung sarcoma can be either primary, that is, develop from lung tissue, or secondary, which is a metastasis of sarcoma from other organs and parts of the body. The secondary form is more common and is detected much earlier than the main tumor focus. Since the symptoms are similar to those of lung cancer, the patient develops an intractable cough, shortness of breath and profuse sputum with blood. But unlike cancer, sarcoma causes an increase in body temperature, severe general weakness and pallor of the skin.

Sarcoma metastases to the lung

Sarcoma metastases to the lung are quite common occurrence, which occurs with tumor lesions of the mammary gland, thyroid gland, liver, and intestines. Metastases in the lungs can appear with various types of neoplasms, hypernephromas, melanomas, semionomas and chorionepitheliomas; may have the form of a single node, but more often multiple, up to 5-6 cm in diameter, have a white or gray-pink color, possibly partially pigmented brown-black.

Metastases to the lung can form branching and diffuse networks, in the lung tissue and under the pleura. Such metastasis is characteristic of cancerous lymphangitis. In rare cases, metastases cause miliary lymphogenous carcinomatosis of the lung. With aspiration metastases, the tumor disintegrates in the overlying parts of the respiratory tract or grows into adjacent tissues. Metastatic nodes in the lungs can re-metastasize to other organs and tissues.

• Metastases of sarcoma in the lungs may not make themselves felt for a long time and may not cause painful symptoms. Most often, a tumor lesion is detected by a routine preventive X-ray examination of the chest.
• Symptoms appear when tumor process the pleura and bronchi are involved. In this case, the patient suffers from chest pain, dry cough with sputum, possibly hemoptysis and fever for a long period of time.
• Symptoms of lung damage cause general deterioration and weight loss. The course largely depends on the primary tumor, multiple or single lesions and previous treatment.

If metastases in the lungs are multiple in nature, then x-rays reveal large focal foci of compaction of the lung tissue of a round shape with clear outlines, which are scattered throughout the lung, but most often in the peripheral parts. Possible hematogenous small-focal metastasis. At multiple lesions single metastases appear, round in shape with clear outlines, up to 10 cm in size.

If sarcoma metastases into the lung grow into large bronchi, this leads to bronchostenosis. On X-ray examination, the lesion appears to be primary lung cancer. Solitary and multiple metastases can disintegrate and form cavities various thicknesses. Most often, the decay cavity appears closer to the periphery of the metastatic tumor node. If metastasis has lymphogenous spread, then the picture is similar to cancerous lymphangitis. When performing an X-ray examination, sarcoma metastases look like expansions and compactions of roots that penetrate into the lung tissue, scatter in a fan-shaped manner and form a thin mesh. Small nodular shadows are clearly visible against the background of the mesh pattern.

To make a diagnosis, anamnesis data and clinical examination of other organs and systems are of particular importance. It is mandatory to conduct a biopsy and differential diagnosis with lung cyst, benign lung lesions, primary lung cancer and pneumonia.

Treatment of sarcoma metastases to the lungs depends on the type of tumor lesion. Thus, for solitary metastases that appear after treatment of the primary tumor, that is, after a long period of time, surgical treatment is used. The patient has a segment or lobe with a tumor node removed. With multiple metastases in the lungs, the patient is treated with chemotherapy or prescribed hormonal drugs that are sensitive to the underlying tumor.

Radiation therapy is carried out for multiple metastases, contamination of the lungs with cancer cells in Ewing's sarcoma, Kaposi's sarcoma, osteogenic and reticulosarcoma. This type of treatment can be used if surgical treatment is not possible. In all other cases, symptomatic therapy is used for treatment. Sarcoma metastases to the lungs have a poor prognosis. Long-term survival of patients is possible with removal of the primary tumor and a full course of therapy.

Kaposi's sarcoma of the lungs

Kaposi's sarcoma of the lungs is a systemic disease that most often affects the skin and mucous membranes. But with this type of neoplasm, internal organs and the lymphatic system suffer. Damage to the lungs by Kaposi's sarcoma occurs against the background of the spread of cancer cells throughout the body, that is, as a result of metastasis, although isolated damage to the lungs is also possible.

The disease is characterized by nonspecific clinical symptoms: sudden loss weight, fever. Patients may complain of pleural chest pain, shortness of breath, hemoptysis, stridor (heavy, noisy breathing). An X-ray examination reveals bilateral (parenchymal, interstitial) infiltrates. The tumor has unclear outlines and massive pleural effusion.

To confirm Kaposi's sarcoma, differential diagnosis and lung tissue biopsy are performed. The patient undergoes transbronchial and endobronchial biopsies, bronchial brush biopsies and pleural studies. Patients exhibit typical manifestations of Kaposi's sarcoma, which look like damage to the trachea and bronchial tree.

Diagnosis of lung sarcoma

Any doctor will agree that the earlier the disease is diagnosed, the better the patient’s prognosis. This is especially true for cancer. The insidiousness of cancer is that it is possible to detect them in the early stages of development only by chance, since cancerous tumors do not manifest themselves in any way at the initial stage of development: no pain symptoms, the person feels quite satisfactorily. Therefore, the patient consults a doctor when painful symptoms begin to appear, and this, most often, is an already advanced, severe stage of the disease.

How is pulmonary sarcoma diagnosed?

• Clinical studies: Blood tests in advanced disease show elevated ESR and varying degrees of anemia.
• Magnetic resonance imaging (MRI). Allows you to determine the classification of the lesion, tumor parameters, and its shape.
• CT scan .
• X-ray examination lungs. It also allows you to determine the dimensions and lung shape and the cancer present, the nature of the lesion.
• Electrocardiogram (ECG) – it is necessary to monitor the function of the heart.
• Radioisotope research. Makes it possible to obtain the difference in the quantitative content of isotopes in healthy and cancerous tissues.
• Angiography. Control of disturbances in the functioning of the blood vessel system.
• Biopsy. Taking samples for histological examination, to determine the type of cancer cells.
• Doppler study of the functioning of the heart and blood vessels of the circulatory system of the pulmonary circulation.

Treatment of lung sarcoma

Treatment of lung sarcoma is divided into several stages.

Surgical treatment of lung sarcoma

It is performed for local damage to the lung and can lead to complete recovery. This type of treatment eliminates painful symptoms, increases patient survival, and is palliative. During surgery, an endarterectomy of the sarcoma can be performed, the entire lung or part of it can be removed.

Surgery involves removing the tumor within healthy tissue. If the patient’s condition is severe and abdominal surgery is impossible, doctors use the radiosurgical method of removal. To do this, use a cyber scalpel or a gamma knife, which are a type of radiotherapy. The use of high-tech methods gives a positive treatment effect for lung sarcoma.

For any manifestations of oncology, including pulmonary cancer, oncologists strive for complete removal of tumor tissue. This method, with local placement and a small coverage area, allows you to bring the patient to complete recovery, otherwise, alleviate the patient’s condition and prolong his life.

Based on the clinical picture, the oncologist resects the entire tumor along with the adjacent tissues. But such an operation is justified if the cancerous tumor is local and has not metastasized to other areas of the lung, capturing large volumes. If the affected area is large, then surgery may be completely ineffective.

An oncologist, planning or not planning an operation, based on the picture and severity of the pathology revealed by the diagnosis. But there are also some criteria that do not allow surgical intervention.

Doctors include contraindications to surgery for lung sarcoma:

• Heart failure.
• Kidney failure.
• Pathology of the pleura.
• Tumor growth outside the lung.
• General weakness of the body.
• Metastasis to other areas of the human body.
• And many other factors.

If, according to all indicators, the operation must be carried out, then the oncologist surgeon determines the plan of the operation and its scale, since the surgical intervention can be gentle (wedge resection), when some segment of the lung is resected, or more extensive, if necessary removal of the entire lung. Naturally, it is impossible to completely remove both lungs. Therefore, when considering each specific case, the doctor is obliged, after weighing all the pros and cons, to come to the optimal decision. Result of the operation: to leave as much healthy lung tissue as possible, while as much cancer-affected matter as possible should be resected. This enables the patient to better adapt to life in new physiological conditions of the body’s functioning. This also reduces the likelihood of repeated relapses. That is, the result of surgery for lung sarcoma largely depends on the competence and experience of the operating oncologist.

In addition to the tumor and nearby tissues, lymph nodes that fall within the area where the pathology is located are usually removed. This helps prevent relapses and gives the patient a good chance of recovery.

Chemotherapy for lung sarcoma

This type of treatment is as important as surgery. Chemotherapy can destroy sarcoma metastases in the lung and significantly reduce the size of the primary tumor. Adequately selected chemotherapy drugs reduce the rate of development of sarcoma. Chemotherapy can be given both before and after surgery. Radiotherapy is used to remove metastases in other organs and is very often combined with stereotactic radiosurgery methods.

Treatment, as with cancer lesions, is combined. Very often, chemotherapy, immunotherapy and surgical methods are used for treatment. But unlike cancerous tumors, sarcoma is more resistant to chemotherapy. That is why much attention is paid to radiotherapy during the treatment process.

Of course, to this day there is an opinion that lung sarcoma is not curable. But modern equipment, effective treatment and diagnostic methods make it possible to cure sarcoma and increase the patient’s life expectancy. Don’t forget about foreign clinics; treatment of sarcoma in medical centers in Israel is particularly popular and highly effective.

Application antitumor drugs allows you to improve the patient’s quality of life and, if not completely cure, then at least prolong his life. It is mainly prescribed after surgical intervention, and if the operation is ineffective, then it is included in the complex of therapeutic measures that should help improve the patient’s condition, remove negative manifestations defeats. And in some cases, this is the only method of treatment (for inoperable tumors).

How effective chemotherapy will be in treatment largely depends on the results of histology, which should determine the type of cancer cells:

• if histology shows small cell cancer, then the use of chemotherapy will significantly reduce symptoms and bring relief to the patient;
• for large cell cancer, such drugs are not so effective and require connection additional methods effects on the cancer cell.

This treatment method allows you to achieve:

• Progressive reduction in the size parameters of the primary tumor (before surgery).
• Removal of “free-standing” mutated cells and small tumors that were not destroyed during surgery.
• If surgery is not advisable, medications are designed to reduce the intensity of symptoms.

Chemotherapy is carried out in courses, with breaks to restore the patient's strength and immune system. The number of such cycles varies and depends on the pathology and its severity. Most often, this is seven to eight times. The attending physician selects medications for each patient individually. Sometimes a course of treatment consists of a complex of several medications, which makes it possible to enhance the effect of each drug.

Here are some chemotherapy drugs that are used to treat lung sarcoma:

• Prospidin

This medicine must be taken under the close supervision of your doctor. During the administration of the drug, which is dripped into a vein or injected slowly intramuscularly, and for another half hour after completion of the procedure, the patient must lie down.

The starting dosage assigned to the patient is purely individual and is 0.05 g for an adult. Administration is carried out once a day or every other day. After three to six days, the dose of the drug is increased to 0.15–0.2 g daily. The therapeutic course dosage is 6 g. If the result obtained is not effective enough, the dosage is adjusted to 0.25–0.3 g and radiation therapy is added to the treatment protocol.

During chemotherapy, it is necessary to exclude all contacts of the patient with carriers of the infection. The drug is administered by qualified personnel under the supervision of an oncologist in compliance with all precautions.

This drug should not be prescribed to patients suffering from hypersensitivity to the components of the drug, severe forms renal and liver failure, with vascular pathology and other diseases.

• Interferon

To stop the inflammatory processes of the upper respiratory tract and lungs, the doctor prescribes a medicine of this nature to the patient. The course of treatment lasts until the danger of infection has passed, or until the symptoms of existing inflammation are completely relieved. This tool consume the solution. It is prepared immediately before use (maximum shelf life is up to two days), diluting the drug (2 ml) with boiled or distilled water at room temperature.

The resulting composition is injected into the nasal cavity or sprayed with a spray. Five drops are dripped twice during the day, and the period between doses should not be less than six hours. If the medicine is sprayed, then about 250 ml is sprayed into each nasal passage. These are prophylactic doses.

If treatment is necessary, the dosage is increased. The sooner you start taking the drug, the higher the effectiveness of taking it will be. Inhalation procedures are also possible, which can be carried out either through oral cavity, and the nose. One procedure requires three ampoules, which are mixed with 10 ml of boiled or distilled water at a temperature of no more than 37°C. The patient receives inhalation twice a day, the interval between these procedures is one to two hours. Instillation or spraying of the drug into the nasal cavity is carried out in the same dosages as for preventive actions, but the interval between doses is reduced to one to two hours. The number of such receptions during the day should be at least five. It is advisable to take the drug for two to three days.

This medicine has no side effects or contraindications.

• Avastin

The drug in question is administered only intravenously using a dropper. Dilute it to the desired consistency with 0.9% sodium chloride solution, observing all sterility requirements. It is necessary that the resulting composition contains the active substance of the drug in a solution of 1.4-16.5 mg/ml.

The initial dose of medication is carried out after the first chemotherapy; subsequent doses are possible both before and after taking chemotherapy. The drug is dripped quite slowly: from 60 to 90 minutes.

Taking Avastin is accompanied by quite serious side effects: increase blood pressure, anemia, constipation, nausea and vomiting, bleeding, exacerbation of problems with the gastrointestinal tract and cardiovascular system, the manifestation of various dermatitis and much more. This drug is strictly contraindicated for people with increased sensitivity to the components of the drug, women during pregnancy and lactation.

• Chlorbutin

The dosage and duration of cycles are determined individually for each patient based on the clinical picture of the patient and his general condition.

The drug is prescribed in doses depending on the number of leukocytes found in the blood serum.

• if the amount of enzymes in the blood is in the range of 30.0–40.0x10 9 /l, then 0.008–0.010 g of the drug is administered to the patient once;
• if leukocytes in the blood are 15.0–20.0x109/l, then the single dosage is 0.006–0.008 g;
• in the case when the quantitative composition falls within the range of 10.0–15.0x10 9 /l, the dose of the administered drug will be 0.004–0.006 g;
• with a leukocyte level of 5.0–10.0x109/l, the dose is 0.004 g.

To avoid irreversible negative processes, maximum dosage course should not exceed 6.5 mg calculated per kilogram of patient weight. If the level of leukocytes in the blood has dropped to 2.0–2.5x109/l, the patient is transferred to a smaller dose of the drug (0.002 g), which is taken once or three times a day.

It is not advisable to use the drug in question for persons who suffer from severe diseases of the gastrointestinal tract, acute failure of the liver and kidneys, and women during pregnancy.

Radiotherapy for lung sarcoma

The method of radiation exposure to mutated cells is used as a component of complex treatment. Radiation therapy for lung sarcoma is considered by oncologists to be the most effective way to target cancer cells. Most often, radiotherapy is used in one protocol together with chemotherapy, but these methods are not interchangeable.

It is this combination that is most productive, for example, in the fourth stage of lung sarcoma.

Cyber ​​knife

This is one of the innovative methods of treating lung oncology, which is already quite actively used in such developed countries as Japan, Israel, America, Germany and others.

This technique does not violate the integrity of the chest and skin, but affects cancer cells by irradiating them with X-ray radiation. Using latest achievements medicine in this field, a modern oncologist can accurately recreate a tumor model: its size and location, which allow, with a high degree of accuracy, to directly influence only cancer cells, destroying them. But the cyber knife should not be perceived as a panacea. Although, using it in conjunction with other methods, good results are obtained, which make it possible to prevent further development of the tumor and destroy existing mutated cells. This prolongs the patient’s life and makes it better quality.

Alternative treatment for lung sarcoma

Classical medicine does not deny the use of treatment for lung sarcoma folk remedies, but they can only be used with the approval of your doctor. Sarcoma is quite aggressive and progresses very quickly. In this situation, the main thing is not to delay it over time, since self-medication with traditional methods takes a lot of time, which may not be enough to save the patient’s life. It is difficult to find a universal recipe that would be suitable for any histological type of tumor. It cannot be said completely that traditional methods of treating lung cancer are ineffective, but they should definitely complement the basic classical treatment, and not be the sole method of treatment.

Palliative treatment of lung sarcoma

It is impossible to talk about a single treatment plan for oncology. Doctors most often use a set of techniques that are applied simultaneously. If the severity of the disease is in the fourth stage, it is almost impossible to completely destroy the cancerous tumor. Then the attending physician uses all methods that can alleviate the patient’s condition. This includes pain relief, oxygen therapy and others.

Prevention of lung sarcoma

Prevention of lung sarcoma is carried out to prevent the development of the disease. There are primary and secondary prevention. Let's take a closer look at these types of disease prevention:

Primary prevention

This type of prevention is called oncohygienic. The patient is given a set of medical and hygienic measures that are aimed at reducing and eliminating risk factors that increase the risk of sarcoma. For prevention, air pollution control is used, both at home and at work.

The most important stage primary prevention- to give up smoking. Promoting a healthy lifestyle and giving up bad habits can reduce the occurrence of malignant tumors tenfold. It is protection from tobacco smoke that reduces the risk of developing sarcoma. Minimizing secondhand smoke is another method of preventing sarcoma.

Secondary prevention

This type of prevention means clinical and medical methods. Patients undergo routine preventive examinations of the lungs and treatment of precancerous processes. There are certain risk groups that require special monitoring to prevent lung sarcoma. The risk group includes mainly men who smoke, who have been suffering from tuberculosis, pneumonia or chronic bronchitis for a long time. Long-term smokers over 50 years of age who have previously been treated for malignant neoplasms are at particular risk.

Prevention of lung sarcoma involves early diagnosis of the disease. People at risk undergo computed tomography and x-ray examination. Surgery malignant neoplasms, is also a method of prevention and prevents the appearance of metastases.

It is quite difficult to advise anything in this direction. Today, prevention can be reduced to some actions that can, if not prevent the disease, then at least detect it in the early stages. During such a period, it is easier to treat, and the patient receives a more positive prognosis for the future.

• If a person often suffers from colds, pneumonia, pneumonia; if the temperature rises to alarming levels, then you need to be wary and it is advisable to undergo a full medical examination at a specialized oncology center.
• It is necessary to lead an active, healthy lifestyle: avoid smoking...
• Monitor your immunity.

Prognosis of lung sarcoma

Quite a lot depends on what type of tumor and the degree of neglect of the disease is shown by the clinical picture during diagnosis. If the tumor is represented by highly differentiated cancer cells and they mutate at a low rate, the prognosis for lung sarcoma in this case will be positive.

Thanks to an integrated approach to the treatment of lung sarcoma and the use of the latest developments, the percentage of patients who managed to live for five years is increasing (up to 5-10% of the total number of cases of the disease). With a timely operation and effective postoperative period complete recovery may occur.

Lung sarcoma responds well to treatment, but it subsequently gives the highest percentage of relapses with extensive metastasis.

The prognosis depends on the size of the malignant neoplasm, the location of the neoplasm and its type, as well as the general health of the patient.

Sarcoma has the most aggressive growth, early and rapid metastasis. The survival rate of patients with sarcoma, but without proper treatment, ranges from 3 to 5 months. This suggests that patients with sarcoma may die approximately six months after diagnosis. Sarcoma is insensitive to chemotherapy; successful recovery and a positive prognosis largely depend on early diagnosis of the disease.

Successful treatment of any malignant tumors is of great importance, as they can metastasize to the lungs. Very often, when a sarcoma is detected, it is of a secondary nature, that is, it arises as a result of metastasis from other tumor foci. Fast diagnosis and timely treatment significantly increases the life expectancy of patients, which means it gives a positive prognosis for the disease.

How long do people live with lung sarcoma?

When faced with this pathology, family and friends, and the patient himself, ask themselves the same question: “How long do people live with lung sarcoma?”

Treating cancer is a difficult task. And as sad as it sounds, it is lung sarcoma that gives the highest percentage of deaths. At effective treatment, the percentage of patients who have lived for about five years is quite large, but only a small percentage of patients survive more than five years. If treatment was not carried out or the disease was diagnosed too late, the life span of such a patient is only two to four months.

Life expectancy depends largely on:

• Depending on the type of tumor, determined by histology. For example, small cell cancer is often detected only in the later stages of the disease, while it grows quickly and metastasizes. It is he who causes the largest percentage of deaths. Large cell is what allows us to give a favorable prognosis.
• The size parameters of the tumor also play a significant role here.
• How extensive is the clinical picture of metastasis of cancer cells to neighboring organs? If the affected area is large, treatment may no longer be effective.

Thus, stage I of the disease kills 50-60% of patients; when stage II of the disease is diagnosed, 70-85% of patients cross the threshold of death.

Life expectancy depends on early diagnosis and effectiveness of treatment. As a rule, 5-10% of patients survive with sarcoma. Lung sarcoma has a poor prognosis compared to other types of malignant diseases. Thus, the five-year survival rate is 3-17%.

Lung sarcoma is one of the most dangerous and difficult to treat malignant neoplasms. The tumor develops rapidly and metastasizes early, so early diagnosis and timely treatment are important for successful treatment. We should not forget about preventive measures that can prevent neoplasms.

Lung sarcoma is a terrible disease that kills greatest number patients' lives. But there is no need to despair. It is necessary to fight to the last, because modern medicine offers a fairly large arsenal of techniques designed to help cancer patients not only overcome this insidious disease, but also lead a person in the future to a normal, familiar life. Each of us is only required to be more attentive to our health, undergo preventive examinations on time and, at the slightest suspicion of illness, immediately go to the clinic.

Lung sarcoma is one of the most aggressive malignant tumors of the respiratory system. It is characterized by a rapid course and active progression with severe symptoms and metastasis to other organs. This type of oncology is quite rare: it accounts for up to 1% of all cases of lung cancer. The source of its development is the immature connective tissue of the respiratory organs. Persons of various age categories may encounter this diagnosis, but most often these are male patients over 40 years of age.

Lung sarcoma is dangerous look tumor, which is characterized by the ability to move into neighboring organs and destroy them. Even after removal of the primary formation, the possibility of relapse cannot be ruled out. In addition, sarcoma actively metastasizes.

It is impossible to determine exactly what could cause such a malignant formation in the lungs. It is only known that it develops from connective tissue. Experts identify a number of factors that provoke the development of this disease:

• hereditary predisposition to the development of various oncological pathologies;
• smoking;
• radioactive radiation in high doses;
• prolonged contact with carcinogens;
• harmful effects of ultraviolet radiation, including solariums;
• unreasonable and uncontrolled use of certain medications;
• unfavorable environmental living conditions.

Persons living in industrial cities with increased pollution are at risk for developing lung sarcoma. These reasons can cause a primary disease, but such a tumor can be the result of a secondary lesion as a consequence of the development of metastases. The cause of a secondary tumor can be sarcoma of the uterus, mammary glands, or soft tissues.

Sarcoma in most cases occupies the peripheral parts of the lungs, affecting its upper lobes. But it is not excluded that the entire organ will be affected completely. In addition, the tumor may look like a polyp-like growth and be located in the bronchi. The neoplasm has a soft consistency and can be either round or polycyclic in shape.

Classification of pathology

Sarcoma is a large massive nodule that fills most of the lung, and sometimes the entire organ. In some cases, the tumor is limited to its tissues by a kind of capsule, but it can also grow directly in the parenchyma.

Lung sarcoma has its own classification. It can be primary or secondary. If the first develops directly in the tissues of the organ, then the second form of pathology is the result of other oncological diseases. Depending on the level of malignancy, sarcoma is divided into 2 types:

1. Tumor with a low degree of malignancy. It is distinguished by the slow division of pathological, cancer cells with a predominance of stroma - connective tissue.
2. A tumor with a high degree of malignancy. It arises as a result of the rapid division of poorly differentiated cells and is characterized by a high content of cancer formations with a small amount of connective tissue. The affected tissue contains foci of necrosis and an abundant vascular network.

Lung sarcoma is also classified according to its origin. In accordance with this, fibrosarcoma is isolated - this formation has a low malignancy and is formed in the bronchi from connective tissue or tissue surrounding the bronchi. Another type is angiosarcoma. Unlike the previous one, it is highly differentiated and affects the blood vessels in the lungs. This type of sarcoma of this organ occurs most often. More rare types are lymphosarcoma, chondrosarcoma, neurosarcoma, liposarcoma and leiomyosarcoma.

In its course, sarcoma goes through 4 stages:

1. At stage 1, a clearly limited single node or infiltrate, no more than 3 cm in size. There are no metastases at this stage.
2. Stage 2 is characterized by an increase in tumor size to 6 cm and the formation of metastases in the lymph nodes at the roots of the organ.
3. Stage 3 sarcoma is characterized by the formation of multiple metastases in the lymph nodes located in the chest. The tumor itself exceeds 6 cm in diameter.
4. The final stage 4 is characterized by the development of metastases to distant organs.

Forms of manifestation of the disease and methods of its diagnosis

Symptoms of sarcoma, especially in the early stages, can resemble lung cancer. But in the first case, the manifestations will be more intense. Symptoms depend on the location and size of the tumor, as well as the stage of development. For pulmonary sarcoma, the symptoms are as follows:

1. General intoxication of the body, which manifests itself in the form of weakness, drowsiness, increased fatigue, lack of appetite, pale skin.
2. Shortness of breath, which is caused by stagnation of blood in the lung affected by the tumor.
3. Frequent recurrence of pneumonia, which is difficult to treat.
4. Dizziness and headaches.
5. Hemoptysis and dry cough.
6. Chest pain and sensation of a foreign body in it;
7. Nausea and vomiting, difficulty swallowing food.
8. Change in voice, appearance of hoarseness.

To obtain data that will confirm or refute the alleged diagnosis, the patient is examined. It includes laboratory and instrumental methods diagnostics The first includes a general and biochemical blood test, which will reveal signs of the development of an oncological process.

Computed tomography and lung radiography are of decisive importance in the diagnosis of lung sarcoma. Using the first method, it is possible to identify the presence of a tumor and its location, determine its size, and it will also be clear how much the tumor has spread to the surrounding layer of tissue.

On X-ray images, sarcoma will be defined as a round or oval shape having uneven edges. If you repeat the procedure after some time, you can notice an increase in the size of the tumor. If it is located in large bronchi, bronchoscopy will help to identify it.

In addition, thoracoscopy is used. To carry it out, a puncture is made in the chest, and with the help of a special instrument they penetrate into the pleural cavity. A scraping is taken from the surface of the lungs for cytological examination in order to identify pathological changes in the cells of the lung tissue.

Treatment methods and prognosis of the disease

To be able to cure the disease, it is necessary to identify it as early as possible. The success of sarcoma treatment is also determined by an integrated approach that combines various treatment methods:

• surgical intervention;
• treatment chemicals, drugs that affect the immune system;
• radiotherapy.

There is no universal treatment plan; an individual scheme is developed for each patient.

The main treatment for sarcoma is surgery. It is carried out taking into account the stage of the disease, the patient’s age and general state of health. Depending on the histology of the tumor, lobectomy, pneumectomy or segmentectomy is used. In the first case, only the part of the lung that is affected by the tumor is removed. In the second, the entire organ in which the sarcoma is localized is removed. During a segmentectomy, only the affected segment of the lung is removed.

If, for one reason or another, the patient has contraindications for abdominal surgery, then radiosurgical removal of the tumor focus is used. The operation is carried out using a cyberknife. The advantage of this method is that there is no need to dissect the chest, since cancer cells are destroyed through exposure to x-rays. This operation is highly effective.

Regardless of the method of performing the operation, it is followed by a course of chemotherapy, which will significantly slow down the active division of cancer cells. With the help of radiotherapy, it affects not only the tumor, but also prevents the appearance of metastases.

Since the disease in question has a high mortality rate, people who suffer from it wonder how long a person with sarcoma can live. Patient survival depends on the stage at which the disease was diagnosed and whether there were relapses. There are several options for predicting survival. Detection and treatment of the disease in the early stages increases the likelihood of survival by 5 years in only half of patients. If sarcoma was detected at stage 2, then up to 70% of patients die. A diagnosed stage 3 sarcoma gives only 1/5 of patients a chance to live 5 years. Detection of the disease at stage 4 has the most unfavorable prognosis, since all patients are expected to die within six months after diagnosis.

Lung sarcoma is a malignant tumor with an aggressive course. In the respiratory system, sarcoma is rare, occurring in 1% of cancer patients. Despite the rarity of its occurrence, it carries with it serious consequences. From this article you will learn about the diagnosis and treatment of patients with pulmonary sarcoma.

Lung sarcoma is formed from a connective tissue cell growing from the mesoderm (or mesoblast) - the middle germ layer, located between the ecto- and endoderm and covering the lungs and bronchi from the outside. It can be located between the alveoli of the lungs, grows quickly, is characterized by malignancy, aggressive course, early metastasis, movement of malignant cells through tissues.

Unlike sarcoma, it arises from epithelial tissue lining the lungs from the inside. is not tied to a specific organ, like other forms of cancer, but affects any organ.

Features of the disease

Pulmonary sarcoma forms a large and massive nodule that occupies most or all of the lung. The node may be delimited from the lung tissue by a capsule, but when it grows into the bronchi, infiltration into the parenchyma occurs.

Like sarcoma, it can be primary, arising directly in the respiratory organs, and secondary, developing as a result of metastasis from other tissues and organs. Metastases penetrate into the lung area through the bloodstream or through lymphatic vessels.

The difference between sarcoma and lung cancer is that it is not an independent nosological form due to its morphological diversity, that is, it combines different types of oncological tumors, the degree of differentiation of which is also different.

Types, types and forms of pulmonary tissue sarcoma

Histologically, primary sarcoma, like lung cancer, is:

• highly differentiated: has a low degree of malignancy (reduced mitotic cell activity, high proportion of stromal elements, low concentration of oncoelements), that is, slow cell division occurs;
• low-grade: has a high degree of malignancy (increased rate of cell division, many tumor particles, a well-developed network of blood vessels, necrotic foci).

There are undifferentiated sarcomas, they are also: spindle cell, round cell and polymorphic cell.

The morphological classification of pulmonary tissue sarcomas includes the following tumor formations:

• – a highly differentiated cancer node, which occurs frequently and affects the walls of blood vessels;
• - grows from bronchial connective tissue or peribronchial (surrounding bronchi), malignancy - low;
• fibrolymphosarcoma - develops from lymphoid tissue cells;
• lymphosarcoma - develops from the tissues of the lymph nodes;
• - grows from adipose tissue cells;
• neurosarcoma - from the connective tissues of the nerve plexuses;
• - affects the cartilage tissue of the bronchial tree;
• - from smooth and striated muscle tissues;
• – from striated muscle tissue;
• hemangiopericytoma - arises from pericytes - cells that are part of the capillary walls.

- a science that studies the stages of their development to determine aggressiveness, volume and methods of treatment, and predict survival.

There are four stages of lung sarcoma, which are based on the quantitative degree of spread and malignancy of the oncological nodes:

• stage 1 lung sarcoma is limited to a capsule node with infiltrate, up to 3 cm in diameter. There are no metastases;
• Stage 2 – node diameter 3-6 cm, single metastases were found in the peribronchial and lymph nodes of the pulmonary root;
• Stage 3 – node diameter – 6 cm or more, metastases were found in the mediastinal lymph nodes, invasion in the pleura;
• Stage 4 lung sarcoma metastasizes to distant organs and lymph nodes from tumors of any size.

Formations in the respiratory organs also include extraosseous and Kaposi. Ewing's sarcoma in the lungs, bronchi and soft tissues around them occurs in 8% of patients in childhood and up to 25-30 years of age, more often in boys. The formation belongs to neuroectodermal tumors due to the similarity of molecular genetic features: rapid growth and early metastasis, absence of symptoms in the initial stage.

In the lungs is systemic disease. It affects the respiratory system, other internal tissues and organs, and lymph nodes. A common cause of its secondary development is metastasis from other primary malignant tumors. Early symptoms include pleural pain attacks in the sternum, shortness of breath, coughing up blood, noisy and hard breath what is called stridor. The radiograph shows infiltrates on both sides: interstitial and parenchymal. With unclear outlines, the formation occurs with massive pleural effusion.

Causes of lung sarcoma

Modern medical scientists are still studying what causes lung sarcoma.

Experiments confirm the negative impact:

• ionizing radiation;
• ultraviolet irradiation;
• chemical substances;
• smoke filled with industrial pipes and air polluted with soot and automobile gases.

Lung sarcoma develops most often in heavy smokers, chemical workers who come into contact with carcinogenic substances, such as pesticides, aniline dyes, asbestos and others. People with a genetic predisposition and a family history of cancer are at risk.

The causes of lung sarcoma may lie in uncontrolled use of medications and poor nutrition: the predominance of “heavy” foods with excess fat and salt, vinegar, spices and a lack of fresh plants in the diet: vegetables and fruits, herbs and berries. Metastasis of osteosarcoma from other organs is the cause of a secondary oncological process in the lungs.
Symptoms and manifestations of the disease

The manifestation of pulmonary sarcoma is similar to the clinical picture of other forms of oncological process in the respiratory organs. The initial stages are difficult to recognize due to the absence or mild symptoms.

At stages 2-4 of the oncological process, the patients’ condition worsens, and the symptoms of pulmonary tissue sarcoma become obvious.

Namely:

• signs of general weakness, fatigue, loss of physical form, performance decreases;
• loss of appetite and feeling foreign body in the sternum area;
• sweat profusely, especially during night sleep;
• chills give way to fever as the temperature rises;
• when the tumor node puts pressure on the heart muscle, shortness of breath appears;
• when the tumor is located near the esophagus, dysphagia develops: it is difficult for the patient to swallow solid food, and later liquid food;
• Blood stagnates in the lung, which leads to hypertrophy of the right atrium and ventricle, and the pathological process of blood circulation in the pulmonary circle begins.

It is important to know! Symptoms of pulmonary sarcoma are also manifested by superior vena cava syndrome: difficulty breathing, convulsions, dizziness, headaches, nausea, hoarseness and cough, which produces sputum with blood elements.

Against the background of secondary pleurisy, pneumonia or an infectious disease, lung sarcoma may also appear, the symptoms of which will be “hidden” behind the manifestations of these diseases. Therefore, differentiated diagnostics will be required.

Diagnosis of the disease

How to identify sarcoma of the lung tissue if symptoms do not appear in the initial stages?

If you do not ignore research methods such as fluorography, ultrasound, and blood tests as preventive measures for oncology, then early diagnosis of lung sarcoma is possible. To confirm the diagnosis, it is necessary to take blood tests: general - to determine ESR and the degree of anemia, and blood - to identify specific antibodies (markers).

And also take an ECG to analyze the state of the functional functioning of the heart and undergo:

• angiography with contrast agents to study the circulatory system;
• MRI and CT scan of the left and right lungs to determine the size of the cancer node and the degree of its advancement into the surrounding tissues;
• X-ray examination;
• radioisotope test to determine the boundary between healthy and diseased tissue to guide subsequent therapy;
• a procedure for removing tissue for the purpose of examining it histologically. performed during thoracoscopy or bronchoscopy;
• Doppler diagnostics of the cardiovascular system.

Treatment of lung sarcoma

If the diagnosis of lung sarcoma is confirmed, treatment is carried out comprehensively and in the following sequence:

• preoperative chemotherapy;
• tumor removal using the following methods: segmentectomy, pneumonectomy or lobectomy;
• radiation therapy (radiotherapy);
• repeated courses of chemotherapy.

Surgical methods

To exclude relapses, a standard operation is performed with wide excision of the tumor and surrounding lymph nodes. If the patient's condition is too severe and there is a serious concomitant pathology, this may not allow the tumor to be removed abdominal surgery. Then special radiosurgical knives are used.

• Segmentectomy

Segmental resection is performed:

1. open method (thoracotomy) - with access to the oncological lesion by opening the chest;
2. video thoracoscopic access to the segment area through small incisions of the sternum in order to reduce blood loss and the risk of infection.

Operations are performed using general anesthesia. Patients are first prescribed a course of antibiotics to improve their general condition and prevent serious complications. In case of lung injury, emergency intervention is used to save life. The procedure is simplified if there is one healthy lung. The segment is an independent bronchovascular unit, so it can be removed using anterolateral, lateral and posterolateral approaches. In this case, the apical segments of the upper lobe, the upper segment of the lower lobe and the basal segments are excised.

Performing an operation open method surgeon:

1. the chest and pleural area are opened;
2. the lung is released from the pleura, with the segment separated last;
3. the bronchus is closed with special staplers;
4. the segmental artery, central vein and bronchial vessels are ligated and intersected;
5. The affected segment is removed with doping (ligation) of the veins between the segments.

Important! A segment is identified from the root to the periphery. To check the tightness of the sutures on the bronchi, the pleural cavity is washed or the lung tissue is inflated. If bubbles appear at the site of segmental excision, additional sutures are applied and drainage is installed in the pleural area to remove accumulated exudate and air.

The operation is performed using X-ray control. If only a few air bubbles are released, they are limited to only one drainage or do nothing. If there is a lot of air coming from the lung tissue, knotted sutures are placed on it and additional drainage is added. It is removed on the 3-4th day after surgery. During this period, active aspiration of exudate from the pleura is carried out, which helps to expand the lung.

Treatment of pulmonary sarcoma by thoracoscopic resection, as follows:

• the patient is positioned and a double-lumen endotracheal tube is inserted;
• the affected lung is excluded from mechanical ventilation;
• The operation is performed through punctures using a special endoscopic instrument.

Insufflation (introduction of gas into the lung cavity) with a pressure of up to 10 mm Hg. Art. when using videothoracoscopy it is rarely used. At the same time, the slightest deterioration in venous return and a decrease in cardiac output. Videothoracoscopy provides a view inside the sternum through two small and enlarged fields of view. In this case, the optics (thorascope) is inserted through a port located behind or below.

Attention! Thoracoscopic operations, compared to the open method, do not cause severe postoperative pain, reduce the number of complications, eliminate large skin incisions and reduce the stay of patients in the intensive care unit to 1-2 days.

Complications. In the most vulnerable patients, with limited lung reserves, empyema sometimes occurs, that is, pus accumulates inside the lung. Bronchial fistulas also form and dangerous bleeding occurs.

Segmentectomy is contraindicated in the presence of:

1. coagulopathies;
2. skin infections;
3. diffuse pulmonary diseases;
4. extensive metastasis to the organ.

• Pulmonectomy

Treatment of lung sarcoma by pneumonectomy involves complete removal of the affected lung under general anesthesia.

During the operation:

• a thoracotomy is performed: anterolateral or posterolateral and the lung is freed from pneumolysis - interpleural adhesions;
• after dissection of the mediastinal pleura, vessels and bronchi in the root of the lung are identified;
• the vessels of the lungs and bronchi are treated separately and start with the pulmonary veins and arteries to prevent the spread of cancer cells;
• allocation pulmonary vessel begin after the connective tissue sheath is cut: the vessel is exposed from the accessible surface, then the lateral and deep areas of the vessel are highlighted;
• the lung with fatty tissue and lymph nodes is removed from the root and adjacent area of ​​the mediastinum.

To reduce the residual cavity in the sternum, the phrenic nerve is divided and sometimes thoracoplasty is performed. After the operation, it is possible that purulent complications, and the bronchial stump may be incompetent.

• Lobectomy

During the operation, one lobe of the lung is removed. The right lung has three lobes, the left lung has two.

Lobectomy is performed in two ways:

• traditional thoracotomy through a large incision through the spread ribs;
• an operation performed through several small incisions. They insert a tiny camera to control the process via video, as well as a surgical instrument. Viewed on the monitor screen inner part chest and there is a pulmonary lobe with an oncological process.

During anterolateral thoracotomy, the cartilage of the 3rd rib is cut to expose the upper lobe of the lung, and the 5th and 6th ribs are cut to expose the lower lobe.

The pulmonary lobe is removed along with the lymph nodes. A drain is placed in the chest to drain excess fluid through tubes. The incisions are then closed with stitches or staples. After layer-by-layer suturing of the thoracotomy wound, air is sucked out from the pleural cavity.

Chemotherapy

To stop tumor cells from dividing, combination treatment drugs in tablets or intravenously:

1. and either Herceptin.

Sarcoma metastases are treated with certain regimens: CAF, FAC, CEF or AC. Before taxanes, treatment is carried out with steroid drugs to reduce side effects.

To exclude recurrence of sarcoma or reduce its frequency, radiation and chemotherapy are used.

Radiation therapy

Irradiation is carried out:

• as the main method of treatment when a localized cancer node is detected;
• to reduce the sarcoma body before surgery;
• for postoperative elimination of traces of oncological process;
• to destroy metastases in the brain and other internal organs.

There are two types radiation therapy– radical and non-radical:

1. Radical radiation therapy can completely destroy sarcoma cells in the early stages and in the presence of tumors that are sensitive to radiation. The course of daily treatment is two weeks.
2. Non-radical radiation therapy prevents the growth of the cancer process and saves the patient’s life if the tumor blocks the respiratory canal or destroys the lung. One or more radiotherapy sessions are used.

It is important to know! Radiation slightly narrows the esophagus, which leads to difficulty swallowing food, heartburn and indigestion. To eliminate pathologies, you should consult a doctor for a prescription. necessary medications and replace solid foods with high-calorie drinks.

In addition to external radiation therapy with the radiation source located outside the body, conformal radiation therapy and intensity-modulated radiotherapy are used. This enables three-dimensional imaging of the oncological node through the use of CT. Using the resulting images, high-dose radiation is targeted. It is possible to automatically change the shape and size of the beam beam to destroy the tumor. Healthy tissues are slightly damaged.

How long do they live (prognosis) for lung sarcoma?

In the early stages of the malignant process, life expectancy for 5 years is possible in 50% of patients (every second patient) with adequate treatment. At the third stage, 20% of patients survive, at the fourth stage – up to 10%.

Prevention of pulmonary sarcoma

For the purpose of primary prevention, comprehensive medical and hygienic measures are carried out aimed at eliminating factors that increase the risk of sarcoma:

• promote cessation of smoking and other bad habits, as well as a healthy lifestyle;
• carry out work to purify polluted air in factories.

Secondary prevention is carried out by routine preventive examinations of the lungs, treatment of precancerous processes, for example, tuberculosis, pneumonia or chronic bronchitis, increasing the immunity of patients.

If the patient has already had surgery to remove a sarcoma, such as a lobectomy, then if signs of infection, fever and chills, redness, swelling, pain, bleeding or discharge from the surgical wound, nausea or vomiting, or shortness of breath appear, you should immediately seek help from a doctor. Timely elimination of symptoms will prevent relapse and prolong the patient’s life.

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