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Lung microcytoma: what is the tumor that Elena suffered from

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Lung microcytoma: what is the tumor that Elena suffered from

In recent years we have become accustomed to hearing from oncologists that cancer today can be cured and at least become chronic when it is simply not possible to heal. Why then did 69-year-old Elena with lung cancer not make it and she decided to end her life in Switzerland? What did she make her so desperate? The fact is that cancers are not all the same and what the Venetian woman who went to Switzerland was suffering from to legally access assisted suicide was an important irreversible lung cancer with metastases.

Non-small cell lung cancer

In Italy, lung cancer is the second most frequent malignancy among men and the third among women. The mortality rate for lung cancer in males is estimated to have decreased by 11.2% compared to 2015, while the estimated mortality rate for lung cancer in women is 5.2% higher. According to the latest Report of the Italian Association of Medical Oncology (Aiom), in 2020 there were over 40,000 new diagnoses: in 85% of cases it is non-small cell lung cancer (NSCLC), characterized in the majority of cases from genetic alterations. Its ability to blend in causes delay in diagnosis: it is often asymptomatic or triggers a symptomatology that is confused with that of other pathologies and presents itself with different ‘identities’. It is a particularly difficult neoplasm to treat, because about 70% of cases are discovered at an advanced stage. And the 5-year survival for people with metastatic non-small cell lung cancer does not exceed 6%.

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But lung cancer can be even worse. This is the case of microcytoma or small cell lung cancer (Sclc) which in Italy affects 12,628 people (represents about 10-15% of lung cancers). “It is a tumor characterized by extremely aggressive biological and clinical behavior, also associated with smoking, like most non-small cell cancers”, explain in the Aiom Report. Giuseppe AltavillaMedical Oncology Unit, Aou Policlinico G. Martino di Messina, e Massimo Di MaioDepartment of Oncology, University of Turin, Ao Order Mauriziano, Turin.

What are the risk factors and symptoms

This type of cancer occurs mainly in smokers (although it can be diagnosed in non-smokers), but the risk factors also concern radon, asbestos, smog and environmental pollution. During the early stages of the disease, the tumor may be asymptomatic, but cough with phlegm or dry cough, blood in phlegm, shortness of breath, wheezing, fever, persistent pneumonia or bronchitis, chest pain, excessive fatigue may appear later. and loss of appetite, which can be followed by weight loss.

How is it diagnosed

Diagnosis is mainly based on nuclear characteristics and is much easier on a cytological sample than on a biopsy. At the time of initial diagnosis, approximately 75-80% of patients already have extrathoracic spread (to other organs), preferably the brain, liver, adrenal glands, bones or bone marrow. To define the treatment it is necessary to define the stage through a computed tomography (CT) examination of the chest and abdomen without and with contrast medium, which allows to define the site, the size and the relationships of the tumor with the adjacent structures. This examination is possibly accompanied by a CT or magnetic resonance imaging (MRI) of the brain. Another examination often required is the FDG-PET, useful to confirm the diagnosis or to check for metastases.

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How can you treat

The combination of chemo and radiotherapy is the standard treatment for patients in good general condition. Combined chemo-radiotherapy treatment is generally considered to be more effective from the beginning or within the second course of chemotherapy, after careful evaluation of the clinical condition. “For decades – continue Aiom oncologists – no progress has been recorded in the treatment of this type of tumor, the only effective pharmacological option being chemotherapy containing platinum. Only recently, interesting results have been obtained with the addition of immunotherapy to platinum-containing chemotherapy, although the possibility of achieving lasting disease control is still limited “. In the rare cases of radically operated limited stage disease, adjuvant chemotherapy treatment with cisplatin-based regimens for 4-6 cycles is indicated.

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