Lung Cancer FAQ

There are three main types of lung cancer. It is important for the patient to know the type of cancer he/she is suffering from as the treatment options and the prognosis are based on this. Do not hesitate at all in requesting this information from your doctor.

• Non-small cell lung cancer : this is the most frequent type of lung cancer. Almost 85% of lung cancers are non-small-cell lung cancers. Epidermoid cancer, adenocarcinoma and large-cell lung cancer are sub-types of non-small cell lung cancer.
• Small-cell lung cancer : about 10-15% of lung cancers are small-cell lung cancers. This type of cancer tends to spread rapidly.
• Carcinoid lung cancer : this type of cancer only represents 5% of all lung cancers. They are also sometimes referred to as neuroendocrine pulmonary tumors. Most of these tumors grow slowly and only spread rarely.

There may be general symptoms such as unusual tiredness, weight loss and/or respiratory symptoms such as difficulty breathing, chest pain, abnormal cough or blood-tinged sputum.

Several examinations are essential to ensure an accurate diagnosis and therefore to offer the best treatment. The aim of the examinations is to perform a diagnostic biopsy of the tumor, to assess the extent of the disease and in the event of surgery, to assess the risks of the operation in particular any cardio-respiratory risks. 

The diagnosis must be established through a biopsy of abnormal tissue. To do this and depending on the location of the tumor, this could be a needle biopsy through the chest wall guided by a scanner (radiological transthoracic biopsy), a biopsy through the airways during a bronchoscopy (endoscopic biopsy) or a surgical biopsy through a mini-incision of the thorax (surgical biopsy by thoracoscopy). The tissue collected will be sent to the pathologist for advanced microscopic analyses to establish an accurate diagnosis and certainty.

A bronchoscopy procedure explores the airways using an instrument the size and flexibility of an electric cable (4 to 6 mm in diameter) with a miniaturized camera at its end which enables the pulmonologist carrying out the examination to see the airways and collect abnormal tissue. The endoscope follows the air trajectory when the subject breathes; starting either at the nose or mouth, the bronchoscope creeps between the vocal cords, runs through the trachea and will be directed as needed either to the left lung or to the right lung. Each air passage divides in two, similar to branches of a tree. Once the diseased area is reached, a miniature forceps is inserted through the inside of the endoscope and collects the desired samples (each sample is the size of half a pin head). There are several types of state-of-the-art techniques for identifying delicate areas inside the lungs. The examination can be performed either under local anesthesia or general anesthesia.

To find out more about a pulmonary tissue biopsy.

A pleural effusion puncture is performed to remove fluid that has built up between the rib cage and the lung. The puncture is performed after local anesthesia of the skin facing the affected area. A dedicated needle is used and inserted through the skin and advanced to the pleural space (space between the lung and the rib cage). The fluid is then aspirated using a syringe placed on the puncture needle. If pleural effusion is considerable (several liters) a small tube, or even a drain (larger tube) may need to be left there to allow the cavity to empty and for the lung not to suffer from the compression exerted on it by the fluid.

As its name suggests, pleural talcage involves instilling (through a drain system) or spraying (by thoracoscopy) a suspension of pure talc into the pleural cavity. The purpose of this procedure is to stick the surface of the lung to the inner surface of the rib cage to close the space in which the effusion water is located and prevent a recurrence of a pleural effusion.