Adenocarcinoma of the lung natural history, complications, and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Common complications of adenocarcinoma of the lung include breathing difficulties, pneumonia, pleural effusion, metastasis, and Horner’s syndrome. The prognosis of adenocarcinoma of the lung varies with the staging of tumor; stage IA have the most favorable prognosis. The presence of metastasis is associated with a particularly poor prognosis.

• The majority of lung cancers present with advanced disease because the symptoms tend to occur later in the course of the disease.^[1]
• The patient experiences non-specific symptoms such as cough, hemoptysis, dyspnea, chest pain, dysphonia, dysphagia, lack of appetite, weight loss, and fatigue from 3 weeks to 3 months before seeking medical attention.
• During the 3 weeks to 3 months course, the tumor cell may double 20 times.^[1]
• In more advanced disease, the tumor may spread to other organs such as the spinal cord, brain, and bone.
• Patients with metastasis may develop symptoms such as leg weakness, paresthesias, bladder dysfunction, seizures, hemiplegia, cranial nerve palsies, confusion, personality changes, skeletal pain, and pleuritic pain.^[1]
• Once the cancer spreads to the other organs, it is most likely to be fatal.

• Breathing difficulties:

• Lung cancer patients may experience dyspnea due to tumor blockage of airways. Fluid build up in the lungs affects lung expansion during inhalation.^[2]

• Pneumonia:

• Cancer growth in the airway may obstruct airflow, leading to breathing difficulties. Accumulation of secretions behind the blockage predisposes patients to pneumonia.

• Pleural effusion:
  • Lung cancer may cause fluid to build up in the lungs which may lead to breathing difficulties.

• Metastasis:
  • Lung cancer metastasizes to are the bones, liver, brain, and adrenal glands.

• Horner’s syndrome:
  • Tumors in the apex of the lung, known as Pancoast tumors, may invade the local part of the sympathetic nervous system, leading to altered sweating patterns and eye muscle problems (Horner’s syndrome).^[3]

• The prognosis of adenocarcinoma of the lung varies with the staging of tumor; Stage IA have the most favorable prognosis.
• The presence of metastasis is associated with a particularly poor prognosis.

Survival rate by stage^[4]

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