TERMINAL STATES AND

PATHOPHYSIOLOGICAL BASES PEA NIMATIONS.

POST RESUSCITATION DISORDERS

5.1. Terminal states, their characteristics

The cessation of vital functions occurs gradually and the dynamism of this process allows us to distinguish several phases observed during the dying of the organism: preagony, agony, clinical Andbiological death.

Pre-agony, agony and clinical death refer to terminal (final) states. A characteristic feature of terminal conditions is the inability of a dying organism to independently exit them without outside help. even if the etiological factor that caused them no longer acts (for example, with a loss of 30% of the blood mass and the bleeding stops, the body survives on its own, and with a loss of 50%, it dies even if the bleeding stops).

Terminal state - is a reversible decline in body functions that precedes biological death when the complex of protective and compensatory mechanisms is insufficient to eliminate the consequences of the action of a pathogenic factor on the body.

Preagonia (preagonal state) - a terminal state preceding agony, characterized by the development of inhibition in the higher parts of the central nervous system and manifested by twilight stupefaction, sometimes with excitation of the bulbar centers. Consciousness, as a rule, is preserved, although it may be darkened and confused; there is a decrease in reflex activity, but eye reflexes are alive. Blood pressure is reduced, the pulse in the peripheral arteries is very weakly filled or not at all

not determined. Breathing, due to increasing circulatory hypoxia and accumulation of carbon dioxide, stimulating the respiratory center, sharply becomes more frequent. Then tachycardia and tachypnea are replaced by bradycardia and bradypnea.

Depression of consciousness, electrical activity of the brain and reflex activity progresses. The depth of hypoxia increases in all organs and tissues, which is associated with cyanosis and pallor of the skin. The body continues to maintain energy metabolism due to reactions that occur with the consumption of oxygen - aerobic metabolism predominates. These manifestations resemble symptoms of shock of degrees III and IY.

The preagonal state ends with a terminal pause (cessation of breathing and a sharp slowdown in cardiac activity up to temporary asystole). Apnea is temporary and can last from a few seconds to 3-4 minutes. It is believed that with increasing hypoxia of the brain, the activity of the vagus nerve can sharply increase - hence apnea. There may be no terminal pause (in case of electric shock). The terminal pause is clearly expressed when dying from blood loss and asphyxia. After the terminal pause, agony sets in.

Agony (agonia; Greek struggle) - a terminal state preceding clinical death and characterized by profound dysfunction of the higher parts of the brain, especially the cerebral cortex big brain, with simultaneous stimulation of the medulla oblongata. Develops after a terminal pause. Consciousness is absent (sometimes it clears up briefly), eye reflexes and reactions to external stimuli disappear. The sphincters relax, and involuntary release of feces and urine occurs.

The main sign of agony is the appearance of the first independent breath after the terminal pause. Breathing is weak at first, then increases in depth and, having reached a maximum, gradually weakens again and stops completely. Auxiliary muscles are involved in breathing - the muscles of the neck and face, i.e. "gasping" breathing appears (English gasping - convulsive, spasmodic). "Gasping" breathing is a pathological breathing characterized by rare,

short and deep convulsive breathing movements. The last agonal breaths resemble the act of swallowing. Agonal breathing is ineffective - alveolar ventilation with it does not exceed 20% of the proper value.

A similar pattern is observed both in relation to cardiac activity and hemodynamic parameters - i.e. after bradycardia and even temporary asystole and a significant decrease in blood pressure against the background of developing agony, it again increases slightly (up to 30-40 mm Hg) due to the resumption and intensification of heart contractions. However, these manifestations of increased vital activity of the body often turn out to be short-lived and quickly fade away. In some cases, such “outbursts” of increased vital activity can be repeated several times, and the period of agony can last for a long time (up to several hours).

In cases where there is no terminal pause, rhythmic breathing of the preagonal period gradually turns into agonal breathing. The appearance of agonal breathing is evidence of severe cerebral hypoxia and is associated with the loss of the inhibitory influence of the cortex on the subcortical centers, interstitial and stem sections of the brain. These departments are disinhibited, which leads to temporary activation of vital functions.

During agony, metabolism changes sharply, catabolism processes prevail over synthesis, the amount of glycogen in organs and tissues decreases, glycolysis sharply increases and the content of lactic acid in organs and tissues increases, the breakdown of high-energy phosphates sharply increases and the level of inorganic phosphate increases. On the part of the sense organs, smell fades first, then taste and vision. Body temperature decreases - hypothermia.

Agony as a reaction of a dying organism is compensatory in nature and is aimed at maintaining life, but it cannot continue indefinitely. In the last stages of agony, vascular paresis develops, blood pressure drops to almost zero, heart sounds are muffled or cannot be heard. Only the carotid pulse is determined. The patient's appearance is characteristic: "Hippocratic face" - "sunken eyes and cheeks", pointed nose, gray-sallow complexion, clouding

cornea, pupil dilation. Then the agony turns into clinical death.

Clinical death (mors clinicalis) - a terminal condition that occurs after the cessation of cardiac activity and breathing and continues until the onset of irreversible changes in the higher parts of the central nervous system. During clinical death, external signs of life (consciousness, reflexes, breathing, heartbeats) are absent, but the body as a whole has not yet died, energy substrates are retained in its tissues and metabolic processes continue, therefore, under certain influences ( we're talking about about resuscitation benefits) it is possible to restore both the initial level and direction of metabolic processes, and therefore restore all functions of the body.

The duration of clinical death is determined by the time that the cerebral cortex experiences when blood circulation and breathing cease. Moderate destruction of neurons and synapses begins from the moment of clinical death, but even after another 5-6 minutes of clinical death, these damages remain reversible. This is explained by the high plasticity of the central nervous system - the functions of dead cells are taken over by other cells that remain viable.

World clinical practice indicates that in normal conditions The duration of clinical death in a person does not exceed 3-4 minutes, maximum - 5-6 minutes. In animals it sometimes reaches 10-12 minutes. The duration of clinical death in each specific case depends on a number of conditions: duration of dying, age, temperature environment, species characteristics of the organism, the degree of activity of excitation processes during dying.

For example, the prolongation of the preagonal period and agony during severe and prolonged hypotension makes revival almost impossible even a few seconds after the cessation of cardiac activity. This is due to the maximum use of energy resources and pronounced structural disorders during the development of hypotension.

A different picture is observed with rapid dying (electrical trauma, drowning, asphyxia, acute blood loss), especially under conditions of hypothermia, since severe irreversible changes do not have time to develop in organs and tissues and the duration of clinical death is prolonged.

Elderly people and patients with chronic diseases experience clinical death of shorter duration than younger people, healthy faces. The duration of clinical death is influenced by resuscitation methods. The use of a heart-lung machine allows you to revive the body and restore the functions of the central nervous system even after 20 minutes of clinical death.

During the process of dying and clinical death, the following changes in the body are revealed:

1. Respiratory arrest, as a result of which blood oxygenation stops, hypoxemia and hypercapnia develop.

Asystole or cardiac fibrillation.

Disorders of metabolism, acid-base status, accumulation of under-oxidized products and carbon dioxide in tissues and blood with the development of gas and non-gas acidosis.

The activity of the central nervous system ceases. This occurs through a stage of excitation, then consciousness is depressed, a deep coma develops, reflexes and bioelectrical activity of the brain disappear.

The functions of all internal organs fade away.

Respiratory cancer is one of the most common diseases. They suffer from it more often smoking men over 55 years of age, but the disease often occurs in women. In terms of mortality, it ranks one of the first places. The chances of survival increase if there is a general positive attitude, competent therapy, and high body resistance. With a combination of these factors, even if stage 4 lung cancer is diagnosed, death can be avoided.

Causes of the disease

The development of malignant tumors is influenced by the following factors:

• Smoking. Tobacco products contain large number carcinogens.
• Poor environmental conditions, lack good nutrition. The incidence rate is especially high among residents of megacities.
• The presence of chronic pathologies of an infectious or bacterial nature (bronchitis, tuberculosis).
• Hereditary predisposition.
• Weakening of the immune system associated with HIV and chemotherapy.

The risk group includes people working in hazardous industries where there are chemical fumes hazardous to health.

Under the influence of these factors, women and men experience pathological changes DNA, as a result of which bronchial epithelial cells begin to mutate, forming a tumor. With a certain degree of organ damage leading to loss of ability to work, a person is issued a disability. It is important to know how to consult a doctor at the first sign.

Types and stages of disease development

Histological classification distinguishes small cell and non-small cell cell carcinoma lung The latter is especially common and accounts for approximately 80% of all cases. These are neoplasms that form from epithelial tissues.

Depending on clinical features classification of lung cancer distinguishes several types of non-small cell form:

• Adenocarcinoma – forms in the peripheral part. The tumor is formed on the basis of the mucous membrane and glandular tissue.
• Squamous cell carcinoma. The neoplasm in this case consists of flat epithelial cells. Often diagnosed central cancer right lung when large bronchi are affected.
• Large cell – the tumor consists of large cells and spreads very quickly.
• Mixed, combining several types.

The mediastinal form of lung cancer, miliary carcinomatosis, is rare. In the first case, a tumor is diagnosed in the mediastinal areas. Miliary carcinomatosis is a lesion of metastases in the form of nodes that differ average degree intensity.

There are 4 stages of lung cancer:

1. The tumor on one of the bronchi measures no more than 3 cm. In stage 1 lung cancer, metastases are usually absent, the lymph nodes and bronchi are not damaged.
2. The tumor grows and takes on dimensions from 3 to 6 cm. Stage 2 lung cancer is characterized by the appearance of single metastases.
3. The tumor becomes more than 6 cm and may occupy the adjacent lobe. Stage 3 lung cancer is identified by metastases detected during diagnosis that appear in the bifurcation lymph nodes.
4. Terminal stage – the tumor grows into nearby organs and tissues. At the last stage of the disease, pericarditis and pleurisy are added, which further worsens the patient’s condition.

On different stages treatment has its own characteristics.

Small cell lung cancer develops in a short period of time, going through only 2 stages:

• Limited. Pathological cells are localized in one organ and nearby tissues.
• Extensive, when metastases are sent to more distant organs.

The fourth stage is not always treatable, therefore it is considered the most dangerous.

Symptoms and signs of stage 4 cancer before death

The disease is often discovered completely by accident. The first symptoms of lung cancer at an early stage, which are just beginning to appear, usually go unnoticed. Postponing a visit to the doctor for minor pain that occurs leads to the disease actively progressing. Usually at an early stage the patient does not focus attention on them. On initial stages This disease is often confused with the common cold. The first signs appear in the form of a slight malaise, a dry cough.

Stage 3 lung cancer, which has gone unnoticed, reveals itself at the next stage with more pronounced symptoms. The patient begins to complain of pain in the chest that occurs when breathing, lack of appetite, coughing attacks with the release of purulent and bloody sputum.

Characteristic symptoms of stage 4 lung cancer before death:

• Shortness of breath that occurs even at rest is the first symptom that you need to pay attention to. Due to the accumulation of exudate and tumor growth, the patient’s breathing becomes intermittent.

• Speech difficulty caused by the lesion cervical lymph nodes. Metastasis results in paralysis vocal cords, the voice becomes hoarse.
• Decrease or complete absence appetite.
• Drowsiness. Due to dehydration and slow metabolism, fatigue occurs, the patient sleeps a lot.
• Apathy. A person loses interest in life.
• Disorientation and hallucinations are typical before death. Memory lapses are possible, speech becomes incoherent. The brain suffers from oxygen starvation, which causes lung cancer.
• Edema. As a result of kidney failure, they form on lower limbs. In case of stage 4 lung cancer with metastases, the latter typically penetrate into the mediastinum, which leads to compression of the veins and the occurrence of edema on the face and neck.
• Unbearable pain is another dying symptom. They arise as a result of damage to other organs by metastases. Often the only way to cope with pain is with the help of narcotic drugs.

The spread of metastases leads to the appearance of diseases unrelated to oncology. This may be pyelonephritis, jaundice, arrhythmia, angina pectoris, peristalsis disorders. Metastasis affects the bones, causing their deformation and severe pain. When stage 4 lung cancer in women and men manifests itself with similar symptoms, treatment usually comes down to using analgesics and narcotic drugs to make the patient’s last days of life easier.

Symptoms of lung cancer in men and women are the same, without specific manifestations. A timely visit to a doctor will prevent the development of the disease, which can result not only in disability, but also death.

The patient's chances of recovery

Even if the first and second stages of lung cancer are missed, the disease can still be overcome. It is strictly forbidden to let it go to such a state when damage to the brain, bones and those symptoms of the disease occur, which are inevitably followed by death. Competent, timely actions help stop the spread of metastases, and treatment of stage 4 lung cancer bears fruit.

Regardless of whether stage 2 or stage 4 lung cancer is treated, different types of the disease have their own prognosis for recovery.

Peripheral damage is said to occur when a pathogenic focus forms in the bronchioles and small bronchi. The neoplasm occurs in areas that are not vital. Helps reverse the disease process surgery and chemotherapy for lung cancer.

Central lung damage is a more severe type of the disease. A pathogenic focus forms where the main blood vessels are concentrated. During the process of growth, the tumor destroys them and moves through the lymphatic system, launching metastases to other organs. The duration of treatment is much longer than that for peripheral tumors. Even if a person receives a disability, he can remain alive.

Video

Video - how to reduce stage 4 cancer?

Diagnostic methods

Diagnose lung cancer early stages instrumental and laboratory methods. In case of tumors, special attention is paid to radiography, MRI, ultrasound, CT.

An important diagnostic step that helps identify pathology is the following laboratory tests:

• A blood test that determines hemoglobin levels.
• Biopsy and histology methods are two procedures during which the tissue taken is examined.

Screening diagnosis of lung cancer is performed using high-frequency equipment. They provide a more complete picture of the disease, which increases the chances of recovery.

How is stage 4 lung cancer treated?

With regular examinations, the initial stage of cancer is detected, when metastases have not yet formed. In this case, surgery is performed to remove the affected part of the lung.

When metastases have already spread throughout the body, it is unlikely that a person will be completely cured, even if the primary focus is removed. Therefore, treatment of stage 4 lung cancer aims to relieve pain and prolong a person’s life as much as possible.

Although an absolute cure is not possible, surgery can improve the patient's condition. But it’s not always possible to do it. At the last stage of the disease, the tumor reaches too large a size, so surgery becomes unsafe. If fluid accumulates in the lungs, a drainage tube is placed.

Chemotherapy, hormonal, and immunomodulatory drugs are usually prescribed. Painkillers for lung cancer help improve the patient's well-being for a short period of time. A method of cancer treatment called ASD fraction 2, which is taken according to a certain scheme with a small amount of milk or tea, has received many positive reviews. When using ASD medicine with fraction 2 according to a certain scheme, the dosage must be observed. It is prescribed individually by the attending physician. Treatment of ASD 2 fraction gives good results in complex therapy along with other medications.

The third stage and even the fourth are not a death sentence. Modern techniques, folk remedies, diet for lung cancer, combined with the desire of the patient himself to recover, can work wonders. Getting used to it new method treatment of cancer - targeted therapy, ensuring rapid destruction of pathogenic cells.

Phytotherapy

Treatment with folk remedies also produces results. Celandine can stop the growth of a malignant tumor. It is used both in complex collections and in the form independent means. To obtain the result, direct contact of the plant with the new growth is required.. With lung cancer, this cannot be achieved, so celandine should be given to the patient in the form of a tincture. Its effectiveness is much higher if taken for lung cancer whose symptoms have just been discovered.

The tincture is prepared from the juice of the plant. The celandine needs to be dug up by the roots, washed, dried a little and ground in a meat grinder. Squeeze the juice from the resulting mass and mix it with alcohol. For 1 liter of juice – 250 ml of alcohol. You should take celandine in the form of this tincture before meals four times a day. One dose is a tablespoon.

You can also use celandine as a compress. It helps relieve pain, especially when metastases have reached the spine. The grass passed through a meat grinder is poured with alcohol. After moistening a piece of cloth in the resulting product, apply it to the sore spot.

Burdock juice helps cure lung cancer. This is a plant traditional medicine also recommends using it to alleviate the patient’s condition. Of course, the question of whether lung cancer can be treated only with folk remedies cannot be answered in the affirmative. This is only an addition to treatment.

Forecast

A positive result depends on the stage at which treatment is started. The patient’s age, lifestyle, tumor size, and general condition of the body also matter. Can't be ignored dietary food, recommended for oncology.

According to statistics, 40% of patients have a survival rate of 5 years. This is if treatment is started in a timely manner and disability is registered. With a local form of the disease and the absence of measures to combat carcinoma, patients live no more than 2 years.

It is impossible to answer unequivocally the question of whether stage 3 lung cancer is curable. A significant role belongs timely diagnosis. The chances of stopping a disease detected at this stage are much greater than when a tumor is detected that affects other organs and lymph nodes. Life expectancy of up to 5 years can be maintained in 24% of patients with large cell neoplasms. At small cell cancer the percentage is two times lower.

Many people are interested in the question of how long patients with stage 4 lung cancer live. The most progressive form is considered to be cellular cancer. Sudden death can occur 3–4 months after discovery of the disease. However, if you treat the patient, taking into account all the nuances of the pathological process, it can be quite optimistic.

It is important to comply with all requirements for caring for cancer patients. Late-stage lung cancer is not curable, but allows you to live for another 5-10 years.

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For most people, when a tumor is discovered, the first question that arises is whether it is malignant. And if the answer is disappointing, then interest in distribution will naturally be oncological process, because everyone knows that the stages of cancer are determined by both the treatment, which can be very painful, and the prognosis, which threatens to be unfavorable.

The variety of neoplastic processes that can originate in the human body cannot be viewed from one perspective. These can be completely different tumors with characteristics unique to them, united by one concept - evil. In addition, malignancy is not always determined by the appearance, reproduction and travel through the body of a “bad” cell. For example, malignant basal cell carcinoma does not show a tendency to metastasize, so such cancer is initial stage can be completely cured, that is, the concepts of “good” and “evil” in this regard are very relative. An important role in determining future bad or good prospects is played by the stages of cancer, which, as one of the main indicators, are used in classification oncological diseases.

Classification and prognosis

Neoplastic processes that can originate in the body can differ greatly in morphological characteristics, preferences of one tissue or another, ability to metastasize, clinical course and prognosis, although they are all often combined into one word - cancer, which is a malignant tumor of epithelial tissue . Oncological processes of a different origin that carry “evil” have different names.

Thus, the basis for classification malignant neoplasms take various (basic) characteristics of the neoplastic process:

• Morphological features of the tumor (its type, degree of malignancy);
• Localization primary focus;
• The size of the tumor, its growth rate;
• The ability of this type of neoplasia to.

TMN classification using an example thyroid gland

International classification (TNM – t humor, n odus, m etastasis) malignant tumors is voluminous and for the most part incomprehensible to a person far from the terminology of the fundamental sciences of medicine, however, when forming groups of tumors, it is primarily focused on the prognosis for cancer in various stages, A stages are determined by:

1. The prevalence of the primary lesion at the time of its detection (T);
2. Reactions of regional lymph nodes (N);
3. The presence or absence of distant metastasis (M).

In addition, each tumor process (taking into account localization) can be classified according to individual parameters:

• By clinical signs (clinical classification), that is, according to data obtained using various diagnostic methods;
• Based on the pathomorphological features of the tumor, which are determined by histological examination;
• Depending on histopathological differentiation (poorly differentiated tumors are more dangerous and “meaner”, they quickly grow into neighboring tissues and metastasize to distant organs).

All these classification issues are very difficult for a non-specialist, but patients are more interested in what the prognosis is for cancer of a certain location depending on the stage of the process, because it is obvious that tumors with different morphological structures will behave differently in the body. In this regard, the stage of cancer is perceived, perhaps, as the most reliable prognostic criterion not only by doctors, but also by patients.

It all depends on the stage

Without delving into numerous classification characteristics, we will try to consider similar prognosis options for various forms of neoplasia depending on the stage. There are five of them:

Stage 0

Stage 0 includes cancer of any location. The boundaries of cancer at stage zero do not advance beyond the boundaries of the epithelium, which gave rise to the neoplasm. An example of stage 0 is carcinoma in situ - a non-invasive (for the time being) epithelial tumor. With adequate treatment, such cancer completely curable.

Stage 1

At this stage, the cancer, in search of a place, slowly expands its borders, but does not go far and does not affect distant organs. The only exception is stomach cancer, which already at the first stage metastasizes to lymph nodes. Mostly, the prognosis for this stage is favorable, the patient can count on healing, the main thing is early diagnosis and immediate measures to eliminate the tumor.

Stage 2

Stage 2 is distinguished not only by the progression of the process in the primary focus, but also by the beginning of metastasis to the lymph nodes (regional). The prognosis for stage 2 cancer depends on the type and location of the tumor.

stages of cancer using the example of an intestinal/esophageal tumor; at stage 4, separated metastases are formed

Stage 3

Here, further progression of the disease is noted, the penetration of cancer into the lymph nodes is obvious, but there are no distant metastases yet, which is an encouraging factor for prolonging the patient’s life. Survival rates for stage 3 cancer are also different for each tumor. The location, type, degree of differentiation of neoplasia, the general condition of the patient and other factors that aggravate the course of the disease or, conversely, help prolong life, all play a role.

When asked whether stage 3 cancer can be cured, the answer is likely to be negative. after all, even in the absence of obvious distant metastases, the malignant process has already taken power over the human body, so count on a long and happy life with stage 3 cancer it is not necessary. The patient's life expectancy depends entirely on the degree of evil brought by the tumor.

Stage 4

Stage 4 is the terminal stage of cancer. Damage to an organ, lymph nodes, metastases to distant organs. However, it should be noted that stage 4 cancer can be diagnosed in the absence of distant metastases. Common, rapidly growing primary tumors or small neoplasms that affect the lymph nodes are also sometimes referred to as stage 4 of the malignant process. Some poorly differentiated tumors and undifferentiated thyroid cancer are also included here, regardless of the size of the tumor and the condition of the regional lymph nodes, but when distant metastases are detected. A cure for stage 4 cancer is in great doubt, or rather, it is completely excluded, even if the primary tumor is completely destroyed, distant metastases will still “eat the person.”

Each tumor has its own prognosis

It is not only difficult but also impossible to describe the stages of all tumors. Meanwhile, it is worth trying to acquaint the reader with the initial stage for tumors that the patient himself can detect ( surface species), as well as the course and prognosis of the most common neoplastic processes localized in the main human organs.

Cancer on the surface

Cancer localized on the skin and visible mucous membranes at the initial stage can be suspected by the person himself if he is inclined to carefully monitor his health.

First appears small speck or a nodule that does not particularly cause concern. If, over a long period of time, it does not disappear, does not go away from the use of various pharmaceutical and folk remedies, it is better for the patient to immediately consult a doctor for clarification of the origin of the incomprehensible and unusual skin elements.

skin tumors: 1 - mole, 2 - nevus dysplasia (moles), 3 - actinic keratosis, 4 - squamous cell carcinoma, 5 - basal cell carcinoma, 6 - melanoma

The initial stage is asymptomatic in most cases, but painful cracks, ulcers, erosions, and seals should alert you to the development of an oncological process.

leukoplakia of the tongue, papillomatosis, erosive changes in the mucosa - common precancerous conditions

early stage lip cancer

It does not occur as often; smokers or people who irritate this area in other ways suffer more. Symptoms of cancer (non-healing cracks, ulcers, peeling, in general, everything that should not be there) are not so painful for the patient that he quickly runs to the doctor, but in vain, because cancer at the initial stage can be cured. This will be very difficult to do in the future.

The initial stage occurs with symptoms of inflammation, so patients attribute everything to manifestations of a common chronic disease and, as a rule, do not rush to see a doctor.

Neoplastic processes that have found a place on the tongue, lips, and throat are combined into one pathology - oral cancer.

Rapid growth and high aggression – lung cancer

Fast-growing, very malignant and very common neoplasms that claim thousands of (mostly male) lives every year. That’s right, this definition primarily concerns, which in growth is ahead of neoplasia of other localizations and behind short time reaches the final stage, leading a person to his deathbed.

In the first stage of lung cancer The size of the tumor usually does not reach 3 cm, the neoplasm does not leave the “place of birth” (segment), and gives practically no symptoms of its presence. Patients may associate any manifestations in the form of cough, shortness of breath, chest pain with the presence of another pathology, for example, chronic bronchitis. Meanwhile, early diagnosis of cancer with actively started treatment at the first stage gives a fairly high survival rate (up to 80%).

Second stage also tends to disguise itself as relative prosperity, but the size of the outbreak doubles (up to 6 cm). The neoplastic process still remains within the lung lobe, but is already beginning to “show interest” in nearby lymph nodes, dispersing single metastases. Cough, sputum (sometimes with blood), pain, fever, signs of intoxication again resemble an exacerbation of long-term chronic diseases of the bronchopulmonary system. This usually confuses the patient, so he does not see a doctor for a long time, thereby wasting valuable time. But the combination with radical treatment ensures survival rate for stage 2 cancer up to 50%. As they say, fifty-fifty, and that’s a lot.

For the third stage The malignant process in the lungs is characterized by further growth of the tumor, which exceeds 6 cm in size and, having affected the lung, metastasizes to nearby lymph nodes.

Last stage (fourth) has a large tumor that has left lung boundaries, which captured neighboring organs and spreading metastases through lymphatic and blood vessels throughout the body. Terminal stage cancer leaves the patient with only a few months to live. The body is destroyed by a tumor, existing methods treatments are useless or can only alleviate suffering, but not really improve the condition. A cure for stage 4 cancer can only be a dream, and people who have overcome stage 4 cancer can only be met on dubious forums on the Internet... But this has already been said before.

Subject of special attention – breast cancer

Often, cancer at the initial stage can be “caught” in lesions. The best diagnostician in this case is the woman herself or (which happens quite often) her husband. This is explained by the fact that female breast is not only an organ that serves to feed the child. She is an object of adoration and admiration among people of the opposite sex, so the attitude towards her is especially reverent and attention is increased. Meanwhile, not everyone and not always succeed in successfully finding the primary focus and coping with carcinoma in situ (non-invasive epithelial tumor); in some, the disease goes through all stages of breast cancer:

characteristic cancerous and precancerous breast changes that are worth paying attention to

• Stage zero – carcinoma in situ(intraductal tumor, lobular cancer, Paget's disease) - a pre-invasive form that gives every chance of complete healing.
• First stage of breast cancer: the tumor is small, its diameter does not exceed 2 cm, it has not yet grown anywhere and, moreover, has not given rise to metastatic growth, the prognosis, of course, is favorable.
• Second stage: The size of the tumor in stage 2 cancer ranges from 2-5 cm, the tumor began to invade additional territories, growing into neighboring tissues, and metastasizing to the lymph nodes.
• Stage Three Severity consists not only in the growth of the tumor, its penetration into neighboring tissues and nearby lymph nodes, but also in the transfer of cancer cells to distant organs. After all, even with radical treatment, evil can lurk, and after 10-15 years (this can be the life expectancy for stage 3 breast cancer) it will remind itself in order to have a fatal outcome, which is why stage 3 cancer is considered incurable.
• For stage four breast cancer the size of the primary lesion no longer matters. The worst thing about stage 4 cancer is that tumor growth completely took over the lymphatic system, “occupied” the chest and spread to the entire body in the form of metastases to distant organs. Cure from stage 4 cancer is impossible by any means, because the scattered “evil” can no longer be collected throughout all the tissues of the body. Radiation and chemotherapy may delay neoplastic growth for some time, but not for long - with stage 4 cancer, life expectancy is from one to three years.

breast cancer stages

By the way, breast cancer is not excluded in males, although this happens very, very rarely.

Purely women's problems

The most vulnerable place of the main reproductive organ of women

Significantly “rejuvenated” in recent years cervical tumors, which experts associate with the spread of papillomavirus infection (HPV). Meanwhile, there is a high probability of detecting a neoplastic process at the stage of its inception, and in other stages this type of oncology is relatively well diagnosed. Thus, before becoming real, the development of a tumor goes through several stages:

stages of cervical cancer

The prognosis for cervical cancer, as with other tumors, depends on the stage. Factors such as the type of cancer and the degree of differentiation of neoplasia are also of considerable importance (the higher the degree, the greater the chance of survival).

The main “killer” of gynecological oncology

Ovarian cancer, having a lot of forms and types, is considered the most unfavorable and uncontrollable oncological process of the female genital area. The most common type is a tumor of the glandular tissue of the ovaries - adenocarcinoma, which is particularly cruel and aggressive. The insidiousness of ovarian cancer also lies in the fact that it presents particular difficulties in diagnosis. The existing symptoms are well linked to the manifestations of chronic gynecological diseases(adnexitis, uterine fibroids, etc.). However Some signs should still alert a woman:

1. causeless weight loss without dieting or exercise;
2. progressive enlargement of the abdomen (accumulation of fluid in abdominal cavity– ascites);
3. indigestion.

Ovarian cancer, like other tumors, goes through 4 stages:

1. The “birth” of a cancer cell, the development of the process within one ovary. The appearance of ascites is already possible at the first stage of cancer, which gives some hope for him early diagnosis and prolongation of life by 5 years in 80% of patients (of course, subject to a combination surgical treatment with other methods).
2. At the second stage Both ovaries, peritoneum, fallopian tubes and uterus are affected. An enlarged abdomen (ascites) with general weight loss tells a woman about the development of a bad disease; the prognosis, of course, worsens.
3. Third stage is no longer difficult to diagnose; problems can be noticed even during normal gynecological examination. Survival rates for stage 3 cancer are low; only every tenth woman in a hundred has a chance to live five years.
4. For stage 4 Cancer is characterized by the spread of metastases throughout the body, but most often they can be found in the lungs and liver. There is no talk of a cure for stage 4 cancer; survival rates are reduced to zero.

The prognosis cannot be the same for everyone; one cannot speak in general about the stage of cancer and life prospects, because in each specific case other factors are taken into account: the histological features of the tumor, the age of the patient, the condition of other organs. Some people can fight longer, while others give up in the first months.

Gastrointestinal tract

Esophageal cancer

They are classified as malignant and aggressive neoplastic processes. It grows quickly, metastasizes early, is difficult and painful to diagnose and treat, and has a very unfavorable prognosis.

This cancer at the initial stage can mislead its owner by the absence of some specific symptoms. A person overcomes difficulties with swallowing, periodic spasms, and choking while eating with the help of liquid. I washed down my food with water - everything seemed to have passed and I could continue to live in peace, so the visit to the doctor is constantly postponed. And, by the way, thoughts of bad things rarely come to mind. However, if the disease is detected at the first stage If you take action quickly, you can count on five (or even more) years of life.

Symptoms of esophageal cancer increase as the tumor develops, which goes through the same stages as other cancers (with germination and metastasis). At the same time, the prognosis is worsening.

On 3-4 stages The voice is already changing, dysphagia is increasing, esophageal vomiting periodically appears, something is constantly bothering the chest, the patient is losing weight, losing the ability to work. Survival rates for stage 3 cancer are low, with active treatment Approximately 25% of patients benefit, but with distant metastasis, only half of them have some prospects.

With stage 4 cancer, patients live barely six months, and full life it can hardly be called.

Number two leader

The leading position in terms of incidence and mortality is still held by lung cancer, which is recognized throughout the world as the invincible “enemy of all times and peoples.” Abundance of carcinogens, bad habits, hereditary predisposition, carriage of Helicobacter pylori infection are factors contributing to the development of a tumor in this localization. Human nature is such that the stomach hears better and more often than other organs (eat, drink, smoke...). Satisfying his (stomach’s) sometimes unreasonable demands, the thrill-seeker “digs his own grave.”

The prognosis for stomach cancer largely depends on the depths the tumor reaches when immersed in the wall of the stomach. For example, early cancer that affects only the superficial layers (mucosal and submucosal) responds well to treatment, so almost all patients survive. However, such bright prospects, unfortunately, cannot await patients whose tumor is already first stage spread not only to the stomach, but also metastasized to the lymph nodes.

stages of stomach cancer

A disorder in the stomach can be quite difficult to notice; symptoms appear late, despite the fact that the tumor can be detected by palpation. Dyspeptic disorders, weakness, aversion to food, weight loss, lack of interest in life - many people attribute these “minor signs” to their usual sensations, especially if for many years suffered from ulcers or gastritis. Pain appears in the later stages (3-4), when the cancer, having reached a large size, has already left the digestive organ.

The terminal stage of stomach cancer is accompanied by great suffering:

• Intense pain;
• Progressive anemia;
• Changes in the blood (leukocytosis, high ESR);
• Intoxication;
• Fever;
• Exhaustion.

The last stage leaves a stomach cancer patient with only a few months to live...

Again gender and age...

All the above stages go through and. More often it strikes large intestine middle-aged and elderly men. The cause of its development, like stomach cancer, is often the patient’s own preferences. The first symptoms (discomfort, fatigue, nervousness) do not give much reason to suspect evil. The appearance obvious signs(pain, intestinal disorders, excretion of blood in feces) is often delayed.

stage of intestinal cancer, stage 4 is characterized by metastasis to the liver

The stage of intestinal cancer, as in the case of neoplasia of other localizations, completely determines the prognosis.

Detection of an oncological process at the first stage ensures a 5-year survival rate of almost 90% of patients; as the degree increases, the chances of living for many years decrease significantly. In the last stage of intestinal cancer, the prognosis is extremely unfavorable, especially if the tumor originated in the distal rectum.

The problems of oncology are solved by specialists, however, according to the author, people far from medicine can play a big role in this if they are aware of the symptoms, stages and methods of treating malignant neoplasms. It is obvious that in most cases we can defeat cancer at the initial stage, the main thing is to detect it in time. And who, if not the patient himself, will be the first to know about the approaching disaster, but at the same time he will not rush to try dubious medicines such as soda and hemlock, but will turn to a medical institution where he will receive qualified assistance.

Video: stages of cancer and other cancer concepts in simple terms

The author selectively answers adequate questions from readers within his competence and only within the OnkoLib.ru resource. Face-to-face consultations and assistance in organizing treatment in at the moment, unfortunately, they do not turn out to be.

No matter what organ or part of the body is affected by cancer, it is scary for any person. Unfortunately, every year a certain number of people hear a similar diagnosis addressed to them. In this article we'll talk specifically about lung cancer, a disease that kills 85% of those affected.

Interesting! According to statistics, cancer of the main respiratory organ occurs 10 times more often in men than in women. Moreover, the susceptibility to the disease increases as a person gets older.

The essence of oncological disease is that due to damage to macromolecules responsible for the preservation and transmission genetic program, normal cells transform into cancer cells. The process involves structural elements of respiratory organs such as bronchi and lungs. It would be logical to assume that failures at the genetic level are provoked by certain factors.

The most dangerous is the influence of carcinogens, which, for example, can be inhaled with cigarette smoke. Therefore, 90% of lung cancer is caused by smoking. tobacco products. Air pollution also plays a significant role. It has been observed that people living in industrial areas are more susceptible to cancer. More rare, but still contributing factors to the disease include:

• human contact with substances of a specific type (arsenic, chromium, cadmium and radon, asbestos and nickel, etc.);
• exposure to radiation;
• advanced form of bronchitis, tuberculosis, pneumonia, bronchiectasis.

Stages of the pathological process and its symptoms

It is known that the most dangerous is lung cancer in the terminal stage of its development, which means extreme degree. But, of course, the disease does not immediately take on this form, but comes to this gradually. For example, at the first stage, the tumor-like formation is small in size, and the cancer cells have not yet had time to spread to the organs lymphatic system. During this period, the tumor size fluctuates between 3-5 cm, in 50% of cases patients reach a 5-year survival rate.

At the second stage, the tumor increases slightly, to a maximum of 7 cm, but does not spread to the lymph nodes. The main danger in such conditions is that there is a possibility of tumor growth into the lining of the respiratory organ and into other areas of the body. The 5-year survival rate is almost halved.

The terminal stage of lung cancer is preceded by the fourth stage. Here the tumor already increases in size and becomes more than 7 cm, and damage to the lymph nodes is inevitable, not only nearby, but also distant ones. But metastases appear at the very last stage of disease development. In the area of ​​the affected or adjacent lung, fluid accumulates, concentrated by cancer cells, in in rare cases it happens close to the heart. As for survival, we are talking about 2-13% for non-small cell cancer, and for small cell cancer it is 1%.

The clinical picture of the disease is as follows: at the beginning of its development, the symptoms are slightly masked. The painful condition is manifested by decreased performance, fatigue, as well as a lack of interest in what is happening around. The following are characteristic features: respiratory diseases, pneumonia, such as fever, mild malaise.

Attention! If such a condition persists for 1-2 months, then this is a serious reason to think about your health.

As the patient's condition worsens and lung cancer enters the terminal stage, more serious symptoms appear:

1. a cough that is dry at first, then becomes hacking and does not go away. However, it is worth noting that, despite a respiratory disease, such a symptom as a cough may be absent;
2. hemoptysis - the presence of streaks of blood in sputum expelled with a cough. These circumstances indicate that the walls of the bronchi are affected. Also during this period there are destructive processes accompanied by damage to blood vessels. If lung cancer is at a terminal stage, then the patient experiences not just streaks of blood, but significant discharge of scarlet blood, which is called pulmonary hemorrhage;
3. chest pain - it is concentrated in the place where the lesion is located tumor process. Its appearance is associated with the fact that pathological process the membrane covering the lungs and walls is involved chest cavity, and subsequently the intercostal nerves. Painful sensations may worsen with deep breathing or coughing;
4. shortness of breath - lack of air, as in calm state, and under loads. This is due to the fact that the formation blocks the normal flow of air through the bronchi. At the same time, the functioning of the affected area of ​​the lung becomes inferior.

Someone with terminal lung cancer may experience difficulty passing food through the esophagus, further indicating the seriousness of their condition. Metastasis occurs to organs such as:

• brain;
• skeletal bones;
• kidneys;
• liver, etc.

This causes symptoms of disruption of their normal functioning.

Treatment

In conditions of stage 4 cancer radical surgery can be used as a way to increase the patient's life expectancy. Also effective is radiation therapy, which allows, by reducing the formation of cancer cells, to alleviate the manifestation of symptoms. In some cases, chemotherapy treatment is prescribed as a complement to courses of ionizing radiation. Such measures can significantly improve the patient's condition.

As mentioned above, one of the complications of metastasis is pleurisy. In order to reduce fluid volumes, the following procedure is performed: using special tool(trocar) the doctor pierces chest wall, after which the fluid and pus accumulated in the cavity are removed.

You should always remember that cancer in the final stages of its development is very difficult to treat. Therefore, you should not neglect your health and life, and at the slightest change in your condition, immediately seek qualified help.

Cancer is very serious illness, which is characterized by the appearance of a tumor in the human body that grows rapidly and damages nearby human tissue. Later, the malignant tumor affects the nearest lymph nodes, and at the last stage metastases occur, when cancer cells spread to all organs of the body.

The terrible thing is that at stages 3 and 4, cancer treatment for some types of oncology is impossible. Because of this, the doctor can reduce the patient’s suffering and slightly prolong his life. At the same time, he is getting worse every day, due to rapid spread metastases.

At this time, the patient's relatives and friends should roughly understand exactly what symptoms the patient is experiencing in order to help survive the last stage of life and reduce his suffering. In general, those dying from cancer due to complete damage by metastases experience the same pain and ailments. How do people die from cancer?

Why do people die from cancer?

Cancer occurs in several stages, and each stage is characterized by more severe symptoms and damage to the body by the tumor. In fact, not everyone dies from cancer, and it all depends on at what stage the tumor was discovered. And here everything is clear - the earlier it was found and diagnosed, the greater the chances of recovery.

But there are still many factors, and even stage 1 or even stage 2 cancer does not always provide a 100% chance of recovery. Since cancer has many properties. For example, there is such a thing as the aggressiveness of malignant tissues - the higher this indicator, the faster the tumor itself grows, and the faster the stages of cancer occur.

The mortality rate increases with each stage of cancer development. The largest percentage is at stage 4 - but why? At this stage, the cancerous tumor is already enormous in size and affects nearby tissues, lymph nodes and organs, and metastases spread to distant parts of the body: as a result, almost all tissues of the body are affected.

At the same time, the tumor grows faster and becomes more aggressive. The only thing doctors can do is reduce the growth rate and reduce the suffering of the patient himself. Usually chemotherapy and radiation are used, then the cancer cells become less aggressive.

Death with any type of cancer does not always occur quickly, and it happens that the patient suffers for a long time, which is why it is necessary to reduce the patient’s suffering as much as possible. Medicine cannot yet fight terminal cancer neglected form, so the earlier the diagnosis is made, the better.

Causes of the disease

Unfortunately, scientists are still struggling with this question and cannot find an exact answer to it. The only thing that can be said is that there are a combination of factors that increase the chance of getting cancer:

• Alcohol and smoking.
• Junk food.
• Obesity.
• Bad environment.
• Working with chemicals.
• Incorrect drug treatment.

In order to at least somehow try to avoid cancer, you must first monitor your health and undergo regular examinations with a doctor and take a general and biochemical analysis blood.

Symptoms before death

That is why the correct treatment tactics, chosen at the last stage of the disease, will help reduce pain and illness for the patient, and also significantly prolong life. Of course, each oncology has its own signs and symptoms, but there are also common ones, which begin immediately at the fourth stage, when damage occurs malignant formations almost the entire body. How do cancer patients feel before death?

1. Constant fatigue. Occurs due to the fact that the tumor itself takes a huge amount of energy and nutrients for growth, and the larger it is, the worse. Let's add metastases to other organs here, and you will understand how difficult it is for patients in the last stage. The condition usually worsens after surgical intervention, chemotherapy and radiation. At the very end, cancer patients will sleep a lot. The most important thing is not to disturb them and let them rest. Subsequently deep sleep may develop into a coma.
2. Appetite decreases. The patient does not eat because general intoxication occurs when the tumor produces a large amount of waste products into the blood.
3. Cough and difficulty breathing. Often, metastases from any organ cancer damage the lungs, causing swelling of the upper body and coughing. After some time, it becomes difficult for the patient to breathe - this means that the cancer has firmly settled in the lung.
4. Disorientation. At this moment, there may be memory loss, the person ceases to recognize friends and relatives. This happens due to metabolic disorders with brain tissue. Plus, there is severe intoxication. Hallucinations may occur.
5. Blue discoloration of extremities. When the patient’s strength becomes low and the body tries with all its might to stay afloat, the blood mainly begins to flow to the vital organs: heart, kidneys, liver, brain, etc. At this moment, the limbs become cold and acquire a bluish, pale tint. This is one of the most important harbingers of death.
6. Spots on the body. Before death, spots appear on the legs and arms due to poor circulation. This moment accompanies the approach of death. After death, the spots become bluish.
7. Muscle weakness. Then the patient cannot move and walk normally, some can still move slightly but slowly to the toilet. But the majority of them lie down and move around.
8. Coma state. It may come suddenly, then the patient will need a nurse who will help, wash and do everything that the patient cannot do in such a condition.

The dying processand main stages

1. Predagonia. Central nervous system disorder. The patient himself does not feel any emotions. The skin on the legs and arms turns blue, and the face becomes earth-colored. The pressure drops sharply.
2. Agony. Due to the fact that the tumor has already spread everywhere, oxygen starvation, heart rate slows down. After some time, breathing stops, and the blood circulation process slows down greatly.
3. Clinical death. All functions are suspended, both the heart and breathing.
4. Biological death. The main sign of biological death is brain death.

Of course, some cancer diseases may have characteristic signs, but we told you about the general picture of death from cancer.

Symptoms of brain cancer before death

Brain tissue cancer is difficult to diagnose in the early stages. It doesn’t even have its own tumor markers, which can be used to determine the disease itself. Before death, the patient feels severe pain in a certain place of the head, he may see hallucinations, memory loss occurs, he may not recognize his family and friends.

Constant change of mood from calm to irritated. Speech is impaired and the patient may utter all sorts of nonsense. The patient may lose vision or hearing. In the end, motor function is impaired.

Last stage of lung cancer

Develops initially without any symptoms. Recently, oncology has become the most common among all. The problem is precisely the late detection and diagnosis of cancer, which is why the tumor is discovered at stage 3 or even stage 4, when it is no longer possible to cure the disease.

All symptoms before death of stage 4 lung cancer relate directly to breathing and bronchi. Usually the patient has difficulty breathing, he constantly gasps for air, he coughs violently with heavy discharge. At the very end it may begin epileptic seizure which will lead to death. Terminal stage lung cancer is very nasty and painful for the patient.

Liver cancer

When a tumor affects the liver, it grows very quickly and damages inner fabrics organ. The result is jaundice. The patient feels severe pain, the temperature rises, the patient feels nauseous and vomits, there is difficulty urinating (the urine may contain blood).

Before death, doctors try to reduce the suffering of the patient himself with medications. Death from liver cancer is very difficult and painful with a lot of internal bleeding.

Bowel cancer

One of the most unpleasant and most severe oncological diseases, which is very difficult at stage 4, especially if a little earlier an operation was performed to remove part of the intestine. The patient feels severe pain in the abdomen, headache, nausea and vomiting. This is due to severe intoxication from the tumor and retained feces.

The patient cannot go to the toilet normally. Since at the last stage there is also defeat bladder and liver, as well as kidneys. The patient dies very quickly from poisoning with internal toxins.

Esophageal cancer

The cancer itself affects the esophagus, and late stages the patient can no longer eat normally and eats only through a tube. The tumor affects not only the organ itself, but also nearby tissues. Metastasis spreads to the intestines and lungs, so pain will appear throughout the chest and abdomen. Before death, the tumor may cause bleeding, causing the patient to vomit blood.

Laryngeal cancer before death

A very painful disease when the tumor affects all nearby organs. He feels severe pain and cannot breathe normally. Usually, if the tumor itself completely blocks the passage, the patient breathes through a special tube. Metastases spread to the lungs and nearby organs. Doctors prescribe large amounts of painkillers at the end.

Last days

Usually, if the patient wishes, the patient’s relatives can take him home, and he is prescribed and given strong drugs and painkillers that help reduce pain.

At this moment, you need to understand that the patient has very little time left and you need to try to reduce his suffering. At the very end, additional symptoms may appear: vomiting blood, intestinal obstruction, severe pain in the abdomen and chest, coughing up blood and shortness of breath.

At the very end, when almost every organ is affected by cancer metastases, it is better to leave the patient alone and let him sleep. The most important thing is that at this moment there are relatives, loved ones, close people next to the patients, who will reduce pain and suffering with their presence.

How to alleviate the suffering of a dying person?

Often the patient's pain can be so severe that conventional medications do not help. Improvement can only be brought about by narcotic substances, which are given by doctors for cancer diseases. True, this leads to even greater intoxication and quick death for the patient.

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