Lung Cancer

Lung cancer, also known as bronchial carcinoma, refers to a malignant tumour on the lung that can affect any area of tissue in the lungs or the bronchi. The tumour is caused when cells in the bronchial system in the lungs, consisting of bronchi and bronchioles, start to divide uncontrollably. These rapidly dividing cells increasingly encroach on healthy lung tissue, and can metastasise (form secondary tumours) by travelling to other organs within the body via the bloodstream or the lymphatic system.

There are two main forms of bronchial carcinoma: small-cell carcinoma and non-small-cell carcinoma.

The main risk factor for lung cancer is smoking.

Other risk factors may include:
- A diet low in vitamins
- Radon (a natural radioactive gas)
- Scars on the lungs
- Genetic disposition (especially for young lung cancer patients)
- High levels of air pollution
- Nickel and quartz dust
- Exposure to asbestos

In some cases, no particular cause can be identified. This is then referred to as idiopathic bronchial carcinoma.


As the early stages of the disease tend to progress without any clear symptoms, patients often do not realise they have contracted lung cancer until it has reached an advanced stage. Some early symptoms which may be an indication of lung cancer can also occur in people suffering from other diseases such as pneumonia or bronchitis. Approximately two thirds of patients suffering from lung cancer are not diagnosed until the disease has already progressed beyond the stage where it could have been cured with surgery, radiation therapy, chemotherapy or immunotherapy.

However, there are certain red flags for lung cancer. These include:
- Persistent hoarseness
- Fever
- Nightly sweats
- Lack of appetite
- Swelling of the throat or face
- Significant unintentional weight loss
- Constant chest pains
- Coughing and coughing up blood
- A chronic cough which becomes worse or changes over time
- Phlegm which changes or becomes more noticeable over time
- Generally feeling listless or unwell
- Persistent tiredness
- Persistent weakness
- Breathlessness occurs for the first time or becomes more frequent
- Increased chest pain
- A cough lasting longer than 4 to 6 weeks (chronic cough)
- Cold or bronchitis that does not improve even after antibiotics
- Neurological symptoms such as paralysis, vision problems or headaches

Consult your doctor if you have one or more of the symptoms listed above, especially if you smoke.


The DZI offers lung cancer patients cutting-edge treatments and the opportunity to take part in clinical trials. An interdisciplinary approach is taken in collaboration with all relevant departments at Universitätsklinikum Erlangen, and treatment tailored to suit each individual patient. When deciding on the most suitable course of treatment, doctors consider the nature of the carcinoma and the extent to which it has spread, as well as the patient’s age and general state of health.

Nowadays, we also have several different options for treating patients whose disease has progressed beyond the stage where a cure is possible. These are predominantly aimed at significantly increasing the patients’ quality of life.

Various treatment options are available, depending on how far the disease has progressed.

Curative care for curable carcinoma:
If the cancer is restricted to one half of the lung and if no more than one metastasis can be detected outside the lung, then treatment is aimed at curing the patient of the cancer. Patients undergo surgery to remove the tumour, and are given a course of chemotherapy, radiation therapy or immunotherapy either before or after surgery. In certain special cases, it is required both before and after surgery. The exact procedure is decided in consultation with the Department of Radiation Oncology and the Department of Thoracic Surgery.

There has been extensive research into this stage of lung cancer. The aim is to increase lung cancer patients’ chances of long-term survival.

Palliative care (for incurable lung cancer):
Treatment for patients at an advanced, incurable stage of the disease focuses on providing systemic, drug-based treatment. There are various different options:
- Modern substances to hinder the formation of new blood vessels in the tumour
- Chemotherapy
- Targeted approaches using tyrosine kinase inhibitors, for cancer cells with certain genetic properties

Immunotherapy is also an option for approximately 15 to 20 percent of all patients. Immune checkpoint inhibitors are given, often in combination with chemotherapy drugs, to prevent cancer cells from influencing the immune system and thereby avoiding elimination.

The relevant hospital departments are currently focusing on clinical trials combining immunotherapy and/or targeted therapies with traditional treatments such as chemotherapy or radiation therapy. Research is also being conducted into combinations of the various targeted medicines or immune checkpoint inhibitors. The first combinations of this type have already been approved for patients with lung cancer, and more are likely to be approved in future.

Do you have any questions on the treatment of lung cancer? Please feel free to get in touch with us by phone, e-mail or via our contact form.