TürkçeCarcinoma is a type of cancer that originates from epithelial tissue and represents the most common group of malignant tumors in humans. It can develop in many organs, including the skin, lungs, breast, prostate, and colon. It results from uncontrolled cell proliferation and has the potential to invade surrounding tissues and metastasize.
Carcinoma types are classified according to the type of epithelial cell from which the tumor develops and the organ in which it occurs. The most common subtypes include squamous cell carcinoma, adenocarcinoma, and basal cell carcinoma. Each subtype may exhibit different biological behavior, rates of spread, and clinical prognostic characteristics.
Carcinoma treatment involves a multidisciplinary approach planned according to the tumor type, stage, location, and the patient’s overall health status. Surgical resection, chemotherapy, radiotherapy, targeted therapies, and immunotherapy are among the most commonly used treatment options.
The diagnosis and risk factors of carcinoma are important for early detection and improving prognosis. Tobacco use, chronic inflammation, genetic predisposition, environmental carcinogens, and certain viral infections are considered risk factors. Diagnosis is generally confirmed through biopsy and imaging methods.
| What Is Carcinoma? | Information |
| Definition | Carcinoma is a malignant tumor originating from epithelial cells. It accounts for the vast majority of cancers. |
| Site of Development | It can develop in organs containing epithelial tissue, such as the skin, lungs, breast, stomach, intestines, and prostate. |
| Causes | Prolonged sun exposure, smoking, alcohol consumption, genetic predisposition, viral infections (e.g., HPV, HBV, HCV), and exposure to chemicals. |
| Symptoms | Symptoms vary depending on the type. They may include a mass, skin ulcer, bleeding, weight loss, and fatigue. |
| Diagnostic Methods | Diagnosis is established through biopsy, imaging methods (CT, MRI, PET), and laboratory tests. |
| Course and Prognosis | It varies depending on the type, stage, and response to treatment. Early diagnosis is of vital importance. |
| Distinguishing Feature | Unlike sarcomas, it originates from epithelial cells; therefore, its treatment and clinical course also differ. |
How Does Carcinoma Develop at the Cellular Level and What Are Its Triggers?
Under normal circumstances, every cell in a healthy body has a specific and orderly life cycle. When its time comes, the cell dies through a programmed process, and a new one is produced to renew the tissue. This perfectly functioning system is tightly controlled by the DNA located within the cell nucleus. However, when cells are exposed over a prolonged period to harmful external factors such as tobacco products, asbestos fibers, severe air pollution, radiation, or chemical substances, this balance gradually begins to deteriorate.
The body enters a continuous cycle of inflammation and repair to heal this chronic damage in the lungs or airways. As the tissue constantly attempts to regenerate, copying errors—known as mutations—occur in the genetic code of the rapidly dividing cells. As these errors accumulate over time, a normal cell transforms into a rebellious structure that becomes insensitive to growth and stop signals, forgets when it should die, and focuses solely on uncontrolled proliferation. In other words, it becomes a carcinoma cell. Therefore, carcinoma is not a condition that develops overnight but rather the result of years of failure in the body’s cellular defense and repair mechanisms.
What Are the Most Common Types of Carcinoma Found Within the Chest Cavity?
The vast majority of carcinomas encountered in thoracic surgery originate from the lungs. Lung cancers, which display highly diverse biological behaviors, are broadly classified into two main groups according to their cellular characteristics. This distinction is extremely important because it determines the tumor’s pattern of spread, biological behavior, and response to surgical treatment.
The first and most common group is Non-Small Cell Lung Cancer (NSCLC). This group includes relatively slower-growing carcinomas for which surgical intervention is most frequently and successfully performed. It also consists of several subtypes. For example, adenocarcinomas usually arise from mucus-producing cells located in the outer parts of the lungs and may even occur in individuals who have never smoked. Squamous cell carcinomas, in contrast, are more commonly found in the central airways of the lungs and have a strong direct association with tobacco use. The second major group, Small Cell Lung Cancer (SCLC), consists of tumors composed of very small cells under the microscope that grow extremely rapidly and tend to spread to other parts of the body even at very early stages.
What Symptoms Does Lung Carcinoma Cause?
As carcinoma tissue begins to grow within the lung, it may progress silently for a long period without causing any symptoms. Since lung tissue itself contains no pain receptors, a person may remain completely unaware until the tumor reaches a considerable size. However, once the tumor begins to obstruct the airways or compress surrounding membranes or nerves, various warning signs appear.
The most common symptoms encountered during clinical evaluation include:
- Persistent cough
- Coughing up blood
- Chest pain
- Shortness of breath
- Wheezing
- Hoarseness
- Loss of appetite
- Unexplained weight loss
What Are the Biological Differences Between Thymoma and Thymic Carcinoma?
At the front of the chest cavity, immediately behind the breastbone, lies a compartment called the mediastinum. Within this region is the thymus gland, which plays a vital role in the development of the immune system, particularly during childhood. Although the gland shrinks and is largely replaced by fatty tissue in adulthood, tumors may still arise from its remaining epithelial cells. These tumors are generally referred to as thymomas or thymic carcinomas.
Thymomas usually grow very slowly and remain encapsulated, showing little tendency to invade or damage surrounding tissues. In most cases, they produce no symptoms and are discovered incidentally during CT scans performed for unrelated medical reasons. Thymic carcinomas, however, possess a much more aggressive biological profile than thymomas. Similar to lung or head and neck cancers, they grow rapidly, invade the major blood vessels surrounding the heart, and spread quickly throughout the body. Therefore, accurately determining the exact cellular subtype is critically important in managing diseases originating from the thymus gland.
Why Is Accurate Staging Vital When Carcinoma Is Suspected?
Once a diagnosis of carcinoma has been established, the first and most important step is to determine precisely how far the tumor has spread throughout the body. This process, known as staging, must be performed meticulously to determine whether the patient can safely undergo major surgery and whether such an operation is likely to provide meaningful benefit.
During staging, the size of the tumor and its proximity to the heart, chest wall, or major blood vessels are carefully evaluated. It is also determined whether cancer cells have spread to the lymph nodes located between the two lungs. In tumors detected early and confined to their original location, surgery has the potential to completely eradicate the disease. However, if carcinoma cells have already spread to distant organs such as the liver, bones, or brain, systemic treatments such as targeted therapies or chemotherapy generally replace surgery.
What Role Does PET-CT Play in the Diagnosis of Carcinoma?
In patients with suspected carcinoma, the diagnostic process usually begins with a high-resolution contrast-enhanced computed tomography scan. CT provides an excellent anatomical map showing the location of the tumor, its size, and its relationship to surrounding organs. However, CT alone cannot determine whether a mass or enlarged lymph node actually contains living, active cancer cells. This is where Positron Emission Tomography (PET), which evaluates cellular metabolism, becomes invaluable.
Because carcinoma cells multiply rapidly and uncontrollably, they require far more energy than normal healthy cells. They meet this demand by consuming glucose at an accelerated rate. Before PET-CT imaging, a very low dose of radioactively labeled glucose solution is injected into the patient’s bloodstream. If carcinoma cells are present anywhere in the body, they preferentially absorb this labeled glucose, producing bright signals on the scan. PET-CT therefore reveals not only how biologically aggressive the tumor is but also whether hidden metastases exist anywhere in the body with a high degree of accuracy.
How Does the EBUS Technique Influence Decision-Making in Carcinoma?
In lung carcinoma, the most critical factor determining whether a patient should proceed directly to surgery is whether cancer cells have spread to the mediastinal lymph nodes located between the lungs. If these lymph nodes contain viable cancer cells, current medical practice recommends beginning systemic therapy before considering surgery. Therefore, tissue samples from these lymph nodes are essential.
In previous years, obtaining these samples required a relatively complex surgical procedure performed under general anesthesia through an incision in the neck. Today, however, this approach has largely been replaced by a minimally invasive technique called Endobronchial Ultrasound (EBUS). EBUS utilizes a thin, flexible bronchoscope equipped with a miniature ultrasound probe at its tip. After the patient is lightly sedated, the bronchoscope is passed through the mouth into the airways. The lymph nodes outside the airway walls are visualized using ultrasound, and tissue samples are collected using a specialized fine needle. This highly reliable procedure requires no external incisions and allows definitive surgical planning for carcinoma.
What Surgical Options Are Available for Lung Carcinoma?
For carcinomas detected at an early stage, complete surgical removal of the diseased tissue with appropriate safety margins remains the primary and most effective treatment approach. However, because each patient’s lung function and tumor location differ, surgical strategies are individualized. Detailed pulmonary function tests performed before surgery ensure that the remaining lung tissue will provide adequate long-term respiratory capacity.
The main surgical procedures used to completely remove lung carcinoma include:
- Lobectomy
- Segmentectomy
- Wedge resection
- Pneumonectomy
Lobectomy involves complete removal of one of the three lobes of the right lung or one of the two lobes of the left lung together with the tumor and is considered the oncological gold standard. However, if the tumor is very small and the patient’s respiratory reserve is limited, more lung-conserving procedures such as segmentectomy, which removes only the smaller anatomical segment containing the tumor, may be preferred.
Why Is VATS, Known as Minimally Invasive Surgery, Advantageous in the Treatment of Carcinoma?
In the past, thoracic surgical procedures were performed through open operations requiring wide separation of the ribs, often resulting in significant postoperative pain. Thanks to advances in medical technology, these demanding procedures have largely been replaced by Video-Assisted Thoracoscopic Surgery (VATS).
With VATS, the chest cavity is not widely opened. Instead, one or several small incisions (ports) are created between the ribs, through which high-definition cameras and specially designed long surgical instruments are introduced. The surgeon performs the procedure while viewing magnified images displayed on large monitors.
The primary advantages of this minimally invasive technique include:
- Reduced postoperative pain
- Shorter hospital stay
- Faster return to daily life
- Lower infection risk
- Preservation of immune function
- Small cosmetic scars
What Innovations Does Robotic Thoracic Surgery Offer in the Treatment of Carcinoma?
The most advanced stage of minimally invasive thoracic surgery is Robot-Assisted Thoracic Surgery. In this system, the camera and surgical instruments inserted into the patient’s chest are attached to sophisticated robotic arms. The surgeon sits at a console outside the sterile field and controls these robotic arms with exceptional precision using finger movements.
The greatest revolution robotic surgery brings to the treatment of thoracic carcinomas is the enhanced depth perception it provides. The camera delivers magnified, crystal-clear, true three-dimensional images beyond the capabilities of the human eye. The robotic instruments can rotate up to 540 degrees around their own axis, offering a range of motion that greatly exceeds that of the human wrist while completely eliminating hand tremors. This precision significantly improves surgical safety and facilitates complete removal of carcinoma cells, especially when operating around difficult tumors located behind the heart or tightly adherent to major blood vessels.
How Is Pleural Mesothelioma, a Carcinoma of the Pleural Membrane, Treated?
Malignant Pleural Mesothelioma, widely associated with asbestos exposure, is a carcinoma arising from the pleural membrane that envelops the lungs. In this disease, malignant cells form a thick shell around the lung, cause continuous accumulation of inflammatory pleural fluid, and prevent the lung from expanding normally during breathing.
Mesothelioma surgery differs considerably from other lung carcinomas and is substantially more complex. In early-stage disease, surgeons attempt to preserve the lung by completely removing only the thickened diseased pleural membranes. However, when the disease has progressed more extensively, far more radical procedures may be required, including removal of the entire lung together with the pleura and, in some cases, portions of the pericardium and diaphragm. Surgery alone is not sufficient for this disease; treatment must also be supported by heated chemotherapy techniques and targeted radiotherapy to establish a comprehensive oncological treatment strategy.
How Is Surgery for Esophageal Carcinoma Performed?
Carcinomas developing in the esophagus involve the neck, chest, and abdomen because of the organ’s unique anatomy, making them particularly complex diseases. A growing esophageal tumor may eventually make swallowing even water extremely difficult.
Surgical treatment usually involves removing the diseased portion of the esophagus and creating a new conduit from the stomach, which is then brought into the chest or neck and connected to the remaining healthy esophagus. In the past, this operation required extensive incisions in both the abdomen and back. Today, however, advanced minimally invasive techniques allow abdominal portions of the procedure to be performed laparoscopically while the thoracic portion is completed using VATS or robotic surgery, enabling patients to recover from these major operations much more comfortably and safely.
How Has Immunotherapy Changed the Treatment of Lung Carcinoma?
Without question, the greatest scientific breakthrough in carcinoma treatment in recent years has been the introduction of immunotherapy. Under normal circumstances, the body’s immune cells possess the ability to recognize and destroy carcinoma cells. However, carcinoma cells learn to evade the immune system by effectively cloaking themselves from immune detection.
Immunotherapy removes this biological camouflage. As a result, the patient’s own immune cells are once again able to recognize and attack the tumor. Particularly when administered before surgery in combination with chemotherapy, immunotherapy can dramatically shrink tumors and eliminate cancer cells within the lymph nodes. In many patients, carcinoma tissue regresses almost completely before surgery. This advancement has made surgery possible even for patients who were previously considered inoperable and has significantly improved long-term survival.
Why Is a Multidisciplinary Tumor Board Absolutely Essential in Carcinoma Treatment?
Carcinomas are highly variable, complex diseases with biological characteristics that differ substantially from one patient to another. For this reason, modern management of thoracic carcinomas never relies on the judgment of a single physician. Instead, treatment decisions are made within comprehensive scientific committees known as Multidisciplinary Tumor Boards.
The primary objective of these boards is to review every imaging study, biopsy result, and molecular genetic analysis collectively in order to develop a treatment plan tailored specifically to each individual patient.
The specialists participating in these multidisciplinary discussions include:
- Thoracic surgeons
- Medical oncologists
- Radiation oncologists
- Radiologists
- Pathologists
- Nuclear medicine specialists
Frequently Asked Questions
Prof. Dr. Alper Fındıkcıoğlu graduated from Istanbul University Faculty of Medicine and completed his thoracic surgery residency at Dr. Siyami Ersek Hospital. He began his academic career at Başkent University in 2005; he received the title of associate professor in 2014 and professor in 2022. He has extensive experience in lung cancer, chest wall diseases, and minimally invasive surgery. Since 2024, he has been continuing his professional work at Acıbadem Hospital.
