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Lung Cancer

more about Lung Cancer

Bronchogenic Carcinoma

  • Lung cancer is the most common cause of cancer death in both men and women.  Breast cancer is more common in women, but lung cancer is more likely to lead to death.  Lung cancer occurs in smokers or those exposed to chemical carcinogens to the lung.  Non-smokers without other risk factors have a low risk of acquiring lung cancer.
  • There are four major cellular types of lung cancer: squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and large cell carcinoma.  For treatment purposes, lung cancer is usually differentiated according to small cell carcinoma or non-small cell carcinoma, which includes the three other types.

  • Cough
  • Cough with blood
  • Shortness of breath
  • Chest pain
  • Hoarseness
  • Appetite loss
  • Weight loss

  • Examination may be normal or lung exam may reveal areas of crackles or decreased breaths sounds.
  • Chest X-ray shows a mass, pleural effusion (fluid, blood, cancer cells or a combination) or an infiltrate.
  • CAT scan may provide a better picture of the mass.
  • Examination of sputum or pleural fluid may confirm diagnosis.  Negative test results do not rule out cancer.
  • Lung biopsy obtained with a needle, CAT scan, bronchoscopy (scope passed from mouth into lungs), and surgical biopsy (open lung surgery to obtain a tissue sample) are diagnostic tests that may be used, depending on the location of the tumor.
  • Laboratory Tests:

- Complete blood count, liver function tests, calcium, parathyroid hormone (PTH), and electrolytes should be checked.

  • Cigarette smoking
  • Asbestos
  • Heavy metal
  • Chloromethyl ether
  • Radiation exposure, such as from atomic bomb blasts and radiation used for cancer treatment

  • For non-small cell lung cancer:
    1. Surgery is recommended if the patient is a viable candidate (see explanation above).  The stage of the lung cancer and general health determine whether a patient will be considered for surgery.  Only 25 percent of lung cancer patients are considered to be surgical candidates at the time of diagnosis.
    2. Chemotherapy and/or radiation may be considered after surgery for cancer that has progressed to advanced stages.
    3. Radiation plus Cisplatin-based chemotherapy are recommended if the patient is not a surgical candidate.
  • For small cell carcinoma:

- Combination chemotherapy is typically used to treat the cancer.  Surgery is not considered helpful because small cell carcinoma has usually spread at the time of diagnosis.  The brain is commonly treated with radiation to treat micrometastases that may have already occurred.

  • Palliative treatment:
    1. This type of treatment may involve radiation therapy and is geared toward alleviating symptoms, even if the disease is not considered to be curable.
    2. Research about alternative therapies, such as vaccines and immunotherapy, are currently in progress.

  • If lung cancer is caught in its early stages, the survival rate is approximately 50 percent.  The five-year survival rate for all diagnosed lung cancers is 10 to 15 percent.
  • If you suspect any symptoms, especially if you are a smoker or have other risk factors, consult a physician as soon as possible.  The earlier lung cancer is diagnosed, the greater the chance of survival.

  • Quitting smoking significantly lowers the risk of developing lung cancer.  Many options are available for quitting smoking, including nicotine patches, nicotine gum, hypnosis, and behavioral techniques.  If you're thinking of quitting smoking, discuss these options with your physician to determine which one may be most effective for you.

  • Lung Cancer Staging

- Lung cancer is staged based on the size or location of the tumor, the extent of lymph node involvement, if any, and the degree of metastasis if it has occurred.  The stages are 0, I, II, III, and IV, rated according to how much the disease has spread.  The higher the stage, the more advanced the disease.

  • Who is a Surgical Candidate?

- Staging indicates whether a person is a candidate for surgical removal of the cancerous tumor.  The following factors are considered to determine the likelihood of successful or unsuccessful surgery and degree of surgical difficulty:

    1. Whether the tumor involves the trachea, carina, or proximal main stem bronchus
    2. Metastases outside the lungs and chest cavity
    3. Malignant pleural fluid
    4. Phrenic nerve or recurrent laryngeal nerve palsy
    5. Superior vena cava syndrome
    6. Tumor involving the esophagus or pericardium
    7. Spread of cancer to the lymph nodes on the opposite side of the mediastinum
    8. Extensive involvement of the chest wall
    9. Poor general health
  • Screening
    1. New studies suggest that CAT scans may be helpful for screening for lung cancer in persons who are at risk for developing lung cancer.
    2. Routine chest X-Rays do not detect cancer early enough to improve survival rates and are not currently recommended for lung cancer screening.

more about Lung Cancer

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