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Bronchogenic
Carcinoma
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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.
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- Cough
- Cough with blood
- Shortness of breath
- Chest pain
- Hoarseness
- Appetite loss
- Weight
loss
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- 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.
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- Cigarette smoking
- Asbestos
- Heavy metal
- Chloromethyl ether
- Radiation exposure, such as from
atomic bomb blasts and radiation used for cancer
treatment
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For
non-small cell lung cancer:
- 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.
- Chemotherapy and/or radiation may
be considered after surgery for cancer that has progressed
to advanced stages.
- 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.
- This type of treatment may
involve radiation therapy and is geared toward alleviating
symptoms, even if the disease is not considered to be
curable.
- Research about alternative
therapies, such as vaccines and immunotherapy, are
currently in
progress.
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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.
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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.
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- 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:
- Whether the tumor involves the
trachea, carina, or proximal main stem bronchus
- Metastases outside the lungs and
chest cavity
- Malignant pleural fluid
- Phrenic nerve or recurrent
laryngeal nerve palsy
- Superior vena cava syndrome
- Tumor involving the esophagus or
pericardium
- Spread of cancer to the lymph
nodes on the opposite side of the mediastinum
- Extensive involvement of the
chest wall
- Poor general health
- New studies suggest that CAT
scans may be helpful for screening for lung cancer in
persons who are at risk for developing lung cancer.
- Routine chest X-Rays do not detect cancer early enough to improve survival rates and are not currently recommended for lung cancer screening.
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