Lung Cancer

Bio 218, Fall 2012-52999

Table of Contents1. Lung Cancer Summary2. Types of Lung Cancer3. Types of Lung Cancer continued4.Diagnostic Imaging5.Risk Factors6.Symptoms7. Conditions8.Diagnostic and Testing9. Diagnostic and testing continued10. Stages of Lung Cancer11. Treatment12. Prognosis13. Conclusion14. Work Cited

Lung Cancer Development of abnormal cells in one or both lungs that

obstruct with the function of the lungs and, ultimately, spread to other parts of the body. It is the leading source of cancer deaths in the United States in both male and females. Commonly results of chronic smokers, but nonsmokers are at risk as well. Forming in tissues of the lung, usually in the cells lining air passages. The two main categories are small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). It is also one of the most preventable kinds of cancer.

Normal Lung

Types of Lung Cancer

1. Small Cell Lung Cancer- also known as oat cell cancer. Is an aggressive type of lung cancer forming in the large central bronchi that can metastasize rapidly into other parts of the body, such as the bones of the body. Accounts for 15-20% of all lungs cancer. Since, this type of cancer spreads quickly before symptom emerge it is difficult to remove through surgery.

Types of Lung Cancer2. Non-Small Cell Lung Cancer- most common type of lung cancer

accounting for 80% of all lung cancers. It spreads less rapidly than SCLC There are three categories of NSCLC

Squamous Cell Carcinoma of lung- cancer that develops in the large central bronchi where the trachea joins. Is the easiest to discover because it spreads slowly and is the most curable if detected early. Does not spread outside of the lungs.

Adenocarcinoma of Lung- begins in the outer portions of the lung and can spread to lymph nodes and surrounding organs. Most commonly seen in women and nonsmokers.

Large Cell Carcinoma of Lung- the least common type of lung cancer originating in the outer edges of lungs. High tendency to spread to surrounding lymph nodes and other locations of the body.

Diagnostic ImagingFigure 1-Squamous Cell

Carcinoma

Figure2-AdenocarcinomaFigure 3- Large Cell Carcinoma

Figure 4- Small cell Lung Cancer (oat cell cancer)

Figure 5- Normal vs. Cancerous Lung

Figure 6- Metastasized tumor

Risk Factors · Tobacco use

· Secondhand Smoke · Chemical exposure- such as

carcinogenic chemicals found in the work place. · Radon exposure

· Family history of lung cancer · Excessive alcohol use

Symptoms General symptoms Persistent cough Changes in a chronic cough or "smoker's cough" Coughing up blood Shortness of breath Chest pain Wheezing Hoarseness Unintentional weight loss Bone pain Headache Recurring respiratory infections, such as pneumonia. Symptoms of Metastasis to the bones Difficulties with vision, weakness on one side of the body, and/or seizures. Symptoms of metastasis to the liver of lymph nodes · Yellowing of the skin or eyes (jaundice). · Lumps or bumps under the skin or enlarged lymph nodes. · Decreased appetite. · Weight loss.

Conditions

· Pleural effusion, the buildup of fluid between the outer lining of the lungs and the chest wall.

· Coughing up large amounts of bloody mucus.

· pneumothorax, Collapsed lung

· Bronchial obstruction · Pneumonia.

Diagnosis and Testing Patient history Physical exam A physician will compile a

medical and surgical history as well as smoking and work history, and ask questions regarding lifestyle, overall health, and list of medications.

Diagnosis and Testing- continued

Imaging testing · X-RAY- may detect abnormalities such as small or large nodule formation or large mass.· CT/ MRI scan- show greater detail of lung in 3D and easily detect if the cancer has spread to other organs or lymph nodes· Bronchoscopy- endoscopy of lungs where a small camera is inserted through the mouth or nose, traveling down the wind pipe and inserted to through the bronchi. The doctor is able to collect samples and examine tumor. Due to the procedure being uncomfortable the patient is under a local anesthetic

Tissue sample· Biopsy- removal of a small tissue sample or a small volume of fluid from the surrounding sac of the lung. · Mediastinoscopy- Biopsy of lymph nodes to detect if cancer spread

Septum Analysis· Septum testing- mucous sample that is tested to determine if cancer cells are present. Is not completely reliable test usually done in conjunction with other medical tests.

Additional Testing· Thoracentesis- a fluid sample from the sac around the lungs to evaluate abnormal cells. Also the removal of excess fluid around the lungs to make breathing easier.· Positron emission tomography (PET)- a scan that help determine if the tumor or enlarged lymph node is cancerous and if surgery treatment is an option also to know if surgery treatment is working

Stages of Lung Cancer SCLC are staged using

a two-stage system:· Limited-stage (LS)

SCLC- refers to cancer that is confined to its area of origin in the chest.

· In extensive-stage (ES) SCLC- the cancer has spread beyond the chest to other parts of the body.

NSCLC are categorized into stage from I to IV in order of severity:

· In stage I- the cancer is confined to the lung. Tumor is generally smaller than 2 inches across.

· In stages II- The tumor may have grown larger than 2 inches or it can be a small tumor that involves surrounding areas such as the diaphragm, pleura, or chest wall and possibly lymph nodes.

· In stage III - tumor may become extremely large and invade other organs

· Stage IV cancer has spread from the chest to other parts of the body.

Slide on the right shows the limited stage of SCLC the tumor is small and localized. In the scan of the chest the lung shows an extensive stage of SCLC, the tumor is metastasizing.

Normal vs. Stage IV

Treatment Treatment of lung cancer depends on the stage of cancer.

Treatment for SCLC and NSCLC are different SCLC- chemotherapy and radiation therapy when combined

help treat SCLC that is limited to the chest region. · Chemotherapy- the standard treatment for this type of lung

cancer. · Radiation therapy-help shrink a rapidly growing large tumor

that is causing symptoms NSLC- Treatment with a combination of the three therapies. o Lung surgery (thoracotomy)- removal of cancer. o Radiation therapy -reduce the risk of cancer returning in the

chest. o Chemotherapy may be used to treat more advanced stages

(stages III and IV). Chemotherapy may also be used after surgery for early stages to reduce the risk of cancer returning.

Prognosis The overall prognosis for lung cancer is unfortunate when

compared with some other cancers. Generally a 5 year survival rate for lung cancer

SCLC PROGNOSIS- the median survival rate is 2-4 months after diagnosis if untreated. Since, SCLC is an aggressive form of lung cancer it spread quickly making surgery and localized radiation less effective .Chemotherapy combined with other methods of survival can prolong survival time. 5-10% of patients are alive 5 years after diagnosed.

NSCLC PROGNOSIS- the overall survival rate is 5 years with only 15% of patients living longer than that time frame. Radiation therapy helps relieve symptoms

Conclusion

Lung cancer is an unfortunate form of cancer that affects 1/13 males and 1/16 females a year.

Black men are the most effected by the cancer followed by white males, where white women are the highest population to be diagnosed in the United States.

Approximately 226,160 new cases of lung carcinoma were diagnosed this year(2012).

The number one way to reduce risk of developing the cancer is by quitting the use of tobacco and reduce exposure to second hand smoke.

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