Lung+Cancer

**__Lung Cancer__** ~Bri Hearn
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**Statistics:**

 * 14.7% of all men who had cancer in the UK in 2008 were diagnosed with lung cancer
 * 11.6% of all women who had cancer in the UK in 2008 were diagnosed with lung cancer
 * Approximately 14% of people in the United States diagnosed with lung cancer survive at least five years after their diagnosis
 * Approximately 15% of people with lung cancer are nonsmokers
 * 80.4% of lung cancers are non-small-cell lung carcinomas
 * 16.8% of lung cancers are small-cell lung carcinomas

**Facts Abut Lung Cancer:** - Small-cell lung cancer (SCLC) à Usually begins in the primary and secondary bronchi; very malignant - Non-small-cell lung cancer (NSCLC) à Usually starts near a central bronchus
 * Most common cancer-related death in both men and women
 * The most common cause is long-term exposure to tobacco smoke
 * It is possible to develop lung cancer from second-hand smoke, even if you do not smoke
 * Two main types of lung cancer
 * Small-cell lung cancer is usually most effectively treated by chemotherapy and radiation.
 * Non-small-cell lung cancer is usually most effectively treated by surgery.

**Stages of Lung Cancer:**
 * Stage 0- Cancer is limited to the air passage lining and has not invaded the lung tissue.
 * Stage I- Cancer is contained in the lung tissues and has not metastasized to the lymph nodes or beyond.
 * Stage II- Cancer has metastasized to the sentinel lymph nodes.
 * Stage IIIA- Cancer metastasized to the auxiliary lymph nodes.
 * Stage IIIB- Cancer has metastasized to areas within the chest region, such as the trachea, blood vessels, heart, and esophagus.
 * Stage IV- Cancer has metastasized outside of the lung to distant parts of the body, such as the brain, liver, or bones.

Stage IV Diagram

**Causes:**
 * Smoking
 * Radon gas
 * Asbestos
 * Viruses
 * Particulate matter

**Diagnosis and Treatment:**


- Most common first diagnostic step - Reveals suspicious areas in the lungs, but are unable to determine if the areas are cancerous
 * Chest x-ray

- Used when chest x-rays do not show an abnormality or do not yield sufficient information about the extent of a tumor -Performed on the chest, abdomen, or brain - Combine multiple images (with help from a computer) to generate cross-sectional views of the body - More sensitive in detecting lung nodules
 * CT scans

- Effective in identifying lung cancer in smokers and former smokers
 * Low-dose helical CT scan

- Used when the precise detail about the tumor’s location is needed - Uses magnetism, radio waves, and a computer to create pictures of body structures -Can detect tiny changes of structures within the lung
 * MRI

- Uses short-lived radioactive drugs to create 3-D colored images of substances in the tissues of the lung - Measure metabolic activity and the function of tissues - Determines whether a tumor tissue is actively growing
 * PET scan

- Creates images of bones on a computer -Determines whether a lung cancer has metastasized to the bones
 * Bone scans

- Examination of the septum under a microscope - Visualization of tumor cells for diagnosis (if a tumor has invaded the airways and is centrally located) - Least risky - Least expensive diagnostic procedure - Limited value since tumor cells are not always present in the septum when there is cancer
 * Sputum cytology

- Examination of the airways - Reveals areas of tumor that can be sampled for diagnosis by a pathologist - People with a tumor located in the central area of the lung usually use this technique
 * Bronchoscopy

- Retrieves cells for diagnosis of lung tumors - Typically used when the tumor is on the periphery of the lungs and is not accessible by bronchoscopy - Generally accurate when the affected tissue is adequately sampled, but adjacent or uninvolved areas of the lung could be mistakenly sampled - Small risk of an air leak
 * Needle biopsy

- Sample of fluid in the space between the lungs and chest wall - May reveal whether a person has lung cancer
 * Thoracentesis

- Used when none of the other diagnostic methods yield an accurate diagnosis
 * Major surgical procedures

- High-energy rays directed at the specific cancer site in the lung - Typically used before or after surgery
 * Radiation

- Series of drugs that circulate via the blood - Kill rapidly growing cells
 * Chemotherapy

- Alone, they cannot diagnose lung cancer - Reveal biochemical or metabolic abnormalities, which often accompany caner
 * Blood Tests

**Signs and Symptoms:**
 * Shortness of breath (dyspnea)
 * Coughing up blood (hemoptysis)
 * Fatigue
 * Weight loss (cachexia)
 * Loss of appetite
 * Hoarse voice (dysphonia)
 * Difficulty swallowing (dysphagia)
 * Chest pains
 * Wheezing
 * Clubbing of the fingernails



**Risk Reduction:**
 * Do not smoke
 * Do not spend a significant amount of time in polluted environments
 * Breathe clean air
 * Avoid second-hand smoke
 * Eat a healthy diet
 * Go to doctor’s appointments regularly
 * Exercise regularly



**Vocabulary:**

Radon gas- Colorless and odorless gas that can cause cancerous mutations

Asbestos- A set of silicate minerals that can cause lung cancer if inhaled

Particulate matter- Soot, which can cause lung cancer if inhaled excessively


 * Resources:**


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 * //Harrison’s Principles of Internal Medicine// by JD Minna and JH Schiller
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 * http://www.webmd.com/lung-cancer/guide/stages-of-lung-cancer
 * http://www.mesothelioma-lung-cancer.org/lung-cancer-staging.html