PRESENTING
LUNG CANCER
BY DAVE HUEY
Lung Cancer: Defined
Uncontrolled growth of malignant cells in one or both lungs and tracheo-bronchial tree A result of repeated carcinogenic irritation causing increased rates of cell replication Proliferation of abnormal cells leads to hyperplasia, dysplasia or carcinoma in situ
Picture of the Lungs
Lung Cancer in the US
According to 2004 statistics, there were 173,770 new cases and 160,440 deaths yearly More deaths from lung cancer than prostate, breast and colorectal cancers combined Decreasing incidence and deaths in men; continued increase in women
1,800,000 1,600,000 1,400,000 1,200,000 1,000,000 800,000 600,000 400,000 200,000 0 1 3 5 10
New Cases Deaths
Women & Lung Cancer
80,660 new cases were reported in 2004 - Account for 12 % of all new cases 68,510 deaths were reported in 2004 - An increase of 150% between 1974 and 1994 Women are more prone to tobacco effects 1.5 times more likely to develop lung cancer than men with same smoking habits
Where Does it Come From?
Radiation Exposure Smoking Environmental/ Occupational Exposure
Asbestos Radon Passive smoke
Smoking Facts
Tobacco use is the leading cause of lung cancer 87% of lung cancers are related to smoking Risk related to:
age of smoking onset amount smoked gender product smoked depth of inhalation
Where does it travel?
Lymph Nodes, Brain, Liver, Adrenal, Gland, Bones
40% of metastasis occurs in the Adrenal Gland
Diagnosis
History and Physical exam Diagnostic tests
Chest x-ray Biopsy (bronchoscopy, needle biopsy, surgery)
Staging tests
CT chest/abdomen Bone scan Bone marrow aspiration PET scan
Symptoms
cough dyspnea hemoptysis recurrent infections chest pain
Syndromes/Symptoms secondary to regional metastases:
Esophageal compression dysphagia Laryngeal nerve paralysis hoarseness Symptomatic nerve paralysis Horner’s syndrome Cervical/thoracic nerve invasion Pancoast syndrome Lymphatic obstruction pleural effusion Vascular obstruction SVC syndrome Pericardial/cardiac extension effusion, tamponade
Two Lung Cancer Cells, Classified
Non Small Cell Lung Cancer (NSCLC)
Adenocarcinoma Squamous Cell Carcinoma
Small Cell Lung Cancer (SCLC)
Oat Cell Intermediate
Large Cell Carcinoma
Combined
Treatment and Staging NSCLC
Stage Stage I a/b Description Tumor of any size is found only in the lung Treatment Options Surgery
Stage II a/b
Tumor has spread to lymph nodes associated with the lung Tumor has spread to the lymph nodes in the tracheal area, including chest wall and diaphragm
Tumor has spread to the lymph nodes on the opposite lung or in the neck Tumor has spread beyond the chest
Surgery
Stage III a
Chemotherapy followed by radiation or surgery
Stage III b
Combination of chemotherapy and radiation Chemotherapy and/or palliative (maintenance) care
Stage IV
SCLC
Limited Stage
Defined as tumor involvement of one lung, the mediastinum and ipsilateral and/or contralateral supraclavicular lymph nodes or disease that can be encompassed in a single radiotherapy port.
Extensive Stage
Defined as tumor that has spread beyond one lung, mediastinum, and supraclavicular lymph nodes. Common distant sites of metastases are the adrenals, bone, liver, bone marrow, and brain.
Conclusion
Smoking cessation is essential for prevention of lung cancer. New screening tools under way. Clinical trials under way. New treatments under way. Treatment can palliate symptoms and improve quality of life. Read first bullet again!!