Lung Cancer Information
The most common forms of lung cancer are squamous cell (epidermoid) carcinoma, small-cell (oat cell) carcinoma, adenocarcinoma, and large-cell (anaplastic) carcinoma. The most common site is the wall or epithelium of the bronchial tree. For most patients, the prognosis is poor, depending on the extent of the cancer when diagnosed and the cells' growth rate. Only about 13% of patients with lung cancer survive 5 years after diagnosis. Lung cancer is the most common cause of cancer death in men and is fast becoming the most common cause in women, even though it's largely preventable.
The exact cause of lung cancer remains unclear. Risk factors include tobacco smoking, exposure to carcinogenic and industrial air pollutants (asbestos, arsenic, chromium, coal dust, iron oxides, nickel, radioactive dust, and uranium), and genetic predisposition.
Signs and Symptoms
The following are the most common symptoms for lung cancer. However, each individual may experience symptoms differently.
Lung cancer usually does not cause symptoms when it first develops, but they often become present after the tumor begins growing. A cough is the most common symptom of lung cancer. Other early symptoms include:
If a doctor suspects lung cancer, he or she may order a chest X-ray as a first step in diagnosis. Frequently, a CT (computer assisted tomography) scan or an MRI (magnetic resonance imaging) will also be ordered. CT scans and MRIs are test that use computerized pictures to show the body in great detail. They can show the size, shape, and location of a tumor. These tools are also useful in finding out if the tumor has spread from the lung to other parts of the chest or to other parts of the body.
Various combinations of surgery, radiation therapy, and chemotherapy improve the prognosis and prolong patient survival. Because lung cancer is usually advanced at diagnosis, most treatment is palliative.
Surgery is the primary treatment for stage I, stage II, or selected stage III squamous cell carcinoma, adenocarcinoma, and large-cell carcinoma, unless the tumor is inoperable or other conditions (such as cardiac disease) rule out surgery. Surgery may involve partial lung removal (wedge resection, segmental resection, lobectomy, radical lobectomy) or total removal (pneumonectomy, radical pneumonectomy).
Preoperative radiation therapy may reduce tumor bulk to allow for surgical resection and may also improve response rates. Radiation therapy is ordinarily recommended for stage I and stage II lesions if surgery is contraindicated, and for stage III disease confined to the involved hemithorax and the ipsilateral supraclavicular lymph nodes. Radiation therapy usually begins about 1 month after surgery (to allow the wound to heal). It's directed to the chest area most likely to develop metastasis.
Chemotherapy drug combinations of fluorouracil, vincristine, mitomycin, cisplatin, and vindesine induce a response rate of 40%, yet have minimal effect on long-term survival. Promising combinations of drugs for treating small-cell carcinomas include cyclophosphamide, doxorubicin, and vincristine; cyclophosphamide, doxorubicin, vincristine, and etoposide; and etoposide, cisplatin, cyclophosphamide, and doxorubicin.
Immunotherapy is investigational. Nonspecific regimens using bacille Calmette-Guerin (BCG) vaccine or, possibly, Corynebacterium parvum offer the most promise.
In laser therapy, also largely investigational, a laser beam is directed through a bronchoscope to destroy local tumors.
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