Bio 218, Fall 2012-52999
1. Lung Cancer Summary
2. Types of Lung Cancer
3. Types of Lung Cancer continued
4.Diagnostic Imaging
5.Risk Factors
6.Symptoms
7. Conditions
8.Diagnostic and Testing
9. Diagnostic and testing continued
10. Stages of Lung Cancer
11. Treatment
12. Prognosis
13. Conclusion
14. Work Cited
 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
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.
2. 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
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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.
Figure 1-Squamous Cell Carcinoma
Figure2-Adenocarcinoma
Figure 3- Large Cell Carcinoma
Figure 5- Normal vs. Cancerous Lung
Figure 6- Metastasized tumor
Figure 4- Small cell Lung Cancer
(oat cell cancer)
· 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
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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.
· 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.
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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.
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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
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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
SCLC are staged using a twostage 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.
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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.
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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
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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.
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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
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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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http://www.clevelandclinic.org/thoracic/Cancer/default.htm
http://lungcancer.adoboo.com/2009/02/staging-of-non-small-cell-lung-cancer.html
http://www.chiff.com/health/disease/lung-cancer.htm http://www.123cancerinfo.com/2012/adenocarcinoma-lung-cancer-0043.html
://www.ucsfhealth.org/conditions/lung_cancer/index.html
http://www.cancercenter.com/lung-cancer/lung-cancer-risk-factors.cfm
http://lungcancer.about.com/od/typesoflungcancer
http://www.webmd.com/lung-cancer/guide/understanding-lung-cancer-basics
http://www.microscopyu.com/galleries/pathology/index.html
http://www.mayoclinic.com/health/lung-cancer/DS00038
http://www.cancer.gov/cancertopics/pdq/treatment/non-small-celllung/Patient/page1#Keypoint5
http://www.pathologystudent.com/?p=4616
http://www.tabers.com/tabersonline/ub/view/Tabers/144056/0/thoracentesis
http://topnews.com.sg/content/21166-anti-smoking-campaign-backed-new-study
http://www.livestrong.com/article/16411-reduce-risk-lung-cancer/