biology lung cancer

8/4/2019 Biology Lung Cancer

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What are cancer?

Cancer is a class ofdiseasesin which a group ofcellsdisplay uncontrolled growth, invasion thatintrudes upon and destroys adjacent tissues, and sometimesmetastasis, or spreading to other

locations in the body vialymphorblood. These three malignant properties of cancers

differentiate them frombenign tumors, which do not invade or metastasize. More dangerous,or malignant, tumors form when two things occur: a cancerous cell manages to movethroughout the body using the blood or lymph systems, destroying healthy tissue in aprocess called invasion that cell manages to divide and grow, making new bloodvessels to feed itself in a process called angiogenesis. When a tumor successfullyspreads to other parts of the body and grows, invading and destroying other healthytissues, it is said to have metastasized. This process itself is called metastasis, and theresult is a serious condition that is very difficult to treat. In 2007, cancer claimed thelives of about 7.6 million people in the world. Physicians and researchers who specializein the study, diagnosis, treatment, and prevention of cancer are called oncologists.

Definition of lung cancer: Cancer that forms in tissues of the lung, usually in the cellslining air passages. The two main types are small cell lung cancer and non-small celllung cancer. These types are diagnosed based on how the cells look under amicroscope.

Symptoms of Lung Cancer :

Lung cancer is a disease that consists of uncontrolledcell growthintissuesof thelung. Thisgrowth may lead tometastasis, which is the invasion of adjacent tissue and infiltration beyond

the lungs. The vast majority of primary lung cancers arecarcinomas, derived fromepithelialcells. Lungcancer, the most common cause of cancer-related death in men and women, is

responsible for1.3 million deathsworldwide annually, as of 2004.[1]

The most commonsymptomsare shortness of breath, coughing (includingcoughing up blood), and weight loss.[2]

The main types of lung cancer are small-cell lung carcinoma and non-small-cell lung carcinoma.

Non-small-cell lung carcinoma (NSCLC) is sometimes treated withsurgery, while small-cell

lung carcinoma (SCLC) usually responds better tochemotherapyandradiation.[3]

The most

common cause of lung cancer is long-term exposure totobacco smoke.[4]

Nonsmokers accountfor 15% of lung cancer cases,[5]and these cases are often attributed to a combination ofgenetic

factors,[6][7]radongas,[8]asbestos,[9]andair pollution[10][11][12]includingsecondhand smoke.[13][14]

Lung cancer may be seen onchest radiographandcomputed tomography(CT scan). The

diagnosisis confirmed with abiopsy. This is usually performed bybronchoscopyor CT-guided

biopsy. Treatment andprognosisdepend on thehistologicaltype of cancer, thestage(degree ofspread), and the patient'sperformance status. Possible treatments include surgery,chemotherapy,

andradiotherapy. Survival depends on stage, overall health, and other factors, but overall only

14% of people diagnosed with lung cancersurvivefive years after the diagnosis
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Early Symptom of Lung Cancer: Cancerous Lesions

The site of the cancerous lesions is the place where the symptoms of lung cancer can occur. Most

often, invasion of the lung tissues cause breathing difficulty, which may cause shortness of

breath, coughing, chest pain, wheezing and coughing up blood.

There may be other related symptoms, if the cancer has spread beyond the bronchia.

For example, if the cancer has invaded the esophagus, it may cause complicated swallowing.

Cancer that has invaded the nerve tissues may cause paralysis of the vocal chords, or hoarseness.

The frequent early symptoms of lung cancer are: -

Constant pain in the chest or elsewhere, (possibly from the cancer spreading to a bone).

Excessive fatigue.

Deteriorating breathlessness.

Chronic cough.

Weight loss &loss of appetite

Hoarseness

Wheezing

Pyrexia of unknown origin

Chest pain

Dyspnea

The above symptoms also being the symptoms of many other lung problems, to determine the

cause, it is always worthwhile to see a physician.

Once you entered the doctors cabin, he will put forth frequent questions about your medicalhistory, along with questions about your accidental or incidental exposure to hazardous

chemicals.

Physical Examination for an Early Symptom of Lung Cancer

After inception of the early symptom of the lung cancer, your physician will subject you for

physical examination. You may be asked to give a sample of sputum for the occurrence of cancercells, if you are suffering from unrelenting cough with sputum (mucus).

Other than this, for easy location of the abnormal spots in your lung, your doctor will order aspecialized X-ray including CT scan or simple chest X-ray.

In order to examine your lungs along with airways, your health care professional may usebronchoscope, and will take sample, or biopsy, of the tumor by means of the bronchoscope itself.


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Through either nostrils or mouth, the bronchoscope will be inserted into ones lung. After finding

the early symptom of the lung cancer, this is one of the several ways in which the doctor collectsthe biopsy sample.

In order to recognize lung cancers of smaller size, most of the physicians are most likely use a

modern CT scan in smokers, which can be treated and cured easily than the large sized lungcancer. To spot small sized cancers, the method called helical-low dose CT scan has been used

extensively.

If the cancer spreads to other parts of the body, various other symptoms may occur. That is, if

there ismetastasis. With the following possible symptoms for each area, Lung cancer can spreadto the liver, the brain, or the bones:

Brain: headaches, seizures, nausea, vomiting, weakness

Liver: stomach pain (especially the right side), jaundice

Bones: bone pain

An MRI, a bone scans and CT scan are the common tests to find out the metastasis stage of your

lung cancer after observing the early symptom of lung cancer.

Sings of Lung cancer

Signs of lung cancer are not found at the early stages of lung cancer. At the initial stages itself,

however, it is better to identify the lung cancer. Some of the signs of lung cancer are chronic

cough, coughing up blood, wheezing, and chest pain, bouts of pneumonia or bronchitis andreason less fever. It is best to consult your doctor if you experience these signs of lung cancer

and check whether you have lung cancer or not.

You are likely to get lung cancer if you experience the following sings of lung cancer: asbestos

fibers, smoking, passive smoking, and air pollution. In the other diseases also the signs of the

lung cancer may be found, so it is better to find the reason for these signs and start the treatmentfor these symptoms. Another thing that plays an important role in getting these symptoms is the

environment in which you live. By inspecting the sputum or by chest x-ray and CT scans,

diagnosis of cancer can be done. With the help of bronchoscope sometimes biopsy sample istaken and tested for lung cancer.


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Statistics for Signs of Lung Cancer

Statistics reveal that only about 15% of the lung cancer cases are detected at an early stage in

order to eliminate the cancer. The important thing you must remember is that, for years together,

cancerous cells grow in your body despite of giving any sings of cancers. Probably you may be

already in the advanced stage of lung cancer if you get to find the symptoms and see thesymptoms.

One of the signs of lung cancer is affect of vocal cord due to the hoarseness. Sometimes

difficulty in swallowing is experienced if the esophagus is affected by the cancer. Some patients

may experience pain in the shoulder also.

Sign of Lung Cancer: Neurological Disorders

Another sign of lung cancer is pain in the bones where it is in the metastasis stage. From yourbones it would have spread to the bones. At the time of the metastasis stage, if the cancer is

extended to the brain then your might suffer signs in some parts of the body that are of

neurological nature such as blurred vision, stroke, headaches and sometimes loss of sensation ornumbness. Cancer cells can produce a hormone called adrenocorticotrophic which leads to the

production of more cortisol hormone by the adrenal glands.

You can also find increased level of calcium in the bloodstream after testing your blood. These

are also the signs of lung cancer. Such signs can be classified as paraneoplastic symptoms.

Depression as a Sign of Lung Cancer

In persons affected by the lung cancer, signs like depression are also found. Such signs are ofpsychological nature. In lung cancer patients, general signs like weight loss or weakness or

fatigue are also found.

If you experience any of these symptoms, it is always better to consult your doctor so that in caseof cancer in order to eliminate it, you get treatment at the early stages itself. Otherwise there is

no point in going for treatment at a difficult where you will be treating cancer to extend your life.


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Sign and Symptom of Lung Cancer

Sign and symptom of lung cancer are normally useful in patients who attend the hospital for curetowards the effective prediction of the severity of the problem. It is confusing to find that about

twenty to twenty five per cent of patients who get affected by lung cancer often show no specific

sign and symptom of lung cancer.

In such group of patients, most of the times, both the patient and the clinician may not think

about the potential of lung cancer. Hence, apparently, it is to be understood that the sign and

symptom of lung cancer need not always be revealed.

Whenever a person coughs, one unnecessarily jump into the conclusion that he or she is beingaffected by lung cancer, but at the same time, when the cough is observed to be existing for

significantly a long period, then one should employ this as sign and symptom of lung cancer in

that patient clinically.

Sign and Symptom of Lung Cancer: Differential Diagnosis

Experienced clinician who effectively deals with sign and symptom of lung cancer will howeverview TB as criteria for differential diagnosis in patients revealing emaciation and chronic cough

in a low-pitched scale. Specifically, when the patient brings out some blood during such

coughing activities, the clinical suspicion will often get strengthened.

Similarly, the lung cancer may be suspected, if the patient exhibits sign and symptom like

persistent chest pain or pain at shoulders or if the patient exhibits breathing activity but withdifficulties. If there is hoarseness or pain in bones as happens in case of successive spread of

lung cancer over bones, again one has to exclude lung cancer. Hence, so as to make an effective

diagnosis, the sign and symptom of lung cancer need to be analyzed largely.

It is considered to be indirect sign and symptom of the lung cancer when cancer in lung tissues

may be accompanied by paraneoplastic symptoms and calcium is elevated in serum of these

patients.

For not only the thoracic specialist but also to the patient with variable levels of lung cancer thesign and symptom of lung cancer may often be of confusing types. Hence, even the specialist hasto repeatedly acquire additional knowledge on the recent kinds of simple signs and symptoms

that can elicit doubts on the presence of lung cancer in the affected patients.


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How to rule out Signs and Symptoms of Lung Cancer?

In order to assist in ruling out the occurrences of lung cancer in people, this may require constantgoing through of various research findings made in different type of medical experts. Currently

to acquire up-to-date information on sign and symptom of pulmonary cancer, even the human

doctors are consulting concerned veterinarians.

Relentless body pain in a generalized form and feeling of depression for a very prolonged time

and feeling of tiredness for a stretched period also are to be considered as the Sign and symptomof lung cancer.

Hence, it is to be understood that the sign and symptom of lung cancer are associated with the

persistence for a long time. However, in the sign and symptom of lung cancer, sudden breathlessepisode is also included.

The etiology, or the root cause of lung cancer, is not always evident. Although tobacco smoking

is the primary etiological factor, scientists agree that many lung cancers have no single cause,

but are instead the result of a combination of several causes that may include exposure to

radon, asbestos, environmental tobacco smoke, and exposures to other hazardous materials.

Don't just assume that your lung cancer was caused by smoking alone. Lung cancer is also a

significant health problem among patients who have never smoked (referred to as "neversmokers").

You could have been exposed to carcinogens decades ago, and many people with lung cancercannot easily remember these exposures. Call us at 1-800-998-9729 and we may be able to help

you identify where you came into contact with hazardous materials that could have increased

your risk for lung cancer.


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Other Causes of Lung Cancer

Radon : A gaseous decay product of radium-226 and uranium-238, radon can result in

the damage of respiratory epithelium through alpha particle emissions. Uraniumminers face an increased risk of lung cancer, probably due to radon-induced

radiation. Many members of the armed forces came into contact with depleteduranium and radon during military service, as did employees of defense

contractors. See our pages onradon as a cause of lung cancer, anduranium as a

cause of lung cancer

Secondhand smoke. Also referred to as environmental tobacco smoke (ETS), secondhandsmoke has been identified as a significant risk factor for lung cancer in the

case of never smokers. Experts estimate that 15 to 35 percent of lung cancercases among never smokers are associated with ETS. More onsecondhandsmoke as a cause of lung cancer.Between smoking and secondhand smoke,

the Centers for Disease Control estimate that 87% of US lung cancer cases

are caused by tobacco.

Asbestos. :Asbestos is known to be a cause of lung cancer and other types of cancer.

The asbestos fibers can become airborne and get in your lungs. Often the

cancer doesnt show up until decades after exposure.Asbestos as a cause of

lung cancer. If you have lung cancer and were exposed to asbestos, evendecades ago, you may be eligible for compensation

Pesticides, especially the mixture called Agent Orange. Agent Orange was sprayed fromairplanes during the Vietnam War and became airborne, entering the lungs of ground troops. The

Department of Veterans Affairs has acknowledged that Agent Orange is carcinogenic and

provides benefits for qualified cancer patients with a history of exposure. See our page on Agent

Orange as a cause of lung cancer.

Heavy metals. These include cadmium, chromium, and arsenic. Heavy metals are in many

products and waste streams. Arsenic has been identified as a causative factor for lung cancerwhen it contaminates drinking water, as seen in specific areas of Chile and Taiwan. The United

States lowered permissible arsenic levels in drinking water several years ago due to health

concerns. See our page onheavy metals as a cause of lung cancer.
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Air pollutants present, for instance, in smoke from burning coal and vapors from cooking oil

have been associated with lung cancer. There are hundreds of chemical constituents in smoke

and combustion products. Even the experts dont know all of the carcinogenic ones, but it is clear

that there is a connection. See our page onhydrocarbons as a cause of lung cancer.

Where Were You Exposed to Carcinogens?

Workplace ExposuresSeveral types of occupational exposures have been identified as factors

that increase the risk of lung cancer among smokers and never smokers. Electricians, painters,

plumbers, steamfitters, pipefitters, and many other jobs brought workers into close contact with

asbestos insulation, cements, ceiling tiles, brakes, and other materials. Carcinogens in thesematerials includeasbestos,beryllium,heavy metals, andhydrocarbons.

Military Service ExposureThousands of veterans have contracted lung cancer after beingexposed toasbestos. Often the cancer doesn't show up until decades after exposure. Members of

all branches of the military were exposed to the same materials as civilian workers were.

Exposure toberylliumanddepleted uraniumwas especially common among servicemen becausethose metals were used in defense systems.Agent orange, the herbicide, was used extensively in

the Vietnam War.

Home ExposureRadon accumulates in the basements of buildings in some areas of the

country, and asbestos was used widely in home construction for decades. Bothradonand

asbestosare known causes of lung cancer and pose risks for people who live in homes with thosematerials.

Pesticides, especially the mixture called Agent Orange. Agent Orange was sprayed fromairplanes during the Vietnam War and became airborne, entering the lungs of ground troops. The

Department of Veterans Affairs has acknowledged that Agent Orange is carcinogenic and

provides benefits for qualified cancer patients with a history of exposure. See our page onAgentOrange as a cause of lung cancer.

Heavy metals. These include cadmium, chromium, and arsenic. Heavy metals are in manyproducts and waste streams. Arsenic has been identified as a causative factor for lung cancer

when it contaminates drinking water, as seen in specific areas of Chile and Taiwan. The United

States lowered permissible arsenic levels in drinking water several years ago due to health

concerns. See our page onheavy metals as a cause of lung cancer.

Air pollutants present, for instance, in smoke from burning coal and vapors from cooking oil

have been associated with lung cancer. There are hundreds of chemical constituents in smoke

and combustion products. Even the experts dont know all of the carcinogenic ones, but it is clearthat there is a connection. See our page onhydrocarbons as a cause of lung cancer.
http://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/organics.html


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Where Were You Exposed to Carcinogens?

Workplace ExposuresSeveral types of occupational exposures have been identified as factorsthat increase the risk of lung cancer among smokers and never smokers. Electricians, painters,

plumbers, steamfitters, pipefitters, and many other jobs brought workers into close contact with

asbestos insulation, cements, ceiling tiles, brakes, and other materials. Carcinogens in thesematerials includeasbestos,beryllium,heavy metals, andhydrocarbons.

Military Service ExposureThousands of veterans have contracted lung cancer after being

exposed toasbestos. Often the cancer doesn't show up until decades after exposure. Members of

all branches of the military were exposed to the same materials as civilian workers were.

Exposure toberylliumanddepleted uraniumwas especially common among servicemen becausethose metals were used in defense systems.Agent orange, the herbicide, was used extensively in

the Vietnam War.

Home ExposureRadon accumulates in the basements of buildings in some areas of the

country, and asbestos was used widely in home construction for decades. Bothradonandasbestosare known causes of lung cancer and pose risks for people who live in homes with those

materials.
http://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/radon.htmlhttp://www.lung-cancer.com/agentorange.htmlhttp://www.lung-cancer.com/uranium.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/organics.htmlhttp://www.lung-cancer.com/metals.htmlhttp://www.lung-cancer.com/beryllium.htmlhttp://www.lung-cancer.com/asbestos.htmlhttp://www.lung-cancer.com/causes-info.html


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There are a number of different treatment options for lung cancer. Standard treatment options

include surgical resection, chemotherapy, and radiation therapy. Newer lung cancer treatment

approaches include photodynamic therapy, electrocautery, cryosurgery, laser surgery, targeted

therapy and internal radiation. Each lung cancer treatment has its own specific ability to fight

cancer and its own set of side effects and possible complications. Therefore while there are

many options, lung cancer treatment needs to be performed judiciously and only after very

careful consideration of a number of factors.

Treatment Guidelines for Non-Small Cell Lung Cancer

Stage Standard TreatmentAlternate Theraphy, clinical trials, for symptom

control, or palliation

Stage 0 Surgical resectionEndoscopic surgery, laser therapy, electrosurgery,

cryosurgery

Stage IA Surgical resection Chemotherapy (adjuvant), radiation therapy

Stage IB Surgical resection Chemotherapy (adjuvant), radiation therapy

Stage

IIASurgical resection

Chemotherapy (adjuvant), radiation therapy (primary or

adjuvant)

StageIIB

Surgical resectionChemotherapy (adjuvant), radiation therapy (primary oradjuvant)

Stage

IIIA

Surgery then

chemotherapy

Chemotherapy and

radiation

Neoadjuvant chemotherapy and radiation

StageIIIB Chemotherapy andradiation

Stage IV

Chemo therapy

Radiation therapy

(palliative)

Surgical resection(palliative)

Combination therapy, internal radiation, targeted therapy,

laser therapy


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Treatment of non-small cell lung cancer

For occult and stage 0NSCLC, surgery is generally curative without the need for radiation orchemotherapy. This is because these stages do not represent invasive lung cancerthe lung

cancer is completely contained within the primary tumor. Therefore when the tumor is surgically

removed, the cancer is gone for good. Obviously the success rate in this case, as with all stages,depends on the quality and accuracy of the lung cancer staging. If cancer cells have migrated

away from the tumor, these stages no longer apply and additional treatment is necessary.

Surgery is indicated for stages I, II, and III of NSCLC. It may also be used forpalliation in stage

4. Palliative therapy, it should be mentioned, is intended to relieve symptoms and improve

quality of life with no real goal of cure or cancer remission. For stages I and II of NSCLC,surgery is the primary treatment of choice. (See page onstaging of lung cancer.)

The surgery that is used to treat the lung cancer is tailored to the patient based on the extent ofthe disease. Since the lung is essential for respiration and for life, preserving as much functional

lung tissue as possible is a primary concern to thoracic surgeons. Surgeons consider how well thepatient will be able to breathe after a portion of lung is removed. At the same time, a sufficient

amount of tumor and surrounding lung must be removed in order to assure that the cancer hasbeen eliminated.Pulmonary function tests(breathing tests) are performed before cancer surgery

to assess the patients overall lung capacity. An estimate is made of the level of lung function

that would exist after the proposed surgery. If the patient will be left with too little lung capacity,either a less aggressive surgery will be performed or the surgery will not be done at all and

alternate treatment will be given. Since people with lung cancer often have other lung diseases

such asemphysema, lung capacity is a very important issue.

There are five lobes of lung, three on the right side of the chest and two on the left. Within these

lobes, the lung is further subdivided into segments according to how the bronchi and bronchiolessupply them with air. This organization is important when planning lung resection surgery.
http://www.lung-cancer.com/types.htmlhttp://www.lung-cancer.com/types.htmlhttp://www.lung-cancer.com/types.htmlhttp://www.lung-cancer.com/staging.htmlhttp://www.lung-cancer.com/staging.htmlhttp://www.lung-cancer.com/staging.htmlhttp://www.lung-cancer.com/staging.htmlhttp://www.lung-cancer.com/stages.htmlhttp://www.lung-cancer.com/stages.htmlhttp://www.lung-cancer.com/stages.htmlhttp://www.nlm.nih.gov/medlineplus/ency/article/003853.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003853.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003853.htmhttp://www.mayoclinic.com/health/emphysema/ds00296http://www.mayoclinic.com/health/emphysema/ds00296http://www.mayoclinic.com/health/emphysema/ds00296http://www.mayoclinic.com/health/emphysema/ds00296http://www.nlm.nih.gov/medlineplus/ency/article/003853.htmhttp://www.lung-cancer.com/stages.htmlhttp://www.lung-cancer.com/staging.htmlhttp://www.lung-cancer.com/staging.htmlhttp://www.lung-cancer.com/types.html


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There are several approaches available to thoracic surgeons. A wedge resection preserves the

most lung tissue but provides the least room for error (meaning there is a reasonable chance of

the cancer recurring). A wedge resection is suited to small primary tumors, usually of the Stage 0and I variety. A segmental resection is a bit more aggressive, taking more lung tissue. However,

the segmental resection is often well suited to stage I and II disease. Again, the risk of missing

cancer cells is weighed against the resulting lung capacity.

A lobectomy is a procedure in which one of the five lobes is completely removed. The largest

lung cancer resection surgery, apneumonectomy(or hemi-pneumonectomy), is when an entirelung is removed, either the left or the right lung. In general, lobectomy and pneumonectomy are

used to treat stage II NSCLC in patients with excellent reserve capacity of the lungs.

There are a number of chemotherapeutic regimens that can be used to treat NSCLC. These are

usually reserved 1) for higher stages of lung cancer (stages III and IV) or 2) as adjuvant therapy,

that is, to be used after surgery or 3) as neoadjuvant therapy, which is treatment before surgery.

Neoadjuvant therapy is done to make the tumor smaller so that surgery will be easier or moreeffective. Adjuvant therapy is performed to kill cancer cells that may have been missed in the

surgery or spread from the primary tumor.

The standard of care in the treatment of NSCLC is to use a platinum-based chemotherapeutic

agent, especially in advanced disease (stages III and especially IV). Most studies have shown

that two agents are better than one. Three agents used in combination do not provide muchadditional benefit but do cause a number of additional, unpleasant side effects. Therefore

chemotherapy regimens usually include two drugs. Often this combination regimen includes a

platinum drug like cisplatin along with either an older (etoposide) or newer (docetaxel,gemcitabine, pemetrexed (Alimta) or vinorelbine) chemotherapeutic drug.

Non-small cell lung cancertumors are not very sensitive to most chemotherapy regimens,

unfortunately. Chemotherapy alone is not considered a curative treatment for NSCLC. Oftenchemotherapy is combined with radiation therapyan approach that is sometimes referred to as

chemoradiation therapy. When the two treatment modalities are combined, the rates of disease

clearance and survival are better than with either treatment alone. Otherwise chemotherapy iscombined with surgery (either as neoadjuvant or adjuvant)
http://anatomy.med.umich.edu/surgical_videos/pneumonectomy.htmlhttp://anatomy.med.umich.edu/surgical_videos/pneumonectomy.htmlhttp://anatomy.med.umich.edu/surgical_videos/pneumonectomy.htmlhttp://www.lung-cancer.com/types.htmlhttp://www.lung-cancer.com/types.htmlhttp://www.lung-cancer.com/types.htmlhttp://anatomy.med.umich.edu/surgical_videos/pneumonectomy.html


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Radiation therapy alone is sometimes used for stage I and II NSCLC when surgery is not

possible due to too little lung capacity. If that stage I or II tumor is resectable, surgery would be

used rather than radiation therapy.

In stage IIIA NSCLC, surgery is still considered first line therapy. When surgery is possible, it is

usually combined with adjuvant chemotherapy. If surgery is not possible in stage IIIA disease,chemoradiation therapy is used. Some specific stage IIIA tumors, like Pancoast tumors or tumors

that have invaded the chest wall, have special treatment approaches.

In stage IIIB, chemoradiation therapy is considered first line. Radiation therapy alone may be

used if patients are concerned with the toxic effects of chemotherapy; however outcomes are

better if both treatment modalities are used. In this stage of NSCLC, surgery is not considered a

curative intervention or effective treatment and is rarely performed. Radiation therapy may beused for palliation of symptoms when tumor invades certain tissues and causes troublesome

symptoms.

Chemotherapy is really the only treatment modality used in stage IV NSCLC. Radiation therapy

and surgery are used to relieve symptoms rather than change the course of the disease or improve

survival. Treatment for stage IV disease most likely will include a platinum-basedchemotherapeutic agent and a non-platinum chemotherapeutic drug. When three drugs are used,

the third is not technically a chemotherapeutic agent but rather targetedtherapy.

Targeted therapy includes drugs, antibodies or other proteins that target and disrupt specific

proteins within the cancer cell. These disrupted proteins are critical for the cancer cells survivalso the treated cell dies or stops multiplying. The use of targeted therapy in stage IV disease alongwith two other chemotherapeutic drugsmay improve overall survival.
http://www.lung-cancer.com/lung-cancer-survival-rate.htmlhttp://www.lung-cancer.com/lung-cancer-survival-rate.htmlhttp://www.lung-cancer.com/lung-cancer-survival-rate.htmlhttp://www.lung-cancer.com/lung-cancer-survival-rate.html


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Treatment of small cell lung cancer

The treatment options in SCLC are less complex than NSCLC, mostly because studies haverepeatedly shown that treatment outcomes are not affected by detailed staging. In other words,placing SCLC in four different stagesdoes not influence treatment choices or outcomes to any

appreciable degree. Thus treatment of SCLC is based mainly on two different stages, limited and

extensive.

Treatment Guidelines for Small Cell Lung Cancer

Stage Standard Treatment Alternate Theraphy

Limited

Radiation Therapy

Chemotherapy (single drug or

combination)

Surgery

ExtensiveRadiation Therapy

Chemotherapy (combination of drugs)

Radiation therapy to the brainprophylactically

Surgery (palliative)

Fortunately SCLC is very sensitive to radiation therapy. Radiotherapy is the treatment modalityused in virtually all cases of limited SCLC disease. Radiation therapy is more effective and

causes fewer side effects in limited disease because, by definition, limited disease can be treatedthrough a single, external radiation port. In extensive SCLC disease, radiation therapy may be

reserved for patients that have not responded to chemotherapy. This is because in extensivedisease, radiation would need to been applied to large areas of the body. As a palliative

intervention in extensive SCLC (and sometimes limited SCLC), certain organs like that brain

may be irradiated prophylactically (in case there is spread).

Chemotherapy is used to treat both limited and extensive SCLC. In limited disease, patients have

been successfully treated with a single chemotherapeutic drug (when combined with radiation).In most cases though, two drugs are used rather than one. These two drugs are commonly a

platinum drug and etoposide. In extensive SCLC, two chemotherapeutic drugs are used. The

specific chemotherapeutic agents used in extensive SCLC vary.

In both NSCLC and SCLC, it may be possible to enroll in a clinical trial of lung cancer

treatments. These trials usually compare new therapies against older ones to see if outcomes can

be improved. Targeted therapies, radiosensitizers, internal radiation sources, and newercombination treatment regimens are just some of the treatment tools being tested in research and

clinical studies. These new treatments may improve survival or may lead to future

breakthroughs.
http://www.lung-cancer.com/stages.htmlhttp://www.lung-cancer.com/stages.htmlhttp://www.lung-cancer.com/stages.html


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