Lung cancer

Normal Lungs vs Cancerous Lungs
ICD-10	C33-C34
ICD-9	162
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OMIM	{{{OMIM}}}
DiseasesDB	{{{DiseasesDB}}}
MedlinePlus	{{{MedlinePlus}}}
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Lung cancer is a cancer of the lungs characterised by the presence of malignant tumours. Most commonly it is bronchogenic carcinoma (about 90%). Lung cancer is one of the most lethal of cancers worldwide, causing up to 3 million deaths annually. Only one in ten patients diagnosed with this disease will survive the next five years. Although lung cancer was previously an illness that affected predominately men, the lung cancer rate for women has been increasing in the last few decades, which has been attributed to the rising ratio of female to male smokers. The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... The Mendelian Inheritance in Man project is a database that catalogues all the known diseases with a genetic component, and - when possible - links them to the relevant genes in the human genome. ... The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... MedlinePlus (medlineplus. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... When normal cells are damaged beyond repair, they are eliminated by apoptosis. ... The lungs flank the heart and great vessels in the chest cavity. ... In medicine, malignant is a clinical term that is used to describe a clinical course that progresses rapidly to death. ... Tumor (American English) or tumour (British English) originally means swelling, and is sometimes still used with that meaning. ... In medicine, carcinoma is any cancer that arises from epithelial cells. ...

Current research indicates that the factor with the greatest impact on risk of lung cancer is long-term exposure to inhaled carcinogens. The most common means of such exposure is tobacco smoke. A risk factor is a variable associated with an increased risk of disease or infection but risk factors are not necessarily causal. ... // Carcinogen In pathology, a carcinogen is any substance or agent that promotes cancer. ... Various smoking equipment including different pipes, and cigars. ...

Treatment and prognosis depend upon the histological type of cancer and the stage (degree of spread). Possible treatment modalities include surgery, chemotherapy, and/or radiotherapy. Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term denoting the doctors prediction of how a patients disease will progress, and whether there is chance of recovery. ... A thin section of lung tissue stained with hematoxylin and eosin. ... In the context of pathology, staging refers to the evaluation of a disease in terms of its progression in the body, or stage. This term is most often used in the context of oncology to establish the stage of development of a certain cancer. ... A typical modern surgical operation For other uses, see Surgery (disambiguation). ... Chemotherapy is the use of chemical substances to treat disease. ... Clinac 2100 C accelerator Radiation therapy (or radiotherapy) is the medical use of ionising radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...

Signs and symptoms

Symptoms that suggest lung cancer include:

• dyspnea (shortness of breath)
• hemoptysis (coughing up blood)
• chronic cough
• wheezing
• chest pain
• cachexia (weight loss), fatigue and loss of appetite
• dysphonia (hoarse voice)
• clubbing of the fingernails (uncommon)

If the cancer grows into the lumen it may obstruct the airway, causing breathing difficulties. This can lead to accumulation of secretions behind the blockage, predisposing the patient to pneumonia. Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ... Hemoptysis is the expectoration of blood or of blood-stained sputum from the bronchi, larynx, trachea, or lungs (e. ... In medicine, chest pain is a symptom of a number of serious conditions and is generally considered a medical emergency, unless the patient is a known angina pectoris sufferer and the symptoms are familiar (appearing at exertion and resolving at rest, known as stable angina). // Causes Cardiopulmonary Important cardiovascular and... Two fatigued men in Tehran The word ‘fatigue’ is used in everyday living to describe a range of afflictions, varying from a general state of lethargy to a specific work induced burning sensation within muscle. ... The appetite is the desire to eat food, felt as hunger. ... Lisp may mean: Lisp programming language Lisp (speech) This is a disambiguation page — a list of pages that otherwise might share the same title. ... In medicine, clubbing (or digital clubbing) is a deformity of the fingers and fingernails that is associated with a number of diseases, mostly of the heart and lungs. ... For the aerial route, see Airway (aviation). ... Dyspnea (Latin dyspnoea, Greek dyspnoia from dyspnoos - short of breath) or shortness of breath (SOB) is perceived difficulty breathing or pain on breathing. ... Pneumonia is an illness of the lungs and respiratory system in which the microscopic, air-filled sacs (alveoli) responsible for absorbing oxygen from the atmosphere become inflamed and flooded with fluid. ...

Many lung cancers have a rich blood supply. The surface of the cancer may be fragile, leading to bleeding from the cancer into the airway. This blood may subsequently be coughed up.

Depending on the type of tumor, so-called paraneoplastic phenomena may initially attract attention to the disease. In lung cancer, this may be Lambert-Eaton myasthenic syndrome (muscle weakness due to auto-antibodies), hypercalcemia and SIADH. Tumors in the top (apex) of the lung, known as Pancoast tumors, may invade the local part of the sympathetic nervous system, leading to changed sweating patterns and eye muscle problems (a combination known as Horner's syndrome), as well as muscle weakness in the hands due to invasion of the brachial plexus. A paraneoplastic phenomenon is a disease or symptom that is the consequence of the presence of cancer in the body, but is not due to the local presence of cancer cells. ... Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder of nerve-muscle (neuromuscular) junction. ... Autoimmune diseases arise from an overactive immune response of the body against substances and tissues normally present in the body. ... Hypercalcaemia is an elevated calcium level in the blood. ... The syndrome of inappropriate antidiuretic hormone (SIADH) is a condition commonly found in the hospital population, especially in patients being hospitalized for central nervous system (CNS) injury. ... Pancoast tumor is a tumor of the pulmonary apex. ... Grays FIG. 838– The right sympathetic chain and its connections with the thoracic, abdominal, and pelvic plexuses. ... Horners syndrome is a clinical syndrome caused by damage to the sympathetic nervous system. ... The brachial plexus is an arrangement of nerve fibres (a plexus) running from the spine (vertebrae C5-T1), through the neck, the axilla (armpit region), and into the arm. ...

In many patients, the cancer has already spread beyond the original site by the time they have symptoms and seek medical attention. Common sites of metastasis include the bone, such as the spine (causing back pain and occasionally spinal cord compression) and the brain. Grays illustration of a human femur, a typically recognized bone. ... Look up spine on Wiktionary, the free dictionary. ... Spinal cord compression develops when the spinal cord is compressed by a tumor, abscess or other lesion. ... Comparative brain sizes In animals, the brain, or encephalon (Greek for in the head), is the control center of the central nervous system. ...

Diagnosis

Performing a chest X-ray is the first step if a patient reports symptoms that may be suggestive of lung cancer. This may reveal an obvious mass, widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (collapse), consolidation (infection) and pleural effusion. If there are no X-ray findings but the suspicion is high (e.g. a heavy smoker with blood-stained sputum), bronchoscopy and/or a CT scan may provide the necessary information. In any case, bronchoscopy or CT-guided biopsy is often necessary to identify the tumor type. Chest X-ray A chest X-ray is a radiological film obtained by X-ray taken of the thorax which is used to diagnose problems with that area. ... The mediastinum is a non-delineated group of structures in the thorax (chest), surrounded by loose connective tissue. ... Structure of the lymph node. ... Atelectasis is defined as collapse of a part of the lung or the whole lung, where the alveoli are deflated, as distinct from pulmonary consolidation. ... Infected (Podcast) is also the name of an internet radio podcast hosted by Martin Sargent. ... Pleural effusion is a medical condition where fluid accumulates in the pleural cavity which surrounds the lungs, making it hard to breathe. ... In medicine, bronchoscopy is the visualization of the lower airways using a flexible or rigid endoscope. ... CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around... A biopsy (in Greek: bios = life and opsy = look/appearance) is a medical test involving the removal of cells or tissues for examination. ...

If investigations have confirmed lung cancer, scan results and often positron emission tomography (PET) are used to determine whether the disease is localised and amenable to surgery or whether it has spread to the point it cannot be cured surgically. PET is not useful as screening, as not all malignancies are positive on PET scan (such as bronchoalveolar carcinoma), and lung infections may be positive on PET Scan. Image of a typical positron emission tomography (PET) facility Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three dimensional image or map of functional processes in the body. ...

Blood tests and spirometry (lung function testing) are also necessary to assess whether the patient is well enough to be operated on. If spirometry reveals a very poor respiratory reserve, as may occur in chronic smokers, surgery may be contraindicated. Blood tests are laboratory tests done on blood to gain an appreciation of disease states and the function of organs. ... Spirometry (meaning the measuring of breath) is the most common of the Pulmonary Function Tests (PFTs), measuring lung function, specifically the measurement of the amount (volume) and/or speed (flow) of air that can be inhaled and exhaled. ...

Types

There are two main types of lung cancer categorized by the size and appearance of the malignant cells seen by a histopathologist under a microscope: small-cell (roughly 20%) and non-small cell (80%) lung cancer. This classification although based on simple pathomorphological criteria has very important implications for clinical management and prognosis of the disease. Histopathology is a field of pathology which specialises in the histologic study of diseased tissue. ...

Non-small cell lung cancer

The non-small cell lung cancers (NSCLC) are grouped together because their prognosis and management is roughly identical. When it cannot be subtyped, it is frequently coded to 8046/3. The subtypes are:

• (M8070/3) Squamous cell carcinoma also starts in the larger breathing tubes but grows slower meaning that the size of these tumours varies on diagnosis.
• (M8140/3) Adenocarcinoma (or for slower growing forms alveolar cell cancer) is a form which starts near the gas-exchanging surface of the lung. It is less closely associated with smoking.
• Large cell carcinoma is a fast-growing form that grows near the surface of the lung. It is primarily a diagnosis of exclusion, and when more investigation is done, it is usually reclassified to squamous cell carcinoma or adenocarcinoma.

The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... In medicine, squamous cell carcinoma is a form of cancer of the carcinoma type that may occur in many different organs, including the skin, the esophagus, the lungs, and the cervix. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... In medicine, carcinoma is any cancer that arises from epithelial cells. ... The term diagnosis of exclusion refers to a medical condition whose presence cannot be established with complete confidence from examination or testing. ...

Small cell lung cancer

• (M8041/3) Small cell carcinoma (SCLC, also called "oat cell carcinoma") is the less common form of lung cancer. It tends to start in the larger breathing tubes and grows rapidly becoming quite large. The oncogene most commonly involved is L-myc. The "oat" cell contains dense neurosecretory granules which give this an endocrine/paraneoplastic syndrome association. It is more sensitive to chemotherapy, but carries a worse prognosis and is often metastatic at presentation. This type of lung cancer is strongly associated with smoking.

The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... Small cell carcinoma is a type of carcinoma usually associated with the lung, though it can be associated with other topographies, such as in cervical cancer. ... Oat cell carcinoma is now referred to as the small cell carcinoma. ... An oncogene is a modified gene that increases the malignancy of a tumor cell. ...

Other types

• (M8240/3) carcinoid (the main representatives in this group)
• (M8200/3) adenoid cystic carcinoma
• cylindroma
• mucoepidermoid carcinoma

The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... Carcinoid is a potentially malignant tumour that occurs in the mucosa of the lungs and digestive tract and potentially in other organs. ... The International Classification of Diseases for Oncology (ICD-O) is a domain specific extension of the International Statistical Classification of Diseases and Related Health Problems for tumor diseases. ... Adenoid cystic cancer (AdCC) is a very rare type of cancer that can exist in many different body sites. ...

Metastatic

The lung is a common place for metastasis from tumors in other parts of the body. These cancers, however, are identified by the site of origin, i.e., a breast cancer metastasis to the lung is still known as breast cancer. The adrenal glands, liver, brain, and bone are the most common sites of metastasis from primary lung cancer itself. Metastasis (Greek: change of the state) is the spread of cancer from its primary site to other places in the body. ...

Causes

Exposure to carcinogens, such as those present in tobacco smoke, immediately causes cumulative changes to the tissue lining the bronchi of the lungs (the bronchial mucous membrane) and more tissue gets damaged until a tumour develops. // Carcinogen In pathology, a carcinogen is any substance or agent that promotes cancer. ... Tobacco smoking is the act of smoking tobacco products, especially cigarettes and cigars. ... A bronchus (plural bronchi, adjective bronchial) is a caliber of airways in the the respiratory tract that conducts air into the lungs. ...

There are four major causes of lung cancer (and cancer in general):

• Carcinogens such as those in cigarette smoke
• Radiation exposure
• Genetic susceptibility
• Viral infection

// Carcinogen In pathology, a carcinogen is any substance or agent that promotes cancer. ... A cigarette will burn to ash on one end. ... Ionizing radiation is a type of particle radiation in which an individual particle (for example, a photon, electron, or helium nucleus) carries enough energy to ionize an atom or molecule (that is, to completely remove an electron from its orbit). ... Genetics (from the Greek genno γεννώ= give birth) is the science of genes, heredity, and the variation of organisms. ... A common alternate meaning of virus is computer virus. ...

The role of smoking

Smoking, particularly of cigarettes, is believed to be by far the main contributor to lung cancer, which at least in theory makes it one of the easiest diseases to prevent. In the United States, smoking is estimated to account for 87% of lung cancer cases in the U.S. (90% in men and 79% in women). There are hundreds of known carcinogens—such as polynuclear aromatic hydrocarbons, nitrosamines, and radioactive heavy metals—present in cigarette smoke. Additionally, nicotine appears to depress the immune response to malignant growths in exposed tissue. The length of time a person continues to smoke as well as the amount smoked increases the person's chances of contracting lung cancer. If a person stops smoking, these chances steadily decrease as the lung damage is repaired. Various smoking equipment including different pipes, and cigars. ... A cigarette will burn to ash on one end. ... In pathology, a carcinogen is any substance or agent that promotes cancer. ... An aromatic hydrocarbon (abbreviated as AH), or arene is a hydrocarbon, the molecular structure of which incorporates one or more planar sets of six carbon atoms that are connected by delocalised electrons numbering the same as if they consisted of alternating single and double covalent bonds. ... Nitrosamines are carcinogenous chemical compounds of the chemical structure R2N-N=O. Nitrosamines are produced from nitrites and amines. ... Radioactive decay is the set of various processes by which unstable atomic nuclei (nuclides) emit subatomic particles. ... The term heavy metal may have various more general or more specific meanings. ...

Passive smoking—the inhalation of smoke from another's smoking—has recently been identified as a much larger cause of lung cancer in non-smokers than previously believed. The US Environmental Protection Agency (EPA) in 1993 concluded that about 3,000 lung cancer-related deaths a year were caused by passive smoking, however since this report was declared null and void by a federal judge in 1998, the true extent is still contested by scientists. Various smoking equipment including different pipes, and cigars. ... The mission of the United States Environmental Protection Agency (EPA) is to protect human health and to safeguard the natural environment: air, water, and land. ...

Asbestos

Asbestos can cause a variety of lung diseases. It increases the risk of developing lung cancer. There is a synergistic effect between tobacco smoking and asbestos in the formation of lung cancer. Fibrous asbestos on muscovite Asbestos Asbestos Asbestos (a misapplication of Latin: asbestos quicklime from Greek ἄσβεστος: a-, not; sbestos, extinguishable) describes any of a group of fibrous metamorphic minerals of the hydrous magnesium silicate variety. ... Synergy or synergism most often refers to the phenomenon of two or more discrete influences or agents acting in common to create an effect which is greater than the sum of the effects each is able to create independently. ...

Asbestos can also cause cancer of the pleura, called mesothelioma (which is distinct from lung cancer). In anatomy, the pleural cavity is the potential space between the lungs and the chest wall. ...

Radon gas

Radon is a colorless and odourless gas generated by the breakdown of radioactive radium, which in turn is the decayed product of uranium, found in the earth's crust. Radon exposure is the second major cause of lung cancer after smoking. The radiation ionizes genetic material, causing mutations that sometimes turn cancerous. Radon gas levels vary by locality and the composition of the underlying soil and rocks. For example, in areas such as Cornwall in the UK (which has granite as substrata), radon gas is a major problem, and buildings have to be force-ventilated with fans to lower radon gas concentrations. In the US, the EPA estimates that one in 15 homes has radon levels above the recommended standard. General Name, Symbol, Number radon, Rn, 86 Chemical series noble gases Group, Period, Block 18, 6, p Appearance colorless Atomic mass (222) g/mol Electron configuration [Xe] 4f14 5d10 6s2 6p6 Electrons per shell 2, 8, 18, 32, 18, 8 Physical properties Phase gas Melting point 202 K (-71 °C... A gas is one of the four main phases of matter (after solid and liquid, and followed by plasma), that subsequently appear as a solid material is subjected to increasingly higher temperatures. ... General Name, Symbol, Number radium, Ra, 88 Chemical series alkaline earth metals Group, Period, Block 2, 7, s Appearance silvery white metallic Atomic mass (226) g/mol Electron configuration [Rn] 7s2 Electrons per shell 2, 8, 18, 32, 18, 8, 2 Physical properties Phase solid Density (near r. ... General Name, Symbol, Number uranium, U, 92 Chemical series actinides Group, Period, Block n/a, 7, f Appearance silvery gray metallic; corrodes to a spalling black oxide coat in air Atomic mass 238. ... Earth cutaway from core to exosphere. ... // An ion is an atom or group of atoms with a net electric charge. ... Soil is material capable of supporting plant life. ... Sedimentary, volcanic, plutonic, metamorphic rock types of North America. ... Motto: Onen hag oll (Cornish: One and all) Geography Status Ceremonial and (smaller) Non-metropolitan county Region South West England Population - Total (2004 est. ... Quarrying granite for the Mormon Temple, Utah Territory. ...

Genetics and viruses

Oncogenes are genes that are believed make people more susceptible to cancer. Proto-oncogenes are believed to turn into oncogenes when exposed to particular carcinogens. Viruses are also suspected of causing cancer in humans, as this link has already been proven in animals. Genetic susceptibility and viral infection are not of major importance in lung cancer, but they may influence pathogenesis. An oncogene is a modified gene that increases the malignancy of a tumor cell. ... The human immunodeficiency virus (HIV) A bacteriophage virus A virus is a submicroscopic parasitic particle that infects cells in biological organisms. ...

Treatment

Treatment for lung cancer depends on the cancer's specific cell type, how far it has spread, and the patient's performance status. Common treatments include surgery, chemotherapy, and radiation therapy. The stage of a cancer is a descriptor (usually numbers I to IV) of how much the cancer has spread. ... In medicine (oncology and other fields), performance status is an attempt to quantify cancer patients general wellbeing. ... A typical modern surgical operation For other uses, see Surgery (disambiguation). ... Chemotherapy is the use of chemical substances to treat disease. ... Clinac 2100 C accelerator Radiation therapy (or radiotherapy) is the medical use of ionising radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ...

Surgery

Surgery is only an option in NSCLC and if the disease is limited to one lung and has not spread beyond its confines. This is assessed with medical imaging (computed tomography, positron emission tomography). Furthermore, as stated, a sufficient respiratory reserve needs to be present to allow for the removal of large amounts of lung tissue. Procedures performed include lobectomy (removal of one lobe), bilobectomy (two lobes) or pneumonectomy (removal of a whole lung). CT apparatus in a hospital Computed tomography (CT), originally known as computed axial tomography (CAT) and body section roentgenography, is a medical imaging method employing tomography where digital geometry processing is used to generate a three-dimensional image of the internals of an object from a large series of two... Image of a typical positron emission tomography (PET) facility Positron emission tomography (PET) is a nuclear medicine medical imaging technique which produces a three dimensional image or map of functional processes in the body. ... A pneumonectomy (or pneumectomy) is an surgical procedure to remove a lung. ... A pneumonectomy (or pneumectomy) is an surgical procedure to remove a lung. ...

The role of sublobar resection (extended wedge resection)continues to be debated for the primary management of NSCLC. Although overall survival appears to be equivalent to that of lobectomy resection, the local recurrence rate has been documented to be over three times more common (19% compared to 5%). Accordingly, sublobar resection has historically been used as a "compromise resection" approach for the management of small (less than 3 centimeters diameter)stage I peripheral NSCLC identified in patients with impaired cardiopulmonary reserve. Recent reports of the use of intraoperative radioactive iodine brachytherapy implants at the margins of sublobar resection suggest that local recurrence can be reduced to that of lobectomy when this is used as a surgical adjunct to sublobar resection.

The role of anatomic segmentectomy (a larger sublobar resection) with complete lymph node staging has also been found to have potential survival benefits similar to lobectomy. Such resections should be limited to peripheral small (less than 2 centimeter diameter)stage I NSCLC where a margin of resection equivalent to the diameter of the tumor can be achieved.

Five-year prognosis is often as good as 70% following complete resection of limited (lesions limited to the lung tissue without lymph node spread - stage 1) disease.

After surgery, adjuvant chemotherapy may be recommended if lymph nodes within the lung tissues resected (stage 2) or the mediastinum (lymph nodes in the peri-tracheal region -stage 3) are found to be positive for cancer spread. Survival may be improved by up to 15% above patients receiving only surgical resection in these circumstances. The role of adjuvant chemotherapy for patients with large stage 1 NSCLC (tumors greater than 3 centimeters diameters without lymph node involvement - stage 1b) remains controversial. Only one randomized study (yet to be published), which was recently conducted by the Cancer and Leukemia -Group B (CALGB)-2004 demonstrated survival benefit with the addition of chemotherapy following surgical resection of stage 1b disease. Three other recent contempory studies of adjuvant chemotherapy have not demonstrated this proposed benefit (IALT-2003, NCI Canada 2004, ANITA 2005). In medicine, adjuvants are agents which modify the effect of other agents while having few if any direct effects when given by themselves. ...

Chemotherapy

Small-cell lung cancer is treated primarily with chemotherapy, as surgery has no demonstrable influence on survival. Primary chemotherapy is also given in metastatic NSCLC.

The combination regimen depends on the tumour type:

• NSCLC: cisplatin or carboplatin, in combination with gemcitabine, paclitaxel, docetaxel, etoposide or vinorelbine. In metastatic lung cancer, the addition of bevacizumab when added to carboplatin and paclitaxel was found to improve survival (though in this study, patients with squamous cell lung cancer were excluded because of problems with pulmonary hemorrhage in this group in the past).
• SCLC: cisplatin or carboplatin, in combination etoposide or ifosfamide; combinations with gemcitabine, paclitaxel, vinorelbine, topotecan and irinotecan are being studied

Cisplatin or cis-diamminedichloroplatinum(II) (CDDP) is a platinum-based chemotherapy drug used to treat various types of cancers, including sarcomas, some carcinomas (e. ... |} Carboplatin is a chemotherapy drug used against some form of cancer. ... Gemcitabine is a nucleoside used as chemotherapy. ... Paclitaxel (Taxol®) is a drug used in the treatment of cancer. ... Docetaxel chemical structure Docetaxel is a chemotherapy drug used in the treatment of cancer. ... Etoposide: chemical structure Etoposide phosphate (Eposin®, Etopophos®, Vepesid®, VP-16®) is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme. ... Vinorelbine (Navelbine) is a chemotherapy drug that is given as a treatment for some types of cancer including breast cancer and non-small-cell lung cancer. ... Bevacizumab (Avastin®) is an anti-angiogenesis drug used in treatment of cancer. ... Cisplatin or cis-diamminedichloroplatinum(II) (CDDP) is a platinum-based chemotherapy drug used to treat various types of cancers, including sarcomas, some carcinomas (e. ... |} Carboplatin is a chemotherapy drug used against some form of cancer. ... Etoposide: chemical structure Etoposide phosphate (Eposin®, Etopophos®, Vepesid®, VP-16®) is an inhibitor of the enzyme topoisomerase II. It is used as a form of chemotherapy for malignancies such as lung cancer, testicular cancer, lymphoma, non-lymphocytic leukemia, and glioblastoma multiforme. ... Ifosfamide (Mitoxana®) Ifosfamide (pronounced i fos fa mide) is chemotherapy that is given as a treatment for many different types of cancer. ... Gemcitabine is a nucleoside used as chemotherapy. ... Paclitaxel (Taxol®) is a drug used in the treatment of cancer. ... Vinorelbine (Navelbine) is a chemotherapy drug that is given as a treatment for some types of cancer including breast cancer and non-small-cell lung cancer. ... Topotecan (Hycamtin®) is a chemotherapy agent that is a topoisomerase 1 inhibitor. ... Irinotecan is a chemotherapy agent that is a topoisomerase 1 inhibitor. ...

Targeted therapy

In recent years, various molecular targeted therapies have been developed for the treatment of advanced lung cancer. Gefitinib (Iressa®) is one such drug, which targets the epidermal growth factor receptor (EGF-R) which is expressed in many cases of NSCLC. However despite an exciting start it was not shown to increase survival, although younger females without a smoking history appear to be deriving most benefit from gefitinib. Gefitinib is a new drug used in the treatment of certain types of cancer. ... GOD DAMN IT WHY DOES IT KEEP SAYINBG I HAVE PRIVATE MESSAGES!!! I DIDNnT DO ANY FUCKING THING!!!!!!!!!!!!!!!!!!!!!!!!!!!!! ...

A newer drug called erlotinib (Tarceva®) has been shown to increase survival in lung cancer patients and has recently been approved by the FDA for second-line treatment of advanced non-small cell lung cancer.[1] Erlotinib hydrochloride (Tarceva®, Genentech/OSIP) is a drug used to treat non-small cell lung cancer and in clinical trials for several other types of cancer. ...

Treatment of non-small cell lung cancer is evolving and the next few years could present exciting developments and new targeted therapies for lung cancer.

Radiotherapy

Radiotherapy is often given together with chemotherapy, and may be used with curative intent in patients who are not eligible for surgery. A radiation dose of 40 or more Gy in many fractions is commonly used with curative intent in non-small cell lung cancer; typically in North America, the dose prescribed is 60 or 66 Gy in 30 to 33 fractions given once daily, 5 days a week, for 6 to 6 1/2 weeks. For small cell lung cancer cases that are potentially curable, in addition to chemotherapy, chest radiation is often recommended. For these small cell lung cancer cases, chest radiation doses of 40 Gy or more in many fractions are commonly given; typically in North America, the dose prescribed is 45 to 50 Gy and can be given in either once daily treatments for 5 weeks or twice daily treatments for 3 weeks. Clinac 2100 C accelerator Radiation therapy (or radiotherapy) is the medical use of ionising radiation as part of cancer treatment to control malignant cells (not to be confused with radiology, the use of radiation in medical imaging and diagnosis). ... The gray (symbol: Gy) is the SI unit of absorbed dose. ...

For both non-small cell lung cancer and small cell lung cancer patients, radiation of disease in the chest to smaller doses (typically 20 Gy in 5 fractions) may be used for symptom control.

Interventional radiology

Radiofrequency ablation is increasing in popularity for this condition as it is nontoxic and causes very little pain. It seems especially effective when combined with chemotherapy as it catches the cells inside a tumor—the ones difficult to get with chemotherapy due to reduced blood supply to the inside of the tumor. It is done by inserting a small heat probe into the tumor to cook the tumor cells. The body then disposes of the cooked cells through its normal eliminative processes. Interventional Radiology (IR) is a subspecialty of Medical imaging (Radiology) in which minimally invasive procedures are performed using image guidance. ...

Epidemiology

Lung cancer distribution in the United States.

The population segment most likely to develop lung cancer is the over-fifties who also have a history of smoking. Lung cancer is the second most commonly occurring form of cancer in most western countries, and it is the leading cancer-related cause of death for men and women. It is expected that 2001 will have seen 169,500 new cases of lung cancer in the US; 90,700 in men and 78,000 in women. Although the rate of men dying from lung cancer is declining in western countries, it is actually increasing for women due to the increased takeup of smoking by this group. Image produced by the Centers for Disease Control and Prevention, a subdivision of the United States Department of Health and Human Services. ... Image produced by the Centers for Disease Control and Prevention, a subdivision of the United States Department of Health and Human Services. ...

The British Doctors Study, published in the 1950s, first offered solid evidence on the link between lung cancer and smoking. The British doctors study is the generally accepted name of a prospective clinical trial which has been running from 1951 to 2001, and in 1956 provided convincing statistical proof that tobacco smoking increased the risk of lung cancer. ... // Events and trends This map shows two essential global spheres during the Cold War in 1959. ...

Not all cases of lung cancer are due to smoking, but the role of passive smoking is increasingly being recognised as a risk factor for lung cancer, leading to policy interventions to decrease undesired exposure of non-smokers to others' tobacco smoke. See also tobacco smoking and Health effects of tobacco smoking Passive smoking (also known as environmental tobacco smoke (ETS), involuntary smoking or secondhand smoke) occurs when the exhaled and ambient smoke from one persons cigarette, pipe or cigar is inhaled by other people. ...

In the Second World and Third World, smoking-related lung cancer is rising rapidly in incidence. Countries such as China are expected to see a marked increase in lung cancer cases as smoking is exceedingly common and other causes of death (such as infections) are becoming less common, revealing an "iceberg" of pulmonary neoplasms. Cheap tobacco products and heavy advertising are seen by health campaigners as a major problem in these countries. A map of countries often considered to make up the Second World. ... For the Jamaican reggae band, see Third World (band). ... Infected (Podcast) is also the name of an internet radio podcast hosted by Martin Sargent. ...

Prevention

Primary prevention

Prevention is the most cost-effective means of fighting lung cancer on the national and global scales. While in most countries industrial and domestic carcinogens have been identified and banned, tobacco smoking is still widespread. Eliminating tobacco smoking is a primary goal in the fight to prevent lung cancer, and smoking cessation is probably the most important preventative tool in this process. Smoking cessation is the effort to stop smoking tobacco products. ...

Policy interventions to decrease passive smoking (e.g. in restaurants and workplaces) have become more common in various Western countries, with California taking a lead in banning smoking in public establishments in 1998, and Ireland playing a similar role in Europe in 2004. It should be noted, however, that the evidence linking passive smoking with chronic lung disease is still shaky (see Smoking ban). See also tobacco smoking and Health effects of tobacco smoking Passive smoking (also known as environmental tobacco smoke (ETS), involuntary smoking or secondhand smoke) occurs when the exhaled and ambient smoke from one persons cigarette, pipe or cigar is inhaled by other people. ... Official language(s) English Capital Sacramento Largest city Los Angeles Area  - Total   - Width   - Length   - % water  - Latitude  - Longitude Ranked 3rd 158,302 sq mi  410,000 km² 250 miles  402. ... 1998 (MCMXCVIII) was a common year starting on Thursday of the Gregorian calendar, and was designated the International Year of the Ocean. ... Europe is conventionally considered one of the seven continents of Earth which, in this case, is more a cultural and political distinction than a physiographic one. ... It has been designated the: International Year of Rice (by the United Nations) International Year to Commemorate the Struggle against Slavery and its Abolition (by UNESCO) 2004 World Health Day topic was Road Safety (by World Health Organization) Year of the Monkey (by the Chinese calendar) See the world in... Smoking bans are government prohibitions or voluntary bans decided by establishment management on tobacco smoking in public or quasi-public indoor areas such as offices, restaurants, hotels, or even outdoor public areas such as parks and sports stadiums. ...

Only the Asian state of Bhutan has a complete smoking ban (since 2005). In many countries pressure groups are campaigning for similar bans. Arguments cited against such bans is criminalisation of smoking, increased risk of smuggling and the risk that such a ban cannot be enforced. Smoking bans are government prohibitions or voluntary bans decided by establishment management on tobacco smoking in public or quasi-public indoor areas such as offices, restaurants, hotels, or even outdoor public areas such as parks and sports stadiums. ... Criminalization or criminalisation is the process by which an act which was previously legal becomes a criminal offense by the passing of legislation or by increased enforcement of legislation when the act was previously condoned. ... A skirmish with smugglers from Finland at the Russian border, 1853, by Vasily Hudiakov. ...

Screening and secondary prevention

Because prognosis depends heavily on early detection there have been several attempts at secondary prevention. Regular chest radiography and sputum examination programs were not effective in early detection of this cancer and did not result in a reduction of mortality.

Computerized tomography (CT) scanning is now being actively evaluated as a screening tool for lung cancer, and it is showing promising results. The National Cancer Institute (USA) is currently completing a randomized trial comparing CT scans with chest radiographs. Several single-institution trials are ongoing around the world. A large group of investigators (the International Early Lung Cancer Action Project) are currently collating the results of 26,000 screen-detected lung cancers and are showing excellent preliminary survivals with these patients. More work is needed in this area. CAT apparatus in a hospital Computed axial tomography (CAT), computer-assisted tomography, computed tomography, CT, or body section roentgenography is the process of using digital processing to generate a three-dimensional image of the internals of an object from a large series of two-dimensional X-ray images taken around...

External links

• Lung Cancer Resources Page at the National Cancer Institute.
• Tobacco Smoke and Involuntary Smoking, Summary of Data Reported and Evaluation 2004 by the IARC.
• A summary of the IARC report by GreenFacts.
• RadiologyInfo- The radiology information resource for patients: Lung Cancer Therapy