lung cancer (redirected from Pulmonary cancer)

lung cancer,

a pulmonary malignancy attributable in the majority of cases to cigarette smoking. Other predisposing factors are exposure to acronitrile, arsenic, asbestos, beryllium, chloromethyl ether, chromium, coal products, ionizing radiation, iron oxide, mustard gas, nickel, petroleum, uranium, and vinyl chloride. Lung cancer develops most often in scarred or chronically diseased lungs. It is usually far advanced when detected because metastases may precede detection of the primary lesion in the lung. Symptoms of lung cancer include persistent cough, hoarseness, dyspnea, purulent or blood-streaked sputum, chest pain, and repeated attacks of bronchitis or pneumonia. Diagnostic measures include x-ray films, fluoroscopy, tomography, bronchography, angiography, cytologic studies of sputum, bronchial washings or brushings, and needle biopsy. Epidermoid cancers and adenocarcinomas each account for approximately 30% of lung tumors; about 25% are small, or oat, cell carcinomas; and 15% are large cell anaplastic cancers. Small cell carcinomas frequently metastasize widely before diagnosis. Surgery is the most effective treatment, but only about 20% are resectable. Lung cancer is essentially incurable unless surgical resection can be accomplished. Thoracotomy is contraindicated if metastases are found in contralateral or scalene lymph nodes. Irradiation is used to treat localized lesions and unresectable intrathoracic tumors and as palliative therapy for metastatic lesions. Radiotherapy may also be administered after surgery to destroy remaining tumor cells and may be combined with chemotherapy. Targeted therapy with drugs such as paclitaxel, carboplatin, irinotecan, and erlotinib has also shown results. Chemotherapy is especially indicated for small cell carcinoma.

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lung cancer

Oncology An epithelial malignancy of the lungs, which accounts for 30% of all cancer deaths in the US, most of which are directly attributable to cigarette use Clinical Persistent cough, hemoptysis, chest pain, weight loss, nonresponsive pneumonia Types Non-small cell cancer–eg, squamous cell carcinoma, adenocarcinoma, bronchoalveolar; small cell (undifferentiated) carcinoma Epidemiology US, ±170,000 new cases, 1999; ±150,000 die/yr due to LC Sites of metastasis Brain, bone, liver, adrenal glands Etiology Most lung CA–83% is directly linked to cigarette smoking; the risk is higher with ↑ number of cigarettes smoked/day and earlier age of smoking; up to 3,000 lung CAs are attributable to second-hand smoke; other factors include high levels of pollution, radiation, and asbestos; cooks and chemists have an ↑ risk Diagnosis Cytology of sputum, biopsy by bronchoscopy, needle localization, or surgical excision Therapy Surgery for resectable non-small cell CA, based on the size of the primary tumor and extent of lymph node involvement and metastases; chemotherapy and/or RT for small cell CA Prognosis Once diagnosed, average Pt survives 1–2 yrs; 5-10% survive 5 yrs after diagnosis; Pts with small cell–undifferentiated carcinoma have a slightly better prognosis than those with squamous cell and bronchoalveolar carcinomas, if it responds to chemotherapy

Lung carcinoma, classification

% Total & Type 5-year survival by stage

    I  II III

38% Squamous cell–epidermoid  38% 16% 9%

23% Adenocarcinoma  32% 7% 3%

 Papillary adenocarcinoma

 Alveolar cell

 Bronchiolar carcinoma

 Mucinous adenocarcinoma

 Adenosquamous carcinoma

29% Small cell/undifferentiated 0% 0% 0%

 Oat cell carcinoma

 Intermediate cell type

 Combined oat cell type

9% Undifferentiated Large cell  30% 6% 5%

Rare Giant cell carcinoma  Rapidly fatal

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Patient discussion about Pulmonary cancer.

Q. My grandfather died of lung cancer because of smoking. what is the probability of me getting a cancerous tumor? What procedure is done to see if a tumor is malignant? Is a simple MRI enough to make that conclusion?

A. Sad.. my brother in law died from smoking, few years ago.
Regardless of family history, smoking is not exactly helthy and does contribute to lung cancer.
Even though the role of heredity in lung cancer is not as well-known, having a family history of lung cancer does increase our risk to some degree. Hereditary lung cancer is higher in women, nonsmokers and those with early onset lung cancer (lung cancer that occurs before the age of 60). Overall, it has been estimated that 1.7% of lung cancers up to the age of 68 are hereditary.

Q. Does the risk for lung cancer remain the same after I stop smoking? I'm 55 years old woman and have been smoking since age 20 one pack a day. Fortunately, after numerous failures I succeeded to stop smoking 5 years ago. I'm happy and feel much better now, but I'm still worried about the possibility of lung cancer- I know that smoking cause lung cancer, but after I've stopped smoking, am I still at risk to have cancer?

A. The answer is a little complicated: as former smoker, the risk for lung cancer does decrease with time. However, it may never return to the risk of someone similiar to you who never smoke to develop lung cancer.

Q. Is it possible to have lung cancer without smoking? My 89 years-old grandfather was told by his doctor that he has lung cancer, after he had cough for almost two months. I thought that lung cancer happens because people smoke, but my grandfather never smoked or drank alcohol and is still in a very good shape (for his age, of course) – is it possible the doctor was wrong and he doesn’t have lung cancer?

A. There are other things that increase the risk of lung cancer-. He may not be a smoker himself, but maybe he was living with a smoker, maybe he worked in an asbestos building, or exposed to substances that cause lung cancer.