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Saturday, June 27, 2009

Lung cancer

Lung cancer is cancer that begins in the lungs, the two organs found in the chest that help you breathe.
The lungs are made up of areas called lobes. The right lung has three lobes; the left lung has two, so there's room for the heart. When you breathe, air goes through your nose, down your windpipe (trachea), and into the lungs where it spreads through tubes called bronchi. Most lung cancer begins in the cells that line these tubes.
There are two main types of lung cancer:
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer.
Small cell lung cancer makes up about 20% of all lung cancer cases.
If the lung cancer is made up of both types, it is called mixed small cell/large cell cancer.
If the cancer started somewhere else in the body and spread to the lungs, it is called
metastatic cancer to the lung.
Lung cancer is the deadliest type of cancer for both men and women. Each year, more people die of lung cancer than breast, colon, and prostate cancers combined.
Lung cancer is more common in older adults. It is rare in people under age 45.
Cigarette smoking is the leading cause of lung cancer.
The more cigarettes you smoke per day and the earlier you started smoking, the greater your risk of lung cancer. There is no evidence that smoking low-tar cigarettes lowers the risk.
However, lung cancer has occurred in people who have never smoked.
Secondhand smoke (breathing the smoke of others) increases your risk of lung cancer. According to the American Cancer Society, an estimated 3,000 non-smoking adults will die each year from lung cancer related to breathing secondhand smoke.
The following may also increase one's risk of lung cancer:
High levels of air pollution
High levels of arsenic in drinking water
Radon gas
Family history of lung cancer
Radiation therapy to the lungs
Exposure to cancer-causing chemicals such as uranium, beryllium, vinyl chloride, nickel chromates, coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust
Early lung cancer may not cause any symptoms. Many times, lung cancer is found when an x-ray is done for another reason.
Symptoms depend on the specific type of cancer you have, but may include:
Cough that doesn't go away
Coughing up blood
Shortness of breath
Chest pain
Loss of appetite
Losing weight without trying
Additional symptoms that may also occur with lung cancer:
Swallowing difficulty
Nail problems
Joint pain
Hoarseness or changing voice
Swelling of the face
Facial paralysis
Eyelid drooping
Bone pain or tenderness
These symptoms can also be due to other, less serious conditions, so it is important to talk to your health care provider.

Exams and Tests
The health care provider will perform a physical exam and ask questions about your medical history. You will be asked if you smoke, and if so, how long you have smoked.
When listening to the chest with a stethoscope, the health care provider can sometimes hear fluid around the lungs, which could (but doesn't always) suggest cancer.
Tests that may be performed include:
Chest x-ray
Sputum cytology test
Blood work
CT scan of the chest
MRI of the chest
Positron emission tomography (PET) scan
In some cases, the health care provider may need to remove a piece of tissue from your lungs for examination under a microscope. This is called a biopsy. There are several ways to do this:
Bronchoscopy combined with biopsy
Pleural biopsy
CT scan directed needle biopsy
Mediastinoscopy with biopsy
Open lung biopsy
Treatment depends on the specific type of lung cancer. Each type is treated differently. Chemotherapy, radiation, and surgery may be needed.
See the individual articles on the different types of lung cancer:
Non-small cell lung cancer
Small cell lung cancer

Outlook (Prognosis)
How well a patient does depends on the following:
Type of lung cancer
Whether or not the cancer has spread
Your age
Your overall health
How well you respond to treatment
The earlier the cancer is found, the better the chances of survival. Lung cancer is a deadly disease. Nearly 60% of people with lung cancer die within a year. However, some people are cured and go on to live many years.
Possible Complications
The cancer may spread to other parts of the body (metastasis). Cancer treatment can cause significant side effects.
When to Contact a Medical Professional
Call your health care provider if you develop symptoms of lung cancer (particularly if you smoke).
If you smoke, quit. It is never too late to stop smoking. You should also avoid breathing in the smoke from other people's cigarettes, cigars, or pipes.
Eating a diet rich in fruits and vegetables may help prevent some cases of lung cancer.
Alberg AJ, Ford JG, Samet JM; American College of Chest Physicians. Epidemiology of lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:29S-55S.
Bach PB, Silvestri GA, Hanger M, Jett JR. Screening for lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:69S-77S.
National Cancer Institute.
Lung Cancer Home Page. Bethesda, MD: U.S. National Institutes of Health. Accessed August 3, 2008
Jett JR, Schild SE, Keith RL, Kesler KA. Treatment of non-small cell lung cancer, stage IIIB: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132:266S-276S.
Johnson DH, Blot WJ, Carbone DP, et al. Cancer of the lung_ Non-small cell lung cancer and small cell lung cancer. In: Abeloff MD, Armitage JO, Niederhuber JE, Kastan MB, McKena WG. Clinical Oncology. 4th ed. Philadelphia, Pa: Churchill Livingstone Elsevier; 2008:chap 76.

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