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Lung Cancer (more information)

Overview

Lung cancer occurs when genetic material responsible for the production of lung cells is damaged. This results in a tumor. Not all tumors found will be malignant or cancerous. Some are benign, non-cancerous, and can be removed with surgery. The tumors are formed from the rapid growth of abnormal cells. Cancer can begin to develop almost as soon as a person is exposed to cancer causing substances. Lung cancer is the leading cancer killer among men and women. Researchers have found that it takes 10 to 20 or more years before the cancer can be detected by today's technology. Lung cancer is broken down into two types of cancer, Non-small cell lung cancer, and Small cell lung cancer.

Non-small cell lung cancer is the most common form of lung cancer and it usually spreads to other parts of the body slower than Small cell lung cancer. The three types of Non-small cell lung cancer are: Squamous cell (epidermoid carcinoma), Ademocarcinoma, and Large cell carcinoma. The most common form of Non-small cell is Adenocarcinoma. Adenocarcinoma represents approximately 40% of lung cancer cases in the US. Adenocarcinoma usually can be found near the outer edges of the lungs. Adenocarcinoma produces small tumors, which are more difficult to detect, that spread to other parts of the body early on. Squamous or Epidermoid cell lung cancer is responsible for 30-35% of lung cancer cases in the US, and occurs most frequently in men. Although squamous carcinoma tends to grow relatively slowly and remain localized in the chest longer than any other cancer, it can cause serious damage to surrounding areas before it is diagnosed. Squamous cell lung cancer can cause ulceration and bleeding as well as obstruction of the breathing tubes. Large cell carcinoma is rarer than squamous carcinoma and Adenocarcinoma, making up only 5-15% of the lung cancer cases in the US. Tumors are normally large by the time a diagnosis is made therefore it has been aptly named Large cell carcinoma. Large cell carcinoma tends to invade the central nervous system, brain and spinal cord.

Small cell lung cancer is also known as oat cell lung cancer. Small cell lung cancer accounts for the remaining 20% of cancer cases in the US. Small cell lung cancer has a dividing time of 30 days faster than non-small cell cancer.

Causes of Lung Cancer

The leading cause of cancer is smoking. Although it is public knowledge that cigars, cigarettes, and other tobacco products contain carcinogens, which can cause lung cancer as well as other illnesses and diseases, large numbers of men are beginning to smoke and continuing to smoke. Men who smoke increase the risk of dying from lung cancer by more than 22 times. More than 94,000 men die from lung cancer each year and the majority of the men dying from lung cancer are minority men. Nine out of ten men that die from lung cancer were smokers and three out of four men who smoke get lung cancer. Second hand or side stream smoke can also cause lung cancer. Second hand smoke is responsible for approximately 3,000 lung cancer deaths as well as approximately 62,000 deaths from heart disease annually.

The second leading cause of lung cancer is Radon gas. Radon gas is a colorless substance without smell that can enter your home or other buildings through the soil underneath the building by way of cracks and gaps in the foundation and insulation. Radon gas can also enter a building through pipes, drains, walls, & other openings. Radon gas is the cause of 12% of lung cancer deaths, equaling 15,000-22,000 deaths. The Environmental Protection Agency estimates that nearly 1 out of 15 houses have unhealthy levels of radon gas in them.

The third leading cause of lung cancer falls under the on-the-job exposure category. This category refers to jobs where there is a lot of exposure to asbestos, uranium, arsenic, and certain petroleum products. This also includes working with insulation, working in coke ovens, and repairing automobile breaks. Another risk factor is excessive exposure to air pollution and contracting tuberculosis.

Prevention

Since smoking is the leading cause of lung cancer the best way to prevent contracting lung cancer is to quit smoking or to never start smoking. If you need help or support to quit smoking contact www.ffsonline.org. Another way to protect yourself from contracting lung cancer is to ask your employer about dust and other substances that you may come in contact with at work. Find out what precautions are being taken to protect you from potentially hazardous materials.

Symptoms

The symptoms of lung cancer are also symptoms of other illnesses and diseases so it is important to go to a doctor to determine whether you have lung cancer or another illness. The symptoms include but aren't limited to: a chronic cough, hoarseness, coughing up blood, fever for unknown reason, wheezing, and repeated bouts of pneumonia. Some symptoms specific to small cell lung cancer are: a change in the color and volume of mucus, bone pain, joint aches, bone fractures that are not related to accidental injury, neck and facial swelling, and bleeding and blood clots.

Diagnosis

Approximately 15% of the cases of lung cancer are diagnosed at the localized stage, before the cancer has spread to other parts of the body. Non-small cell lung cancer and small cell lung cancer are diagnosed in different ways. Adenocarcinoma is found in the mucus glands. Squamous carcinoma is located in the bronchial tubes. Whereas large cell carcinoma is found near the surface. There are several different ways to discover whether or not you have lung cancer and what type of lung cancer you have. Some of the ways lung cancer is detected is through chest x-ray, MRI, CT, PET scans, Sputum cytology, Bronchoscopy, and biopsies. The newest form of CT scans, the helical low-dose CT scan, are more sensitive than regular x-rays, allowing tumors to be found easier. An MRI is similar to a CT scan. The only difference is that the MRI uses magnetic fields in place of x-rays to create an image. A PET scan is a scan that traces the way the body cells metabolize. When a sputum cytology is done coughed up phlegm from the lungs is examined under a microscope to check for abnormal or cancerous cells. Another way of being checked for lung cancer is to have a bronchoscopy done. A bronchoscopy is a process in which a small fiberoptic tube is passed through the nose or throat to view the lungs. If tumors or abnormal cells are spotted on the lungs, biopsies can be obtained through the bronchoscope. A biopsy is simply the removal of tissue from the lung but, there are several ways this can be done, other than using a bronchoscope. One way is by inserting a needle through the chest in to the lungs. Another is by removing and examining an enlarged lymph node on the neck. Occasionally an open lung biopsy must be performed. Your doctor will determine which of these tests are appropriate for you.

Treatment

Treating lung cancer depends on lots of different things. Your treatment is determined based upon what type of lung cancer you have, what stage you are currently in, and the severity of your case. It is recommended that you take the time to research several different types of treatments and treatment options before deciding which one you and your doctor feel is best to treat your symptoms. The charts below should prove to be helpful with determining the right treatment for your current state.
Non-Small Cell Lung Cancer

Stages of Non-Small Cell Lung Cancer	Description	Treatment
Stage I A/B	Tumor of any size found in lung only	Surgery
Stage II A/B	Tumor has spread to lymph nodes associated with the lungs	Surgery
Stage III A	Tumor has spread to lymph nodes in tracheal area including the chest wall and diaphragm	Chemotherapy followed by radiation therapy or surgery
Stage III B	Tumor has spread to lymph nodes on the opposite lung or on the neck	Chemotherapy and Radiation
Stage IV	Tumor has spread beyond the chest	Chemotherapy or Palliative care

Small Cell Lung Cancer

Stages of Small Cell Lung Cancer	Description	Treatment
Limited	Tumor found in one lung and in nearby lymph nodes and is amenable to radiation	Chemotherapy and Radiation
Extensive	Tumor has spread beyond one lung and/or to other organs	Chemotherapy

Surgery is chosen depending upon the location of the tumor and is only used in the early stages of development of the cancer. Some tumors are two big to be removed by surgery so your doctor may advise radiation therapy of chemotherapy. There are different types of surgeries that can perform, such as cryosurgery. Cryosurgery is a surgery in which the tumors are frozen and killed. Radiation therapy is the use of high energy x-rays that kill cancer cells. Radiation therapy is seldom used by itself. It is normally used chemotherapy and sometimes with surgery. The purpose of radiation therapy is to offer some relief from pain or blockage of airways. Chemotherapy is the use of drugs that are effective against cancer cells. The drugs can either be injected or taken in the form of pills. Chemotherapy may be used along with surgery. Chemotherapy is used in more advanced cases to relieve symptoms as well as is used in all stages of small cell lung cancer.

Another option for treatment is to take part in a clinical trial. Clinical trials are responsible for the steady progress and breakthroughs made with new drugs being put on the market to combat lung cancer. Clinical trials are designed to find safer more effective treatments for cancer patients. Less than 5% of cancer patients take part in clinical trials however, because they feel as though they are being used like guinea pigs or lab rats. For every clinical trial done there is a protocol plan, a detailed description of what is to go on during the respective clinical trial. Once a protocol plan has been developed it is the job of the FDA (Food and Drug Administration) to ensure that the newly found treatment is safe and effective for treating lung cancer. All trials are tested in a lab to make sure that they are safe for humans. The purpose of the clinical trial is to find new drugs that work against lung cancer. In order for the drug to become available to the majority of people it must prove to be effective in the clinical trials. Occasionally the FDA must re-approve a drug because another use has been found for it.

As with treatment for any illness of disease there are side effects. All side effects aren't present in every case nor do they effect each person in the same way.

Types of Treatment	Side Effects
Surgery	pain at the site of the incision; the inability of the immune system to fight off infections; * avoid being around those that have bad colds*
Radiation Therapy	The severity of the side effects depends upon the dosage and the size of the treated area. fatigue, sore throats, skin irritation can result
Chemotherapy	because blood cells are effected by chemotherapy the immune system is weakened; blood clots; confusion/loss of mental clarity; constipation; diarrhea; fatigue; hair loss

Other Side Effects

Name	Symptoms
Esopagitis	difficulty swallowing; It may be easier to drink a liquid diet or to eat soft foods. Be sure to notify your doctor of the difficulty swallowing because it may be caused by something else.
Fatigue	Fatigue may gradually increase as therapy continues. Take more naps during the day during treatment and try to sleep straight through the night
Fibrosis	May cause pain in the chest when breathing or moving in certain ways. Exercising can prevent this. Talk with a physical therapist or pulmonary rehabilitation specialist for exercises that may help.
Pneumonitis	About 10% of people develop fever, cough, and shortness of breath 4-6 weeks after treatment
Skin Irritations	Skin in the treatment area may look red and feel irritated. Most lotions, powders, and deodorants should not be used during radiation because they might interfere with radiation, not producing the desired effects. Ask your doctor or nurse about lotions that will soothe the irritation but not interfere with the radiation.
Sore Throat	They normally only last for a week or two. Drink milkshakes, soups, or prepared liquid supplements with they last.

Alternative Medicine

There are other treatments available beyond the standard surgery, radiation therapy, and chemotherapy. Monoclonal antibodies, photodynamic therapy, anti-angiogenesis agents, and lung cancer vaccines are just a few options that are available. Monoclonal antibodies are antibodies that target specific cancer proteins, killing cancerous cells. Photodynamic therapy is a combination of chemicals and light. Anti-angiogenesis agents are drugs that inhibit blood vessels that feed tumors.

A new study, done at University of Texas M.D Anderson Cancer Center, found that a natural plant product by the name of deguelin appeared to target cancerous and pre cancerous cells, stopping their growth, while having minimal effect on the normal cells. Researchers say that deguelin is found several different types of plant species and belongs to the flavonoid family. Flavonoids can be found in tea, chocolate, and wine. The hope is that agents will be developed and brought to clinical testing sometime in the near future.

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