Lung Cancer1 Essay

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Lung Cancer1





Lung cancer is not just one disease but rather a group of diseases. All forms of cancer
cause cells in the body to change and grow out of control. Most types of cancer cells form
a lump or mass called a tumor. Cells from the tumor can break away and travel to other
parts of the body where they can continue to grow. This spreading process is called
metastasis. When cancer spreads, it is still named after the part of the body where it
started. For example, if breast cancer spreads to the lungs, it is still breast cancer, not lung
cancer. Another word for cancerous is malignant, so a cancerous tumor is referred to as
malignant. But not all tumors are cancer. A tumor that is not cancer is called benign.
Benign tumors do not grow and spread the way cancer does. They are usually not a threat
to life. A few cancers, such as blood cancers (leukemia), do not form a tumor. Most
cancers are named after the part of the body where the cancer first starts. Lung cancer
begins in the lungs. The lungs are two sponge-like organs in the chest. The right lung has
three sections, called lobes. The left lung has two lobes. It is smaller because the heart
takes up more room on that side of the body. The lungs bring air in and out of the body,
taking in oxygen and getting rid of carbon dioxide gas, a waste product. The lining around
the lungs, called the pleura, helps to protect the lungs and allows them to move during
breathing. The windpipe (trachea) brings air down into the lungs. It divides into tubes
called bronchi, which divide into smaller branches called bronchioles. At the end of these
small branches are tiny air sacs known as alveoli. Most lung cancers start in the lining of
the bronchi but they can also begin in other areas such as the trachea, bronchioles, or
alveoli. Lung cancer often takes many years to develop. Once the lung cancer occurs,
cancer cells can break away and spread to other parts of the body. Lung cancer is a life-
threatening disease because it often spreads in this way before it is found. Lung cancer is
the leading cause of cancer death for both men and women. During the year 2000 there
will be about 164,100 new cases of lung cancer in this country. About 156,900 people will
die of lung cancer: about 89,300 men and 67,600 women. More people die of lung cancer
than of colon, breast, and prostate cancers combined. Lung cancer is fairly rare in people
under the age of 40. The average age of people found to have lung cancer is 60. If lung
cancer is found and treated by surgery early, before it has spread to lymph nodes or other
organs, the five-year survival rate is about 42%. However, few lung cancers are found at
this early stage. The five-year survival rate for all stages of lung cancer combined was
14% in 1995, the last year for which we have national data. A risk factor is something that
increases a person's chance of getting a disease. Some risk factors, like smoking, can be
controlled. Others, such as a person's age, can't be changed. Smoking is by far the leading
risk factor for lung cancer. More than 8 out of 10 lung cancers are thought to result from
smoking. The longer a person has been smoking, and the more packs per day smoked, the
greater the risk. If a person stops smoking before lung cancer develops, the lung tissue
slowly returns to normal. Stopping smoking at any age lowers the risk of lung cancer.
Cigar and pipe smoking are almost as likely to cause lung cancer as cigarette smoking.
There is no evidence that smoking low tar cigarettes reduces the risk of lung cancer.
Nonsmokers who breathe the smoke of others also increase their risk of lung cancer. Non-
smoking spouses of smokers, for example, have a 30% greater risk of developing lung
cancer than do spouses of nonsmokers. Workers exposed to tobacco smoke in the
workplace are also more likely to get lung cancer. There are other risk factors for lung
cancer besides smoking. People who work with asbestos have a higher risk of getting lung
cancer. If they also smoke, the risk is greatly increased. The type of lung cancer linked to
asbestos, mesothelioma, often starts in the pleura. This type of cancer is covered in a
separate American Cancer Society document. Although asbestos was used for many years,
the government has now nearly stopped its use in the workplace and in home products.
Besides smoking and asbestos, there are a few other risk factors for lung cancer. These
include certain cancer-causing agents in the workplace, radon gas, and lung scarring from
some types of pneumonia. Also, people who have had lung cancer in the past have a
higher chance of having it again and, as mentioned earlier, the risk of lung cancer increases
with age. Some studies have shown that the lung cells of women who smoke may develop
cancer more easily than those of men. Clearly, the best way to prevent lung cancer is not
to smoke or be around those who do. Young people should not start smoking, and those
who already smoke should quit. Everyone, especially babies and children, should be
protected from breathing in other people's smoke. While some people believe that air
pollution is a major cause of lung cancer, the truth is that air pollution only slightly
increases the risk. Smoking is by far the more important cause. Even so, some people who
have never smoked or worked with asbestos still get lung cancer. Since we do not know
why this happens, there is no sure way to prevent it. Since most people with early lung
cancer do not have any symptoms, only about 15% of lung cancers are found in the early
stages. Although most lung cancers do not cause symptoms until they have spread, you
should report any of the following symptoms to your doctor right away. Often these
problems are caused by some other condition, but if lung cancer is found, prompt
treatment could extend your life and relieve symptoms.
A cough that does not go away
Chest pain, often made worse by deep breathing
Hoarseness
Weight loss and loss of appetite
Bloody or rust-colored sputum (spit or phlegm)
Shortness of breath
Fever without a known reason
Recurring infections such as bronchitis and pneumonia
New onset of wheezing
When lung cancer spreads to distant organs, it may cause:
Bone pain
Weakness or numbness of the arms or legs, dizziness
Yellow coloring of the skin and eyes (jaundice)
Masses near the surface of the body, caused by cancer spreading to the skin or to
lymph nodes in the neck or above the collarbone
Less often, there are some other clusters of symptoms (called syndromes) that can point to
a possible lung cancer. Lately, some new tests to find lung cancer early have been
developed. These tests are still being studied and are not yet used on a regular basis.
If there is a reason to suspect you may have lung cancer, the doctor will use one or more
methods to find out if the disease is really present. In addition, a biopsy of the lung tissue
will confirm the diagnosis of cancer and also give valuable information that will help in
making treatment decisions. If these tests find lung cancer, more tests will be done to find
out how far the cancer has spread. After taking your medical history and doing a physical
exam the doctor might want to do some of the following: Imaging tests: these tests use x-
rays, magnetic fields, sound waves or radioactive substances to create pictures of the
inside of the body. Some of the imaging tests used to find lung cancer and to see where in
the body it may have spread include x-rays, CT scan (computed tomography), MRI
(magnetic resonance imaging), PET (positron emission tomography) scans, and bone
scans. Sputum cytology: a sample of phlegm (spit) is looked at under a microscope to see
if cancer cells are present. Needle biopsy: a needle is placed into the tumor to remove a
piece of tissue. The tissue is looked at in the lab to see if cancer cells are present.
Bronchoscopy: a lighted, flexible tube is passed through the mouth into the bronchi. This
test can help find tumors or it can be used to take samples of tissue or fluids to see if
cancer cells are present. Mediastinoscopy: with the patient asleep, tissue samples are taken
from the lymph nodes along the windpipe through a small hole cut into the neck. Again,
looking at the tissue under a microscope can show if cancer cells are present. Bone
marrow biopsy: a needle is used to remove a small piece of bone, usually from the back of
the hip bone. The sample is checked for cancer cells. Blood tests: certain blood tests are
often done to help see if the lung cancer has spread to the liver or bones. There are two
major types of lung cancer. The first is small cell lung cancer, or SCLC. The other is non-
small cell lung cancer, or NSCLC. If the cancer has features of both types, it is called
mixed small cell/large cell cancer. Small cell lung cancer accounts for about 20% of all
lung cancers. Although the cancer cells are small, they can multiply quickly and form large
tumors. The tumors can spread to the lymph nodes and to other organs such as the brain,
the liver, and the bones. Small cell lung cancer is usually caused by smoking. Other names
for small cell lung cancer are oat cell cancer and small cell undifferentiated carcinoma.
Non-small cell lung cancer is the most common type of lung cancer, accounting for almost
80% of lung cancers. There are three subtypes within this group. Some types grow more
quickly than others. Ask your doctor to explain which of these you have. There are a few
other rare types of lung cancer not covered in this document. Staging is the process of
finding out how far the cancer has spread. This is very important because your treatment
and the outlook for your recovery depend on the stage of your cancer. There are different
staging systems for small cell and non-small cell lung cancer. Small cell lung cancer
staging For small cell lung cancer a two-stage system is most often used. These are limited
stage and extensive stage. Limited stage usually means that the cancer is only in one lung
and in lymph nodes on the same side of the chest. If the cancer has spread to the other
lung, to lymph nodes on the other side of the chest, or to distant organs, it is called
extensive. Small cell lung cancer is staged in this way because it helps to determine the
best treatment for each group. Many people with small cell lung cancer will already have
extensive disease when it is found. The staging system most often used for non-small cell
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