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Primary lung cancer Causes and Risks:
Most lung cancers (83%) are associated with, and probably caused by, cigarette smoking . The more cigarettes smoked per day and the earlier the age at which smoking started, the greater the risk of lung cancer. Second-hand smoke has also been shown to increase the risk. Government surveys show that as many as 3,000 people each year develop lung cancer from second-hand smoke. High levels of pollution, radiation, and asbestos exposure may also increase the risk. Cooks and chemists also have an increased risk.
Lung cancer begins by cellular changes in the bronchial epithelial cells and can invade adjacent tissues before symptoms are noticed.
There are many types of lung cancer, but most can be categorized into two basic types, small cell and nonsmall cell. In general, the small cell type has usually spread by the time of diagnosis and is treated by chemotherapy and/or radiation therapy . The nonsmall type may not have spread at the time of diagnosis, and surgical resection of this type may be possible. Metastatic lung cancer (the spread of cancer ) can occur to almost any area of the body with common sites being the brain, bone, bone marrow, and liver. Treatment is based on determining the cellular type of the cancer, and by staging, which determines the size of the primary tumor and the extent of spreading to lymph nodes or sites of metastasis . Lung cancer is the leading cause of death in both men and women. The peak incidence occurs between 55 and 65 years old. The incidence is 1 out of 1,000 people.
Prevention:
If you smoke, stop smoking . Try to avoid second-hand smoke . Routine screening of high-risk individuals (men over 45 years old smoking 40 or more cigarettes a day) may help detect the disorder early.
Symptoms:
Additional symptoms that may be associated with this disease:
Signs and Tests:
Listening to the chest with a stethoscope ( auscultation ) shows persistent localized wheezing . Examination of the hands may show clubbing of the fingers (soft tissue enlargement at the tips of the fingers).
Tests that may be performed include: This disease may also alter the results of the following tests:
Treatment:
The treatment depends upon the type of cancer and the stage of the disease. Surgical resection (cutting out the tumor ) is usually indicated for disease that has not spread beyond the lung. Chemotherapy and radiation therapy are other forms of treatment.
Support Groups:
The stress of illness can often be helped by joining a support group where members share common experiences and problems. See cancer - support group .
Prognosis:
The overall survival for 5 years is less than 10%. When surgical resection is feasible for disease that has not spread beyond the lung, survival rates can be as high as 35 to 40%.
Complications:
Call Your Healthcare Provider:
Call for an appointment with your health care provider if risk factors for developing lung cancer are present; or if you develop symptoms of lung cancer (particularly if you smoke).
Bronchoscopy is a surgical technique for viewing the interior of the airways. Using sophisticated flexible fiber optic instruments, surgeons are able to explore the trachea, main stem bronchi, and some of the small bronchi. In children, this procedure may be used to remove foreign objects that have been inhaled. In adults, the procedure is most often used to take samples of (biopsy) suspicious lesions and for culturing specific areas in the lung.
This is an illustration of the major features of the lungs and bronchial tree. The inset is of the alveoli. They are the microscopic blood vessel-lined sacks in which oxygen and carbon dioxide gas are exchanged.
This CT scan of the upper abdomen shows an adrenal metastasis (spreading of a tumor to the adrenal gland, above the kidney) in a person with lung cancer.
A lateral view of a CXR in a patient with central cancer of the lung.
A CXR in a patient with central cancer of the right lung. Notice the white mass in the middle portion of the right lung (seen on the left side of the picture).
This chest X-ray shows adenocarcinoma of the lung. There is a rounded light spot in the right upper lung (left side of the picture) at the level of the second rib. The light spot has irregular and poorly defined borders and is not uniform in density. Diseases that may cause this type of X-ray result would be tuberculous or fungal granuloma, and malignant or benign tumors.
This X-ray shows a single lesion (pulmonary nodule) in the upper right lung (seen as a light area on the left side of the picture). The nodule has distinct borders (well-defined) and is uniform in density. Tuberculosis (TB) and other diseases can cause this type of lesion.
This CT scan shows a single lesion (pulmonary nodule) in the left lung. This nodule is seen as the light circle in the upper portion of the dark area on the left side of the picture. A normal lung would look completely black in a CT scan.
This chest CT scan shows a cross-section of a person with bronchial cancer. The two dark areas are the lungs. The light areas within the lungs represent the cancer.
This is a chest X-ray of a person with bronchial cancer. This is a front view, where the lungs are the two dark areas and the heart and other structures are white areas visible in the middle of the chest. The light areas that appear as subtle branches extending from the center into the lungs, are cancerous.
This CT scan shows a cross section of the lungs of a person with lung cancer. The two dark areas in the middle of the screen are the lungs. The light areas in the left lung represent the cancer.
This is a picture of a lung removed from a lung cancer patient.
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