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Lung cancer
Anatomy of lungs The lungs are the major organs of the respiratory system, and are divided into segments and then into lobules, hexagonal divisions of the lungs that are the smallest subdivision detectable to the naked eye. The right lung has three lobes and is slightly larger than the left lung, which has two lobes. The lungs are divided by the mediastinum. This area contains the heart, trachea, esophagus, and many lymph nodes. The top of each lung (called the apex) extends into the lowest part of the neck, just upon the level of the first rib. The bottom, or base, of each lung extends down to the diaphragm, which is the chief breathing-associated muscle that separates the chest from the abdominal cavity. The lungs are covered by a covering membrane known as the pleura, and are parted from the abdominal cavity by the muscular diaphragm.
Lung cancer introduction You are asking yourself what is lung cancer ? I'll tell you what is it . Lung cancer is cancer that starts in the lungs. Cancer is a disorder where cancerous cells grow out of control, taking over normal cells and organs in the body. Lung cancer is not really thought of as a single disease, but rather a accumulation of various diseases that are characterized by the cell type that makes them up, how they behave, and how they are treated. There are two major types of lung cancer. Non-small cell lung cancer and small cell lung cancer . Non-small cell lung cancer is the most usual type of lung cancer. It generally spreads more slowly than other lung cancers. There are three major types of non-small cell lung cancer : squamous cell carcinoma , adenocarcinoma , large cell carcinoma . Small cell lung cancer is a less common type of lung cancer and it spreads faster than non-small-cell lung cancer. There are three major types of small cell lung cancer: small cell carcinoma , mixed small cell/large cell , combined small cell carcinoma . There are also other types of lung cancer. Causes of lung cancer It is estimated that 80% of cancer deaths are due to smoking. The Much less frequent causes of lung cancer are exhibited to:
- Inorganic arsenicals
Screening tests Screening is looking for cancer before a person has any symptoms. This can aid find cancer at an early stage. When abnormal tissue or cancer is found early, it may be easier to treat. By the time symptoms appear, cancer may have begun to spread. Examples of screening tests for lung cancer contain :
It is as a rule held that there are no useful screening tests accessible for lung cancer. In all of the studies conducted to date, comparing persons who are screened with chest x- rays and/or sputum samples, there has never been a documented decrease in deaths from lung cancer due to screening. In the nonattendance of a useful screening tool, the best way we can decrease the number of lung cancer deaths is to help people to quit smoking.
Signs of lung cancer Unfortunately, the symptoms of lung cancer can take many years to develop which frequently leads to diagnosis at an advanced stage of this disease. Some of the symptoms
Many of these symptoms are non-specific, and could represent a difference of different conditions; however, your physician needs to check you if you have any of these problems.
Lung cancer diagnosis There are a assortment of techniques to aid physicians in obtaining an accurate tissue diagnosis. Selecting the most appropriate test as a rule requires consultation with a pulmonologist, interventional radiologist, or thoracic surgeon. Chest X-ray. A chest x-ray is as a rule the prime test performed to estimate any concerns based on a careful history and physical. This may display a mass in the lungs or enlarged lymph nodes. Sometimes the chest x-ray is normal, and additional tests are needed look for a suspected lung cancer. Even if a mass is found, these are not always cancerous and further studies are needed. Typically, two views of the chest are taken, one from the back and the other from the side of the body as the patient stands against the image recording plate. Bronchoscopy . In a bronchoscopy, a lung expert inserts a tube into the airways to envisage and take a sample of the tumor. This action is used when the tumor is found in the large airways and can be reached by the scope. Patients are given anesthesia during this action to reduce discomfort. Fine-needle aspiration. With this action, a hollow needle is inserted through the chest wall . This is often performed with computed tomography (CT) control - when the needle is inserted through the chest wall - or with endoscopic ultrasound through the airway or the esophagus. This can be performed for tumors that cannot be reached by bronchoscopy. Mediastinoscopy.This action is done in the operating room under general anesthesia. A scope is inserted just above the sternum (the breast bone) into the area amidst the lungs to take tissue samples from lymph nodes. A surgeon can then characterize the stage of the tumor and decide whether surgery is an option. Thoracentesis. The surgical puncture of the pleural cavity using a hollow needle, in order to draw back fluid . When lung cancer affects the periphery of the lungs, it can create a fluid build up among the lungs and the lung lining ( pleural effusion ) If fluid is present in the chest cavity, the doctor can remove a sample by inserting a thin needle into the chest among the ribs. This fluid is then examined for cancer cells. If there is a large amount of fluid in the chest cavity, this action can as well be used to delete enough fluid to improve the patient's breathing. Video-assisted thoracoscopy (VATS). Video-assisted thoracoscopy is a newer modality that may be used to cross section small peripheral tumors (less than 2 cm in diameter), pleural tumors, or pleural effusions for diagnostic or staging purposes. The doctor inserts a tube through a small incision to collapse one lung. This creates a space where a pen-sized tool with a video apparatus enters the chest wall. The doctor then visually inspects the exterior of the lung and chest wall. The physician performs biopsies of nodules or masses while watching the action on a video screen. Pulmonary function tests. The tests determine how much air your lungs can hold, how quickly you can move air in and out of your lungs, and how well your lungs put oxygen into and depose carbon dioxide from your blood. The tests can diagnose lung diseases, measure the gravity of lung problems, and check to see how well medicine for a lung disease is working. Usually it is spirometry . Complete blood count (CBC). This test determines the number of red blood cells, white blood cells, and platelets within the blood. CT scan. The CT scan provides a comprehensive view of the lungs and chest. Bone scan. May as well be performed to rule out suspicions of metastasis to the bones. Metastasis is the action wherein cancerous cells break away from the original tumor, travel, and grow within other body parts.
Staging of lung cancer Correct staging of lung cancer is of main moment for the treatment planning process. Medicine choices are highly complicated even for physicians with great experience in the field and they as a rule depend on the stage of the disease: surgery yes or no, now or later, radiation therapy combined with chemotherapy or chemotherapy alone, chemotherapy and radiation before surgery or after, or both. Stages of non-small cell lung cancer : Stage I.Cancer at this stage has invaded the underlying lung structure but hasn't spread to the lymph nodes. Stage I can be divided into IA and IB. Stage IA means the tumour is small (3cm or less across). Stage IB means the cancer is larger or that it is growing in the main airway of the lung (the main bronchus). Stage IB includes cancers that have grown into the inner covering of the lung or caused a partial collapse of the affected lung. Stage II. This stage cancer has spread to neighboring lymph nodes or invaded the chest wall. Stage IIIA. At this stage, cancer has spread from the lung to lymph nodes in the center of the chest. Stage IIIB. The cancer has spread locally to areas such as the heart, blood vessels, trachea and esophagus -all within the chest -or to lymph nodes in the locality of the collarbone or to the tissue that surrounds the lungs within the rib cage (pleura). Stage IV. Means the cancer has spread to another lobe of the lung from where it started or to another part of your body, for example the liver or bones. Stages of small cell lung cancer: Confined disease .Cancer that can only be seen in one lung, in neighbouring lymph nodes or in fluid sorrounding the lung (pleural effusion) Extensive disease .Cancer that has spread outside the lung to the chest or to more parts of the body
Lung cancer treatment Chemotherapy and radiotherapy - from time to time it is not likely to delete all the cancer by surgery. In this context, chemotherapy and/or radiotherapy are given to decrease the tumour and to annihilate any remnants of the cancer to block it spreading more. Chemotherapy and radiotherapy are as well used to decrease the tumour prior to surgery. Lung cancer can spread to the brain. Once In A While radiotherapy may be given to the brain to help decrease the risk of this happening in the future. This is called prophylactic radiotherapy. For more information, please see the separate Bupa factsheets, Chemotherapy and Radiotherapy. Drug treatments. Drug treatment such as erlotinib (Tarceva) may aid to stop the cancer growing so quickly. Erlotinib is sometimes used to treat people whose cancer has come back after initial treatment, or has not responded to at least one course of chemotherapy. Surgery . Surgery is the preferred care for patients with early stage NSCLC. Unfortunately, 60%-80% of every patients who have late or metastatic disease are not acceptable for surgery. - Lobectomy An operation for lung cancer is major surgery. Many people experience pain, weakness, fatigue, and shortness of breath after surgery. Most have problems moving around, coughing, and breathing completely. The healing period can be several weeks or even months.
Prognosis for lung cancer For non-small cell lung carcinoma, prognosis is as a rule poor. Coming complete surgical resection of stage IA disease, five-year survival is 67%. With stage IB disease, five-year survival is 57%. The five-year survival rate of patients with stage IV NSCLC is about 1%.
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