Lung Cancer

Causes of Lung Cancer

Smoking including passive exposure to cigarette smoke

Radiation from uranium and radon

Metals such as arsenic, chromium, nickel

Granulomatous diseases such as sarcoidosis

Lung fibrosis

Scleroderma

Air pollution

Signs and Symptoms

Cough, most common and worry about a chronic cough that changes in character
Difficulty breathing, Chest pain, Coughing up blood, Finger nail changes termed clubing, Anorexia, Weight loss, Anemia, Fever

Investigations and Screening

Imaging: Chest X-ray, CT chest and upper abdomen scan, PET scan, bone scan
Sputum Cytology
Tissue Biopsy by bronchoscopy, percutaneous, mediastinoscopy

Lung Cancer Interesting points:

2/3 of primary lung cancer is found  in the upper lungs

2/3 of metastases found in the lower lungs – believed to be due to transport of tumor cells through the blood to the lower ares of the lungs as there is more blood flow in the lower areas of the lungs.

Lung Cancer Treatments and Therapy

There is currently no role for chemotherapy alone, only in combination with other treatments.

Common Lung Cancer Chemotherapy

1) cisplatin and etoposide
2) paclitaxel, vinorelbine, and gemcitabine
3) new biologic’s which are drugs that target specific molecules include the Epidermal growth factor inhibitor (Geritirdb)

Lung Cancer Chemotherapy Complications

- bleeding, blood cell suppression leading to anemia and neutropenia, tumour lysis syndrome, infection

Specific Chemothearpy Side-Effects

- hemorrhagic cystitis (cyclophosphamide)

- cardiotoxicity (doxorubicin)

- renal toxicity (cisplatin)

- peripheral neuropathy (vincristine)

Lung Cancer Cure

Only chance for cure is resection when tumour is still localized

Lung Cancer Surgery Mortality Rates

-    6% if pneumonectomy
-    3% if lobectomy
-    1% if segmentectomy

Lung Cancer Prognosis

5-year survival rates for different subtypes

- squamous 25%
- adenocarcinoma 12%
- largerge cell carcinoma 13%

- small cell lung cancer 1%