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LUNG CANCER

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Fiona Li

on 14 January 2014

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Transcript of LUNG CANCER

LUNG CANCER
FACTS ABOUT LUNG CANCER
WHAT CAUSE LUNG CANCER?
Treatment Opptions
PREVENTIONS
Number of New Cases and Deaths per 100,000
: The number of new cases of lung and bronchus cancer was 61.4 per 100,000 men and women per year. The number of deaths was 49.5 per 100,000 men and women per year. These rates are age-adjusted and based on 2006-2010 cases and deaths.
AT A GLANCE
Lifetime Risk
: Lifetime risk is the probability of developing or dying from a disease in the course of one's lifespan. Based on the most recent data, approximately 6.9 percent of men and women will be diagnosed with lung and bronchus cancer at some point during their lifetime.
Prevalence of this cancer
: There are an estimated 399,431 people currently living with lung and bronchus cancer.
Who Gets This Cancer?

Lung cancer is more common in men than women, particularly African American men. Smoking is widely recognized as the leading cause of lung cancer. The number of new cases of lung and bronchus cancer was 61.4 per 100,000 men and women per year.
How Common is This Cancer?
Who Dies From This Cancer?

Death rates for lung cancer are higher among the middle-aged and older populations. Lung and bronchus cancer is the first leading cause of cancer death in the United States. The number of deaths was 49.5 per 100,000 men and women per year.

Keeping track of the number of new cases, deaths, and survival over time (trends) can help scientists understand whether progress is being made and where additional research is needed to address challenges, such as improving screening or finding better treatments.
Using statistical models for analysis, rates for new lung and bronchus cancer cases have been falling on average 1.3% each year over the last 10 years. Death rates have been falling on average 1.7% each year over the same period. 5-year survival trends are shown below the figure.
Changes Over Time
Survival by Stage
Cancer stage at diagnosis, which refers to extent of a cancer in the body, determines treatment options and has a strong influence on the length of survival. In general, if the cancer is found only in the part of the body where it started it islocalized (sometimes referred to as stage 1). If it has spread to a different part of the body, the stage is regional ordistant. The earlier lung and bronchus cancer is caught, the better chance a person has of surviving five years after being diagnosed. For lung and bronchus cancer, 15.3% are diagnosed at the local stage. The 5-year survival for localized lung and bronchus cancer is 53.5%.
5-Year Relative Survival (2003-2009)
SMOKING and PASSIVE SMOKING
Tobacco smoke contains over 4,000 chemical compounds, many of which have been shown to be cancer-causing, or carcinogenic. The two primary carcinogens in tobacco smoke are chemicals known as nitrosamines and polycyclic aromatic hydrocarbons. The risk of developing lung cancer decreases each year following smoking cessation as normal cells grow and replace damaged cells in the lung. In former smokers, the risk of developing lung cancer begins to approach that of a nonsmoker about 15 years after cessation of smoking.


Asbestos is made up of tiny fibers that can escape into the air. When breathed in, these fibers can stay in your lungs for a long time. If the fibers build up in your lungs, they can lead to lung cancer. The workplace is a common source of exposure to asbestos fibers, as asbestos was widely used in the past for both thermal and acoustic insulation materials. Today, asbestos use is limited or banned in many countries. Both lung cancer and mesothelioma (a type of cancer of the pleura or of the lining of the abdominal cavity called the peritoneum) are associated with exposure to asbestos. Cigarette smoking drastically increases the chance of developing an asbestos-related lung cancer in exposed workers. Asbestos workers who do not smoke have a fivefold greater risk of developing lung cancer than non-smokers, and those asbestos workers who smoke have a risk that is 50 to 90 times greater than non-smokers.
Asbestos fibers
Radon decays quickly, giving off tiny radioactive particles. When inhaled, these radioactive particles can damage the cells that line the lung. Long-term exposure to radon can lead to lung cancer, the only cancer proven to be associated with inhaling radon. There are estimated 12% of lung cancer deaths attributable to radon gas, or 15,000 to 22,000 lung cancer-related deaths annually the Radon gas can travel up through soil and enter homes through gaps in the foundation, pipes, drains, or other openings. The U.S. Environmental Protection Agency estimates that one out of every 15 homes in the U.S. contains dangerous levels of radon gas. Radon gas is invisible and odorless, but can be detected with simple test kits.
Radon gas

Air pollution, from vehicles, industry, and power plants, can raise the chance of developing lung cancer in exposed individuals. Up to 1% of lung cancer death are attributable to breathing polluted air, and experts believe that prolonged exposure to highly polluted air can carry a risk similar to that of passive smoking for the development of lung cancer.
Familial predisposition

Lung disease
Air pollution
Prior history of lung cancer
While the majority of lung cancers are associated with tobacco smoking, the fact that not all smokers eventually develop lung cancer suggests that other factors, such as individual genetic susceptibility, may play a role in the causation of lung cancer. Numerous studies have shown that lung cancer is more likely to occur in both smoking and non-smoking relatives of those who have had lung cancer than in the general population. Recent research has localized a region on the long (q) arm of the human chromosome number 6 that is likely to contain a gene that confers an increased susceptibility to the development of lung cancer in smokers.
The presence of certain diseases of the lung, notably chronic obstructive pulmonary disease (COPD), is associated with a slightly increased risk (four to six times the risk of a nonsmoker) for the development of lung cancer even after the effects of concomitant cigarette smoking are excluded.

Survivors of lung cancer have a greater risk than the general population of developing a second lung cancer. Survivors of non-small cell lung cancers (NSCLCs, see below) have an additive risk of 1-2% per year for developing a second lung cancer. In survivors of small cell lung cancers (SCLCs) the risk for development of second cancers approaches 6% per year.
Types and Staging of Lung Cancer
There are two major types of lung cancer, non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Staging lung cancer is based on whether the cancer is local or has spread from the lungs to the lymph nodes or other organs. Because the lungs are large, tumors can grow in them for a long time before they are found. Even when symptoms—such as coughing and fatigue—do occur, people think they are due to other causes. For this reason, early-stage lung cancer (stages I and II) is difficult to detect. Most people with lung cancer are diagnosed at stages III and IV.
non small cell lung cancer
small cell lung cancer

There are three common types of non small cell lung cancer. These are grouped together because they behave in a similar way and respond to treatment in a different way to small cell lung cancer. They make up about 87 out of 100 lung cancers. The three types are
Squamous Cell Cancer
Adenocarcinoma
Squamous cell carcinoma

Adenocarcinoma

Large cell carcinoma
Non Small Cell Lung Cancer
Squamous cell cancer is the most common type of lung cancer. It develops from the cells that line the airways and it is often found near the centre of the lung in one of the main airways (the left or right bronchus). This type of cancer is often due to smoking. The number of people developing squamous cell lung cancer is going down.
Adenocarcinoma also develops from the cells that line the airways. But it develops from a particular type of cell that produces mucus (phlegm). It is often found in the outer areas of the lungs. The number of people developing adenocarcinoma is increasing and it may soon become more common than squamous cell lung cancer.
Large Cell Carcinoma
called large cell carcinoma because the cells look large and rounded under a microscope. This type of lung cancer tends to grow quite quickly.
Stage 1
Stage 2
Stage IIA


In the occult (hidden) stage, cancer cannot be seen by imaging or bronchoscopy. Cancer cells are found in sputum (mucus coughed up from the lungs) or bronchial washing (a sample of cells taken from inside the airways that lead to the lung). Cancer may have spread to other parts of the body.

Occult (hidden) stage


In stage 0, abnormal cells are found in the lining of the airways. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is also called carcinoma in situ.

Stage 0 (carcinoma in situ)
In stage I, cancer has formed. Stage I is divided into stages IA and IB:

•Stage IA: The tumor is in the lung only and is 3 centimeters or smaller.
•Stage IB: Cancer has not spread to the lymph nodes and one or more of the following is true:
The tumor is larger than 3 centimeters but not larger than 5 centimeters.
Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.
Cancer has spread to the innermost layer of the membrane that covers the lung.
Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.


Stage II is divided into stages IIA and IIB. Stage IIA and IIB are each divided into two sections depending on the size of the tumor, where the tumor is found, and whether there is cancer in the lymph nodes.

Stage IIB
(1) Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also, one or more of the following is true:

The tumor is not larger than 5 centimeters.
Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.
Cancer has spread to the innermost layer of the membrane that covers the lung.
Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.
or

(2) Cancer has not spread to lymph nodes and one or more of the following is true:

The tumor is larger than 5 centimeters but not larger than 7 centimeters.
Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.
Cancer has spread to the innermost layer of the membrane that covers the lung.
Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.
(1) Cancer has spread to nearby lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also, one or more of the following is true:

The tumor is larger than 5 centimeters but not larger than 7 centimeters.
Cancer has spread to the main bronchus and is at least 2 centimeters below where the trachea joins the bronchus.
Cancer has spread to the innermost layer of the membrane that covers the lung.
Part of the lung has collapsed or developed pneumonitis (inflammation of the lung) in the area where the trachea joins the bronchus.
or

(2) Cancer has not spread to lymph nodes and one or more of the following is true:

The tumor is larger than 7 centimeters.
Cancer has spread to the main bronchus (and is less than 2 centimeters below where the trachea joins the bronchus), the chest wall, the diaphragm, or the nerve that controls the diaphragm.
Cancer has spread to the membrane around the heart or lining the chest wall.
The whole lung has collapsed or developed pneumonitis (inflammation of the lung).
There are one or more separate tumors in the same lobe of the lung.
Stage IIIA is divided into three sections depending on the size of the tumor, where the tumor is found, and which lymph nodes have cancer.
Stage 3
Stage IIIA(1)
Stage IIIA(2)
Stage IIIA(3)
Stage IIIA
Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are near the sternum (chest bone) or where the bronchus enters the lung. Also:

•The tumor may be any size.
•Part of the lung (where the trachea joins the bronchus) or the whole lung may have collapsed or developed pneumonitis (inflammation of the lung).
•There may be one or more separate tumors in the same lobe of the lung.
•Cancer may have spread to any of the following:
Main bronchus, but not the area where the trachea joins the bronchus.
Chest wall.
Diaphragm and the nerve that controls it.
Membrane around the lung or lining the chest wall.
Membrane around the heart.
Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are within the lung or near the bronchus. Also:

•The tumor may be any size.
•The whole lung may have collapsed or developed pneumonitis (inflammation of the lung).
•There may be one or more separate tumors in any of the lobes of the lung with cancer.
•Cancer may have spread to any of the following:
Main bronchus, but not the area where the trachea joins the bronchus.
Chest wall.
Diaphragm and the nerve that controls it.
Membrane around the lung or lining the chest wall.
Heart or the membrane around it.
Major blood vessels that lead to or from the heart.
Trachea.
Esophagus.
Nerve that controls the larynx (voice box).
Sternum (chest bone) or backbone.
Carina (where the trachea joins the bronchi).
Cancer has not spread to the lymph nodes and the tumor may be any size. Cancer has spread to any of the following:

•Heart.
•Major blood vessels that lead to or from the heart.
•Trachea.
•Esophagus.
•Nerve that controls the larynx (voice box).
•Sternum (chest bone) or backbone.
•Carina (where the trachea joins the bronchi).
Stage IIIB
Stage IIIB(2)
Stage IIIB is divided into two sections depending on the size of the tumor, where the tumor is found, and which lymph nodes have cancer.
Cancer has spread to lymph nodes above the collarbone or to lymph nodes on the opposite side of the chest as the tumor. Also:

•The tumor may be any size.
•Part of the lung (where the trachea joins the bronchus) or the whole lung may have collapsed or developed pneumonitis (inflammation of the lung).
•There may be one or more separate tumors in any of the lobes of the lung with cancer.
•Cancer may have spread to any of the following:
Main bronchus.
Chest wall.
Diaphragm and the nerve that controls it.
Membrane around the lung or lining the chest wall.
Heart or the membrane around it.
Major blood vessels that lead to or from the heart.
Trachea.
Esophagus.
Nerve that controls the larynx (voice box).
Sternum (chest bone) or backbone.
Carina (where the trachea joins the bronchi).
Stage IIIB(1)
Cancer has spread to lymph nodes on the same side of the chest as the tumor. The lymph nodes with cancer are near the sternum (chest bone) or where the bronchus enters the lung. Also:

•The tumor may be any size.
•There may be separate tumors in different lobes of the same lung.
•Cancer has spread to any of the following:
Heart.
Major blood vessels that lead to or from the heart.
Trachea.
Esophagus.
Nerve that controls the larynx (voice box).
Sternum (chest bone) or backbone.
Carina (where the trachea joins the bronchi).
Stage IV
In stage IV, the tumor may be any size and cancer may have spread to lymph nodes. One or more of the following is true:

•There are one or more tumors in both lungs.
•Cancer is found in fluid around the lungs or the heart.
•Cancer has spread to other parts of the body, such as the brain, liver, adrenal glands, kidneys, or bone.
STAGES
Small cell lung cancer accounts for the remaining 15 percent of lung cancers. Small cell lung cancer results from smoking even more so than non-small cell lung cancer. It grows more rapidly and spreads to other parts of the body earlier than non-small cell lung cancer. It is also more responsive to chemotherapy.
Small Cell Lung Cancer
STAGES
Limited Stage
Extensive Stage
In this stage, cancer is found on one side of the chest, involving just one part of the lung and nearby lymph nodes.
In this stage, cancer has spread to other regions of the chest or other parts of the body.
Surgery
Chemotherapy
Wedge resection: Surgery to remove a tumor and some of the normal tissue around it. When a slightly larger amount of tissue is taken, it is called a segmental resection.
Lobectomy: Surgery to remove a whole lobe (section) of the lung.
Pneumonectomy: Surgery to remove one whole lung.
Sleeve resection: Surgery to remove part of the bronchus.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy, external and internal radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.
Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells without harming normal cells. For example, monoclonal antibodies and tyrosine kinase inhibitors are two types of targeted therapy being used in the treatment of non-small cell lung cancer.
Targeted Therapy
Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment also called cryotherapy. For tumors in the airways, cryosurgery is done through an endoscope.
Stage IIIA
Stage IIIB
Cryosurgery
Patients are given a general anaesthetic or a drug to make you drowsy. Then, the doctor puts a flexible tube called a bronchoscope down the patients, into the airway.
Electrocautery is a treatment that uses a probe or needle heated by an electric current to destroy abnormal tissue. For tumors in the airways, electrocautery is done through an endoscope.
Electrocautery
Don't smoke
Avoid secondhand smoking
Test your home for radon.
Have the radon levels in your home checked, especially if you live in an area where radon is known to be a problem. High radon levels can be remedied to make your home safer. For information on radon testing, contact your local department of public health.
Avoid carcinogens at work.
Take precautions to protect yourself from exposure to toxic chemicals at work. Follow your employer's precautions.
Eat a diet full of fruits and vegetables.
Exercise most days of the week.
Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be harmful. For instance, researchers hoping to reduce the risk of lung cancer in heavy smokers gave them beta carotene supplements. Results showed the supplements actually increased the risk of cancer in smokers.
The doctor chooses a cancer treatment plan based on a number of factors, such as your overall health, the type and stage of your cancer, and your preferences. Options typically include one or more treatments, including surgery, chemotherapy, radiation therapy or targeted drug therapy. In some cases you may choose not to undergo treatment.
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RESOURCES
Health Science 20
Teacher: Ms Rioux

By: Benjamin Yang& Fiona Li
CONCLUSION
By doing this project, the most important thing that we learn is to treasure our life and highly concern our health. Having a healthy life style such as choosing a healthy diet with a variety of fruits and vegetables, having proper exercise and avoiding cigarettes as well is the most significant way to prevent ourselves from cancers.

Also, as lung cancer is common and is difficult to cure, we should convey the knowledge that we learn from this research to our families and friends, and encourage them to have a healthy lifestyle in order to maintain their health.
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