lung cancer

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lung cancer,

cancercancer,
in medicine, common term for neoplasms, or tumors, that are malignant. Like benign tumors, malignant tumors do not respond to body mechanisms that limit cell growth.
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 that originates in the tissues of the lungslungs,
elastic organs used for breathing in vertebrate animals, excluding most fish, which use gills, and a few amphibian species that respire through the skin. The word is sometimes applied to the respiratory apparatus of lower animals.
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. Lung cancer is the leading cause of cancer death in the United States in both men and women. Like other cancers, lung cancer occurs after repeated insults to the genetic material of the cell. By far the most common source of these insults is tobacco smoke, which is responsible for about 85% of U.S. lung cancer deaths (see smokingsmoking,
inhalation and exhalation of the fumes of burning tobacco in cigars and cigarettes and pipes; in the 21st cent., vaping, the similar use of e-cigarettes, also has become common. Some persons draw the smoke into their lungs; others do not.
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). The incidence of lung cancer in other countries follows their smoking patterns. Some other carcinogens known to cause lung cancer are found in the workplace. These include bischloromethyl ether and chloromethyl ether in chemical workers, arsenic in copper smelting, and asbestosasbestos,
common name for any of a variety of silicate minerals within the amphibole and serpentine groups that are fibrous in structure and more or less resistant to acid and fire.
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 in shipbuilders and other asbestos workers. Radonradon
, gaseous radioactive chemical element; symbol Rn; at. no. 86; mass no. of most stable isotope 222; m.p. about −71°C;; b.p. −61.8°C;; density 9.73 grams per liter at STP; valence usually 0. Radon is colorless and the most dense gas known.
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 poses a risk to uranium and fluorspar miners and may pose a risk in some private residences as well. African Americans have a higher incidence of lung cancer than European Americans, even after adjusting for smoking.

Types of Lung Cancer

Lung cancers are classified according to the type of cell present in the tumor. The majority are referred to as non–small cell carcinomas. These include squamous cell or epidermoid carcinomas (the most common type worldwide), adenocarcinomas, and large cell carcinomas. Small cell carcinoma (which includes the subtypes oat cell and intermediate) comprises approximately 20% to 25% of lung cancers; it often has metastasized by the time it is detected. Lung cancer most commonly spreads to the brain, bone, liver, or bone marrow.

Symptoms

The primary symptoms of lung cancer are cough, shortness of breath, hoarseness, blood in the sputum, and pain. In some types, the cancer cells themselves produce hormones or other substances that can create an imbalance and result in various symptoms. Metastatic lung cancer also can cause symptoms that result from its effect on the organ to which the cancer has spread.

Diagnosis and Treatment

Diagnosis of lung cancer may be made by physical examination, chest X rays, bronchoscopy (see bronchoscopebronchoscope
, long, tubular instrument with a light at the tip that is inserted through the windpipe and bronchial tubes to examine these structures. By passing other instruments through it, foreign bodies and obstructions can be removed and tissue or secretions may be removed
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), or percutaneous needle biopsybiopsy
, examination of cells or tissues removed from a living organism. Excised material may be studied in order to diagnose disease or to confirm findings of normality. Preparatory techniques depend on the nature of the tissue and the kind of study intended.
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 (insertion of a fine needle through the skin and into the lung to obtain tissue for study). In many cases definitive diagnosis is made after surgical specimens have been evaluated. Evaluation of suspected sites of metastasis may involve CAT scansCAT scan
[computerized axial tomography], X-ray technique that allows relatively safe, painless, and rapid diagnosis in previously inaccessible areas of the body; also called CT scan.
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 or magnetic resonance imagingmagnetic resonance imaging
(MRI), noninvasive diagnostic technique that uses nuclear magnetic resonance to produce cross-sectional images of organs and other internal body structures.
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 (MRI). A special CAT-scanning technique (helical low-dose CAT-scanning) has also been used for initial diagnosis because it can detect small tumors before they have spread.

Lung cancer is staged according to its location, size, cell type, and spread. This staging plus the state of health of the patient are used to determine treatment.

Treatment typically consists of surgical excision of the tumor alone or in combination with either external-beam radiation therapy or chemotherapy using one or more anticancer drugs. Photodynamic therapy is sometimes used if the cancer is still localized. In this therapy a substance that makes cells more sensitive to light is injected into the body. When it has passed out of most of the tissues, but remains in the cancer cells, the cancer is destroyed by a beam of laser light.

Prevention

Not starting to smoke or ceasing to smoke is by far the most effective lung cancer preventive. The risk of lung cancer in ex-smokers begins to decline about five years after quitting, and after 15 to 20 years their risk is 80% less than that of smokers. The reduction in cigarette smoking since the 1964 report of the Surgeon General's Advisory Committee on Health began to be translated into a decrease in the incidence of lung cancer in the 1990s; this decrease averaged more than 1% per year from 1990 to 1995. The preventive role of dietary antioxidantsantioxidant,
substance that prevents or slows the breakdown of another substance by oxygen. Synthetic and natural antioxidants are used to slow the deterioration of gasoline and rubber, and such antioxidants as vitamin C (ascorbic acid), butylated hydroxytoluene (BHT), and
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 is under study.

Bibliography

See D. N. Carney, ed., Lung Cancer (1995). See also publications of the National Cancer Institute and the American Cancer Society.

The Columbia Electronic Encyclopedia™ Copyright © 2013, Columbia University Press. Licensed from Columbia University Press. All rights reserved. www.cc.columbia.edu/cu/cup/
References in periodicals archive ?
"Before this study began there had been few large clinical trials of this type in small cell lung cancer.
"If we find what genes NFIB is regulating, that could provide new targets for small cell lung cancer therapy," Dooley said.
Among the patients with small cell lung cancer, 12 had limited disease while 51 had extensive disease.
However, a more recent randomized "sister" study of PCI in small cell lung cancer that was presented at the same meeting showed a significant increase in neurocognitive decline at 1 year in the higher-dose PCI arm, compared with the lower-dose PCI arm, he said.
Small cell lung cancer tumours spread so quickly that they can rarely be removed by surgery.
It might also make it easier for scientists, when looking at new chemotherapy treatments in trials, to compare their effectiveness in different groups of patients with small cell lung cancer.
In response to such findings, the updated NCCN guidelines now list smoking cessation and counseling as part of the initial evaluation of patients with small cell lung cancer.
The study, presented at the BTS Winter Meeting in London, found that nearly twice as many women as men under the age of 65 are diagnosed with small cell lung cancer. Seven out of ten of these cases could not be helped by surgery.
Non-small cell lung cancer is the most common type of lung cancer (about 85% of lung cancers) and it usually grows and spreads more slowly than small cell lung cancer. Squamous cell carcinoma, adenocarcinoma, and large cell carcinoma are all subtypes of non-small cell lung cancer.
Researchers discuss such aspects as cytological tools to help the diagnosis and management, distinguishing small cell carcinoma from large cell neuroendocrine carcinoma, the impact of tumor motion in the three-dimensional radiotherapy of lung cancer, clinical presentation and diagnostic modalities, whether the curative thoracic radiotherapy is cost-effective in extensive-state small cell lung cancer, optimal treatment of small cell lung cancer, and therapeutic strategy for primary and pure neuroendocrine carcinoma of the bladder.
"For patients with small cell lung cancer, there are really only about two chemotherapy options.