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Document related concepts

The Cancer Genome Atlas wikipedia, lookup

• Lung cancer is the leading cancer killer in
the United States.
• Every year, it accounts for 30% of all
cancer deaths—
• more than cancers of the breast, prostate,
and ovary combined.
It is the third most frequently diagnosed
cancer in the United States, behind
prostate cancer in men and breast cancer
in women
• Most patients are diagnosed at an
advanced stage of disease, so therapy is
rarely curative.
• The overall 5-year survival for all patients
with lung cancer is 15%, making lung
cancer the most lethal of the leading four
Positive survival factors
Female sex (5-year survival of 18.3% for
women versus 13.8% for men),
Younger age (5-year survival of 22.8% for
those less than 45 years versus 13.7% for
those over 65 years)
White race (5-year survival of 16.1% for
whites versus 12.2% for blacks).
• Cigarette smoking is the primary cause of lung
• Secondhand (or passive) smoke exposure (an
excess risk of 24% )
• Preexisting lung disease (13% )
• Exposure to a number of industrial
compounds, including asbestos, arsenic, and
chromium compounds
• Chronic obstructive pulmonary disease
Field cancerization
• Risk is increased for cancers of the oral
cavity, pharynx, larynx, tracheobronchial
tree and lung, and esophagus
Preinvasive Lesions
• Squamous Dysplasia and Carcinoma In
• Atypical Adenomatous Hyperplasia
• Diffuse Idiopathic Pulmonary
Neuroendocrine Cell Hyperplasia
Invasive or Malignant Lesions
• Non-Small-Cell Lung Carcinoma
Squamous Cell Carcinoma
Bronchoalveolar Carcinoma
Large-Cell Carcinoma
• Neuroendocrine Neoplasms
Grade I NEC
Classic or typical carcinoid
Grade II NEC
Atypical carcinoid
Large-cell type
Small-cell type
• Salivary Gland–Type Neoplasms
Metastatic Symptoms
• CNS metastases : headache, nausea and vomiting,
seizures, hemiplegia, and speech difficulty.
• Bone metastases : lytic, producing localized pain
• Spinal cord compression :
• Liver metastases : incidental finding on CT scan
• Adrenal metastases : asymptomatic
Skin and soft tissue metastases : painless
subcutaneous or intramuscular masses
• Early-Stage Disease :
The current standard of treatment is
surgical resection
• Pancoast tumor (apical tumor) :
an induction radiation dose of 30 to 35 Gy
followed by surgery 4 to 5 weeks later
• Stage III disease :
a combination of chemotherapy and
Small-Cell Lung
• Small-cell lung carcinoma (SCLC)
accounts for about 20% of primary lung
• is not generally treated surgically.
• These aggressive neoplasms have early
widespread metastases
• limited" SCLC : Patients present without
evidence of distant metastatic disease, but
often have bulky locoregional disease