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LUNG CANCER
Dr.Mohammadzadeh
• 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
cancers
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).
Epidemiology
• Cigarette smoking is the primary cause of lung
cancer.
• 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
(COPD)
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
Situ
• Atypical Adenomatous Hyperplasia
• Diffuse Idiopathic Pulmonary
Neuroendocrine Cell Hyperplasia
Invasive or Malignant Lesions
• Non-Small-Cell Lung Carcinoma
Squamous Cell Carcinoma
Adenocarcinoma
Bronchoalveolar Carcinoma
Large-Cell Carcinoma
• Neuroendocrine Neoplasms
Grade I NEC
Classic or typical carcinoid
Grade II NEC
Atypical carcinoid
Grade III NEC
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
Treatment
• 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
radiation
Small-Cell Lung
Carcinoma
• Small-cell lung carcinoma (SCLC)
accounts for about 20% of primary lung
cancers
• 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