Presentation on theme: "The BIG Kahuna among Tumors"— Presentation transcript:
1 The BIG Kahuna among Tumors Lung CancerThe BIG Kahuna among Tumors
2 Why is Lung Cancer the BIG Kahuna? Number 1 cause of cancer deaths in both men and women nowOnly major cancer that continues to show an increase in rates of new casesHas an overall 5-year survival rate of less than 50% (approximately 44%)One of the most preventable but least treatable of cancers
3 Major Types of Lung Tumors 99% of all lung cancers arise from the epithelial cells of lung tissue and are therefore Bronchogenic CarcinomasApproximately 1% arise from lymphoid tissue or other supporting structures within the lung; these are mostly Mesotheliomas
4 Bronchogenic Carcinomas Two TypesSmall Cell (SCLC)Non-small Cell (NSCLC)Important to differentiateSmall Cell are more aggressive and respond better to chemotherapy and radiationNon-small Cell are best treated with surgery (unless advanced); chemotherapy not as useful
5 Non-small cell lung cancer 3 types Squamous Cell (also called epidermoid) – cancer of the cells that line the bronchi or small and large airways – the most commonAdenocarcinoma - cancer of the mucus producing or gland cells within the lungGiant Cell - cancer of the cells that make up the walls of the air sacks
6 Small Cell Lung Cancer Also called Oat Cell Cancer involving the small cells that resemble lymphocytes and line the walls of the bronchi and alveoli (air sacks) as infection fighters
7 Risk Factors SMOKING!!!!! Secondary smoke Environmental Occupational exposure to radiation or inhaled carcinogensAir pollutionImmuno-suppressed statesDiet
8 Smoking Smoking markedly increases risk for ALL forms of lung cancer The risk appears to be non-linear; the more a person has smoked, and the longer they have smoked combines to accelerate risk as they get olderEven after smoking cessation of years, former smokers still have a greater risk than people who have never smoked
9 Secondary SmokeThe Environmental Protection Agency has declared secondary smoke a major carcinogenThe risk to persons from secondary smoke may in fact be higher for the same amount of exposure as for the smoker, because secondary smoke is NOT filtered through the cigarette
10 Environmental Exposures Environmental Radiation, especially radonOccupational radiation exposure as seen in uranium, coal, and iron minersMedical radiation, especially adjuvant radiation for breast cancer treatment, Hodgekins Disease or lymphomasAsbestos – the primary risk for mesotheliomas and sarcomas of the lung
11 Immuno-suppressed States HIV/AIDS patientsTransplant patients on anti-rejection drugsPersons with certain auto-immune diseases such as Rheumatoid Arthritis or Ankylosing SpondylitisPersons with other forms of cancer
12 DietDietary deficiencies in Vitamin E and Beta Carotene are associated with increased incidence of lung cancer among already high risk smokersVitamin A in significant doses has been shown to reduce the incidence of lung cancer and retard its progression
13 ALL of the other risk factors in lung cancer are adversely affected by SMOKING!!!
14 It is important to note that lung cancer does NOT have a large hereditary factor, so you can’t blame this cancer on not choosing your parents well!
15 Prevention NEVER start smoking Smokers need to QUIT Should note that marijuana is even more toxic to the lungs that tobacco with a higher riskSmokers need to QUITAvoid second-hand smoke, especially children and young people because effects are cumulative
16 Prevention (continued) Pay attention to air quality indices and warningsAvoid exposures to other airborne carcinogens whenever possibleWear approved and properly fitted respirators in hazardous occupations like coal mining and fire fightingAvoid exposure to radiation when possible
17 Hazardous RadiationMost common airborne radiation exposure is radon which is found naturally around concreteIf you have a concrete basement, have it checked for radon levels; if high, insulate it and/or ventilate itDon’t ask for or insist on x-rays that you might not need; avoid excessive CT scans
18 DetectionSingle most common symptom of lung cancer is a persistent cough without the presence of infection, especially a cough that changes or becomes bloodyDefinitive study is usually a chest x-ray; questionable cases may need a CT scan of the chest or an MRIAbsolute diagnosis needs a tissue sample from a biopsy or bronchoscopy
19 More on DetectionHoarseness without presence of infection or another obvious cause is another disturbing symptom, usually caused by tumor invading or wrapping itself around the nerve to the vocal cords, or direct invasion of the cords
20 Staging Lung cancer is staged by looking at three things The size and location of the tumorThe presence of lymph nodes with tumor in themThe presence or absence of metastasesThe higher the number in each of these categories: T, N, M, the worse the disease
21 Treatment - NSCLCNon-small cell tumors with no metastases and few or no positive lymph nodes are best treated with complete surgical excision of the segment or lobe of the lung involvedIf lymph nodes are positive or if there has been local spread, radiation and chemotherapy may be addedIf metastases are present, chemotherapy is usually essential
22 Treatment - SCLCThe hallmark of small cell lung cancer treatment is chemotherapy as many of these cancers are exquisitely sensitive to the newer chemotherapy regimensRadiation can be used as an adjunct or in some cases as the primary therapy
23 PrognosisThe overall prognosis in lung cancer is not good – that’s why prevention is SO IMPORTANT – STOP SMOKING!!!In early NSCLC disease 5 year cure rates may be as high as 85%Stage 4 disease with metastases is dismal, less than 1% with survival of less than 6 months being the rule
24 Prognosis (continued) Intermediate disease is becoming more amenable to treatment as newer regimens of chemotherapy are being discovered and surgical techniques are improvingEven in non-operable terminal disease, palliative radiation and chemotherapy can improve quality of life frequently
25 Recurrent DiseaseThe incidence of a new primary tumor, frequently in the other lung, is very common in post-lung cancer patients, so frequent surveillance and follow up is essentialIF YOU DON’T SMOKE, DON’T START, IF YOU DO, QUIT NOW!
26 THE GREAT AMERICAN SMOKEOUT The Great American Smokeout is this monthContact your local chapter of the American Cancer Society for more information or callOr go to
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