1. WHAT IT IS & WHAT YOU NEED TO KNOW
Lung Cancer
WHAT IT IS & WHAT YOU NEED TO KNOW

2. What is lung cancer?
2 types:
1. Non-small cell lung cancer (NSCLC). 85% of cases
2. Small cell lung cancer -10%- 15% of all lung cancer cases.
here are 2 major types of lung cancer:
Small cell lung cancer (SCLC)
Non-small cell lung cancer (NSCLC)
(If a lung cancer has some cells with characteristics of SCLC and other cells with characteristics of NSCLC it is called a combined small cell/non-small cell cancer. This is uncommon.)
These 2 types of lung cancer are treated very differently. This document focuses on small cell lung cancer. Non-small cell lung cancer is discussed in the separate document, Lung Cancer (Non-Small Cell).
Small cell lung cancer
About 10% to 15% of all lung cancers are small cell lung cancer (SCLC), named for the size of the cancer cells when seen under a microscope. Other names for SCLC are oat cell cancer, oat cell carcinoma, and small cell undifferentiated carcinoma.
SCLC often starts in the bronchi near the center of the chest. It tends to grow and spread quickly, and it has almost always spread to distant parts of the body before it is found.
Non-small cell lung cancer
About 85% to 90% of lung cancers are non-small cell lung cancer (NSCLC). There are 3 main subtypes of NSCLC:
Adenocarcinoma
Squamous cell carcinoma
Large cell carcinoma
The cells in these subtypes differ in size, shape, and chemical make-up when looked at under a microscope. But they are grouped together because the approach to treatment and prognosis (outlook) are similar. They are discussed further in our document Lung Cancer (Non-Small Cell).
Other types of lung cancer
Along with the 2 main types of lung cancer, other tumors can occur in the lungs.
Lung carcinoid tumors: Carcinoid tumors of the lung account for less than 5% of lung tumors. Most are slow-growing tumors that are called typical carcinoid tumors. They are generally cured by surgery. Some typical carcinoid tumors can spread, but they usually have a better prognosis (outlook) than small cell or non-small cell lung cancer.Atypical carcinoid tumors are less common. The outlook for these tumors is somewhere in between typical carcinoids and small cell lung cancer. For more information about typical and atypical carcinoid tumors, see our document, Lung Carcinoid Tumor.
Other lung tumors: Other types of lung tumors such as adenoid cystic carcinomas, hamartomas, lymphomas, and sarcomas, are rare and are treated differently from the more common lung cancers. They are not discussed in this document.
Cancers that spread to the lungs: Cancers that start in other organs (such as the breast, pancreas, kidney, or skin) can sometimes spread (metastasize) to the lungs, but these are not lung cancers. For example, cancer that starts in the breast and spreads to the lungs is still breast cancer, not lung cancer. Treatment for metastatic cancer to the lungs is based on where it started (the primary cancer site). For information on these cancers, refer to our separate documents on each.

3. Symptoms of lung cancer
Early stage symptoms:
Chest pain
Cough that doesn't go away
Coughing up blood
Fatigue
Losing weight without trying
Loss of appetite
Shortness of breath
Wheezing
Late stage symptoms:
Bone pain or tenderness
Eyelid drooping
Facial paralysis
Hoarseness or changing voice
Joint pain
Nail problems
Shoulder pain
Swallowing difficulty
Swelling of the face or arms
Weakness
*Talk about how early signs of lung cancer may not be present, and that these symptoms can often be the cause of other, less serious problems.

4. Biggest cause of lung cancer
The number one cause of lung cancer is cigarette smoke.
Smoking contributes to 70 percent and 87 percent of lung cancer deaths in women and men, respectively.
Men who smoke are 25 times more likely to develop lung cancer. Women are 25.7 times more likely, compared to never smokers.

5. Second-hand smoke
Exposure to secondhand smoke causes approximately 3,400 lung cancer deaths among nonsmokers every year.
Nonsmokers have a 20-30% greater chance of developing lung cancer if they are exposed to secondhand smoke at home or work.

6. The molecule behind most lung cancers
Benzo[a]pyrene
Comes about by the burning
of wood, cigarettes, car exhaust, coal tar,
and charbroiled foods.
Charring/smoking food
increases the risk of taking in
BAP.
*Explain how smoking causes benzo[a]pyrene to be metabolized by the liver into a carcinogen.

7. Other causes of lung cancer
Asbestos
Long term exposure to carcinogens
Family history of lung cancer
High levels of air pollution
High levels of arsenic in drinking water
Radiation therapy to the lungs
Asbestos is the name given to a group of minerals that occur naturally in the environment as bundles of fibers that can be separated into thin, durable threads. These fibers are resistant to heat, fire, and chemicals and do not conduct electricity. For these reasons, asbestos has been used widely in many industries.
People may be exposed to asbestos in their workplace, their communities, or their homes. If products containing asbestos are disturbed, tiny asbestos fibers are released into the air. When asbestos fibers are breathed in, they may get trapped in the lungs and remain there for a long time. Over time, these fibers can accumulate and cause scarring and inflammation, which can affect breathing and lead to serious health problems (6).
Exposure to cancer-causing chemicals such as coal products, mustard gas, chloromethyl ethers, gasoline, and diesel exhaust

9. How many people are affected by lung cancer?
224,390 are estimated to be diagnosed in 2016.
The number of deaths due to lung cancer has increased approximately 4.3 percent between 1999 and from 152,156 to 158,656.

11. Metastasis
Spreading of the cancer from the lung to other parts of the body.
Once the cancer has spread, it becomes much more difficult treat. Early detection can prevent this from happening.

12. Lung cancer survival rates
The lung cancer five-year survival rate (16.3%) is lower than many other leading cancer sites
The five-year survival rate % for cases detected when the disease is still localized
 For distant tumors - the five-year survival rate - 3.5%.
Again, kind of my job is to make sure that people do look into it sooner rather than later.

13. Screening Process Low-dose spiral CT scans:
have been shown to decrease the risk of dying from lung cancer in heavy smokers
Must get annual scan if you are a heavy smoker or quit within the last 15 years.
If not a smoker, scan is not necessary.
Eligibility criteria for the trial included: a ≥30 pack year history of cigarette smoking; smoking cessation ≤15 years if a former smoker; no history of lung cancer; no history of other life threatening cancers in the prior five years; no hemoptysis or weight loss to suggest a diagnosis of lung cancer; and no chest CT in the prior 18 months. The trial had an estimated 90% power to detect a 20% relative reduction in lung cancer mortality. Prior to the launch of the NLST, a feasibility study conducted by six of the LSS screening centres in 3318 former and current smokers established the ability to recruit, randomize and retain volunteers on a study of LDCT versus chest X-ray.8,9

14. Treatment
Surgery, radiation therapy, chemotherapy, and targeted therapies.
Radiation alone (for limited disease) or combined with chemotherapy (for extensive disease) is the usual treatment of choice for small cell lung cancer.
On this regimen, 70-90% of patients with limited disease and 60-70% of those with extensive disease experience remission, though the cancer almost always returns.

15. How do I avoid getting lung cancer?
Do not smoke!
If you are in an environment where smoking does occur, talk to your doctor about getting a CT scan to detect for lung cancer.
Early detection prevents the spread of the cancer
(metastasis).
As mentioned earlier

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17. Questions or Comments?
Thank You!!

18. Sources 1.http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004529/
2. Cancer Treatment and Survivorship Facts and Figures 3. 4. 5. 6. 7. 8. 9.
Other types of lung cancer
Along with the 2 main types of lung cancer, other tumors can occur in the lungs.
Lung carcinoid tumors: Carcinoid tumors of the lung account for less than 5% of lung tumors. Most are slow-growing tumors that are called typical carcinoid tumors. They are generally cured by surgery. Some typical carcinoid tumors can spread, but they usually have a better prognosis (outlook) than small cell or non-small cell lung cancer.Atypical carcinoid tumors are less common. The outlook for these tumors is somewhere in between typical carcinoids and small cell lung cancer. For more information about typical and atypical carcinoid tumors, see our document, Lung Carcinoid Tumor.
Other lung tumors: Other types of lung tumors such as adenoid cystic carcinomas, hamartomas, lymphomas, and sarcomas, are rare and are treated differently from the more common lung cancers. They are not discussed in this document.
Cancers that spread to the lungs: Cancers that start in other organs (such as the breast, pancreas, kidney, or skin) can sometimes spread (metastasize) to the lungs, but these are not lung cancers. For example, cancer that starts in the breast and spreads to the lungs is still breast cancer, not lung cancer. Treatment for metastatic cancer to the lungs is based on where it started (the primary cancer site). For information on these cancers, refer to our separate documents on each.