Running head: LUNG CANCER 1 Lung Cancer YourFirstName YourLastName University title
LUNG CANCER 2 I. AbstractLung cancer is the abnormal growth of cells in the lungs especially in the bronchi lining(Driscoll, 2003). There are two types of lung cancer namely: Non-small cell lung cancer(NSCLC) and small cell lung cancer (SCLC). NSCLC is the most commonly known type oflung cancer with SCLC making it up to 20% of all lung cancer cases reported in hospitals.Metastatic lung cancer is the one that starts from other parts of the body and spreads to thelungs (Falk and Williams, 2010). Cigarette smoking has been identified as the leading causeof lung cancer (Falk and Williams, 2010). Other causative agents of lung cancer include airpollution, exposure to cancer-causing materials and chemicals, exposure to radiationuncontrollably and drinking water whose arsenic levels is very high. General symptoms thataccompany lung cancer include chest pains, fatigue, persistent cough, wheezing, loss ofappetite, and weight loss. Other symptoms depend on the type of lung cancer that one may besuffering from. In diagnosis of lung cancer, biopsy is the commonest type of diagnosticmethod that is used to confirm the stage at which the cancer has reached. Other methods,such as X-ray and CT scans, are used in detecting the cancerous cells (Walker, 2006).Treatment of cancer depends on the stage at which it has reached. Surgery is usually done atthe early stages of tumor development. Chemotherapy and radiation therapy are used whentumor development has advanced and has spread rapidly to other parts of the body (Walker,2006).Keywords: Non-small cell lung cancer (NSCLC), small cell lung cancer (SCLC), cigarretesmoking, biopsy, surgery, chemotherapy and radiation therapy, World Health Organization(WHO).
LUNG CANCER 3 Table of ContentsI. Abstract ……………………………………………………………. 2II. Lung Cancer…………………………………………………………4(a). Types of Lung Cancer………………………………………..4(b). Common Causes of Lung Cancer……………………………5(c). Common Symptoms of Lung Cancer………………………..6(d). Diagnosis of Lung Cancer……………………………………6(e). Methods Used in Lung Cancer Treatment……………………7III. References……………………………………………………………10 II. Lung Cancer (a). Types of Lung Cancer Lung cancer is the abnormal growth of cells in the lungs especially in the bronchilining (Driscoll, 2003). There are two major types of lung cancer namely; Non-small cell lungcancer (NSCLC) and cell lung cancer (CLC). One suffers from mixed small and large cellslung cancer if both NSCLC and CLC are present. Another, less commonly known, type oflung cancer is the metastatic lung cancer, which spreads from other parts of the body to thelungs (Falk and Williams, 2010). Non-small cell lung cancer is the most common type of lung cancer that spreads in thelungs in a slow manner than the small cell lung cancer (Falk and Williams, 2010). NSCLCoccurs in various forms namely adenocarcinomas, which is mostly found in the outer parts ofthe lungs; squamous cell carcinomas, which is found at the center of the lungs (next tobronchus); and the large cell carcinomas, which is found in any section of the lungs andgrows at a faster rate than the other two forms of lung cancer (Falk and Williams, 2010).
LUNG CANCER 4 Small cell lung cancer represents 15-20% of all lung cancer problems that arereported in health centers (Driscoll, 2003). SCLC is slightly less commonly found in womenthan in men. Driscoll (2003) points out that SCLC is 100% associated with smoking and it isvery rare to find a case where people who have never engaged in smoking, suffering fromSCLC. It is the most dangerous type of lung cancer as it starts from the bronchi, which aresituated at the center of the lungs (chest), spreading slowly to the other parts of the lungs.Although the cancerous cells are very tiny, they grow rapidly creating large tumors, whichmetastasizes to other parts of the body including bones, liver, and the brain (Falk andWilliams, 2010). SCLC is classified as either limited, where chest cancer that is curablethrough radiotherapy; or extensive, where cancer has spread to other body organs, beyond thechest region (Falk and Williams, 2010). Statistics from World Health Organization (WHO) indicate that, more people aredying of lung cancer than of prostrate, breast, and colon cancers combined, each year(Driscoll, 2003). Lung cancer is less common in children and young adults but it is morewidespread to the older people especially those are above the age of 45 (Driscoll, 2003). (b). Common Causes of Lung Cancer In most cases, cigarette smoking is the leading cause of lung cancer (both NSCLC andCLC). The risk of getting cancer through smoking of cigarette is dependent on the age of thesmoker at the time he or she started smoking and the number of cigarettes that one smokes ina day (Falk and Williams, 2010). Passive smokers, who inhale second-hand smoke or rathersmoke from active smokers, also have high chances of getting lung cancer (Falk andWilliams, 2010). According to study conducted by American Cancer Society, 3000 passivesmokers are estimated to die from lung cancer (Walker, 2006).
LUNG CANCER 5 It has not yet been proven that low-tar cigarretes reduces the risk of getting lungcancer but research has proven that smoking of marijuana may lead to the growth ofcancerous cells in the lungs but not in their development (Falk and Williams, 2010). Other causes of lung cancer are usually discussed under the two major types of lungcancer. For instance; NSCLC is also caused by drinking water whose arsenic levels are veryhigh and by high level of air pollution (Falk and Williams, 2010). Having a medical historyof radiotherapy may also increase the chances of NSCLC through the abnormal growth ofcells in the bronchi lining or by working in an environment that is heavily polluted withcancer-causing materials and chemicals such as coal products, asbestos, uranium, gasoline,chloromethyl ethers, beryllium, gasoline, vinyl chloride, mustard and radon gas, nickelchromates, diesel exhausts, alloys, preservatives, pigments, paints and compounds containingheavy metal chlorides and formaldehydes. SCLC is mostly caused by cigarrete smoking (Falkand Williams, 2010). (c). Common Symptoms of Lung Cancer Early symptoms of early lung cancer include; pain in the chest, coughing bloodpersistently, fatigue, appetite loss, wheezing, and breathe shortness due to limited supply ofair. Symptoms of NSCLC include; pain in bones, joints, and shoulders, fragile, and weakbones, paralysis in facial muscles leading to facial swelling, change in tonal voice, loose anddiscolored nails and difficulty in swallowing (Driscoll, 2003). Symptoms of SCLC includephlegm (bloody sputum), chest pain, coughing persistently, loss of appetite, wheezing, breathshortness, and loss of weight (Falk and Williams, 2010). (d). Diagnosis of Lung Cancer In most cases, lung cancer is always diagnosed when a CT scan or an X-ray scan isbeing run for another purpose (Walker, 2006). In the diagnosis of NSCLC, questionsconcerning your medical and smoking history are usually asked and a physical examination
LUNG CANCER 6is carried out. By using the stethoscope, during the physical exam, a doctor can hear fluidaround the chest region that could suggest the possibility of having lung cancer. In somecases, a biopsy is usually performed to confirm the diagnosis of NSCLC. This involves theremoval of a small piece of tissue from the lungs and then examining it under the microscope.In order enhance the effectiveness of this technique, some other methods are usuallyincorporated in this technique. These include; bronchoscopy combined with biopsy, pleuralbiopsy, CT-scan-directed needle biopsy, open lung biopsy, and endoscopic esophagealultrasound with biopsy and mediastinoscopy with biopsy (Walker, 2006). If the biopsy results indicate that lung cancer is present, imaging processes areimplemented to determine the cancer stage, that is how big the growth or tumor is and howfast has it spread from the origin. NSCLC is therefore divided into five stages namely: Stage0 when cancer is just beneath the lung’s inner lining; Stage I when cancer has not reached thelymph nodes; Stage II when cancer has reached the lymph nodes in the vicinity of the originaltumor; Stage III when cancer is past the lymph nodes and is spreading to the surroundingtissues; and Stage IV when cancer has spread to other organs of the body (Kernstine andReckamp, 2011). Other tests that may be performed in the diagnosis of lung cancer or to see how muchit has spread include bone scan, chest X-ray, Complete blood count, CT scan of the chest,thoracentesis, MRI of the chest, Positron emission tomography scan and sputumtest(Kernstine and Reckamp, 2011).Diagnosis of SCLC is similar to that of NSCLC in all aspects. In addition to the methods thatare incorporated in biopsy, in order to enhance it efficiency and effectiveness, video-assistedthoracoscopy is also utilized in enhancement of the biopsy process. (e). Lung Cancer Treatment Methods
LUNG CANCER 7 Treatment of NSCLC depends on the stage at which the cancer has reached. There arevarious treatment methods for NSCLC. Notable among these is surgery. It is performed whenNSCLC is at stage I, that is, when it has not reached the lymph nodes. There are three formsof surgery namely lobectomy, removing one of the lung lobes; pneumonectomy, where theentire lung is removed; and segment or wedge removal, which involves removal of a part ofthe lung (Walker, 2006). Chemotherapy is another form of treatment that involves the use of drugs to stop thegrowth of new cancer cells and to kill them too. Chemotherapy is usually performed whenNSCLC has reached the fourth stage. Chemotherapy that is administered before surgery inorder to increase the effectiveness of those treatments, is known as neoadjuvant therapy whilethe one administered after the surgery in order to kill the remaining cancer cells, is known asadjuvant therapy. An important thing to remember when administering chemotherapy, is tobe very careful in preventing further complications from taking place and controlling anysymptoms that would further arise from this form of treatment. Radiation therapy uses radiations, especially X-rays, to kill e cancerous cells. It maybe used along with chemotherapy to treat cancer when surgery is impossible. Radiationtherapy is mostly used to reduce symptoms such as swelling and problems in breathing and toreduce pain due to cancer that has spread up to the bones (Walker, 2006). It is important tonote that controlling symptoms when radiation therapy is underway and after the therapy, isof great paramount. Other forms of therapy that are employed in relieve NSCLC symptoms includephotodynamic therapy, which activates a drugs using a special type of light in order to kill thecancerous cells; and laser therapy which uses a small light beam to kill the cancerous cellsthrough burning.
LUNG CANCER 8 Since SCLC spreads quickly in the body, a form of chemotherapy, that uses drugs,which are administered either orally or through an injection, is usually employed. The mostcommonly used drug is known as etoposide, which can be in combination with eithercarboplatin or cisplatin(Kernstine and Reckamp, 2011). The use of surgery may be of verylittle use since the tumor has already spread by the time diagnosis is done. If there is a tumorthat has not spread significantly at the time of diagnosis, then , surgery can be done followedby radiation therapy or chemotherapy. A combined radiation therapy and chemotherapy isusually administered to patients whose SCLC has reached the fourth stage, to help reduce thesymptoms of SCLC and not curing it. III. ReferencesDriscoll, B. (2003). Lung cancer. Totowa, N.J: Humana Press.Falk, S. A., & Williams, C. J. (2010). Lung cancer. Oxford: Oxford University Press.Kernstine, K. H., & Reckamp, K. L. (2011). Lung cancer: A multidisciplinary approach todiagnosis and management. New York: Demos Medical.Walker, J. (2006). Lung cancer: Current and emerging trends in detection and treatment.NewYork: Rosen Pub. Group.