KHADEEJATH FARSANA CH ZMCTE,CHERKALA

1. LUNG CANCER
Khadeejath Farsana C.H
Roll No: 3
Natural Science
Zainab Memorial College ofTeacher Education
Cherkala, Kasaragod, Kerala

2. INTRODUCTION
• Lung cancer occurs when a malignant tumour
develops inside the lungs, in structures such as
bronchi1
• Capable of metastasizing to other parts of the
body.
• Spreads to other organs by any of three
mechanisms: through blood vessels, lymph
system or direct extension.
Figure 2: Organs affected by Lung metastasis
Figure 1 : Lung with tumour

3. EPIDEMIOLOGY
• Lung cancer inflicts a major disease burden on the
world as it is the most common cancer diagnosed
and the major reason of death2.
• Third most common cancer in the UK, with the
diagnoses of 46,400 people in 20153.
• Its mortality is strongly associated to age, with
the top mortality rates being in people aged 75 or
over in UK(48%).
• 19% (1.6 million) of cancer associated deaths are
from lung cancer which includes 17% male and 2%
female.
Figure 3: Estimated Cancer death, 2015

4. PATHOGENESIS
• 80% of the lung cancer are caused by cigarette
smoking
• Air pollution
• Exposure to industrial hazards such as uranium,
asbestos and radiation
• Genetic mutations of onco-genes and tumour
suppressor genes such as EGFR, EML4-ALK, k-ras, p53,
c-myc etc4.
• Tissue scarring
Basal cell
Proliferation
Hyperplasia of goblet
cells
Metaplastic
stratification of
squamous epithelium
Atypical metaplasia Carcinoma in situ
Infiltration of cancer
through basement
membrane
Spread to regional
lymph nodes
Haematogenous
dissemination
Figure 5: Histological progression in the pathogenesis of lung
cancer6
Figure 4 : Pathogenesis of lung carcinoma by
cigarette smoking5

5. CLINICAL FEATURES
Chest, back or
shoulder pain
Feeling breathless
Fatigue/tiredness
Loss of appetite
Frequent chest
infections
Finger clubbing
Difficulty
swallowing
Swelling in face or
neck
Hoarseness
Unexplained
weight
loss
Chronic cough
Coughing up
blood

6. TYPES OF LUNG CANCER
There are two main type of lung cancer6:
Non-small cell lung cancer, NSCLC (85%)
 Squamous cell carcinoma
 Large cell carcinoma
 Adeno carcinoma
Small cell lung cancer (15%)
 Small cell carcinoma
 Combined small cell carcinoma
Figure 6: NSCLC and SCLC appearance

7. NSCLC: SQUAMOUS CELL CARCINOMA
• Moderate to poor differentiation
• makes up 30-40% of all lung cancers
• more common in males
• most occur centrally in the large bronchi
• Uncommon metastasis that is slow effects the liver, adrenal glands and
lymph nodes.
• Associated with smoking
• Not easily visualized on xray (may delay dx)
Figure 7: Squamous
cell carcinoma

8. NSCLC: ADENO CARCINOMA
• Increasing in frequency. Most common type of Lung cancer (40-50% of all
lung cancers).
• Clearly defined peripheral lesions (RLL lesion)
• Glandular appearance under a microscope
• Easily seen on a CXR
• Can occur in non-smokers
• Highly metastatic in nature
• Pts present with or develop brain, liver,
adrenal or bone metastasis
Figure 8: Adeno
Carcinoma

9. NSCLC: LARGE CELL CARCINOMA
• Makes up 15-20% of all lung cancers
• Poorly differentiated cells
• Tends to occur in the outer part (periphery) of lung, invading sub-segmental
bronchi or larger airways
• Metastasis is slow BUT
• Early metastasis occurs to the kidney, liver organs as well as the adrenal
glands

10. SMALL CELL LUNG CANCER
• originates from neuroendocrine-cell precursors.
• Rapid doubling time, high growth fraction.
• Early development of widespread metastases.
• High response rates to both chemotherapy and radiotherapy.
• SCLC is the most common solid tumor associated with paraneoplastic
syndromes: SIADH, ACTH production syndrome, and Eaton-Lambert
syndrome.
Figure 9: Small cell
carcinoma

11. STAGES OF LUNG CANCER
STAGE 1
Tumour less than 3 cm
No metastasis
STAGE 2
Tumour less than 6 cm
Single metastases observed
STAGE 3
Tumour more than 6 cm
Metastases in the lymph nodes
STAGE 4
Tumour passed to
other organs
Stages of Lung cancer in detail: https://www.youtube.com/watch?v=I7tlPOEkjnw

12. DIAGNOSIS
Diagnosing method Details
Chest x-ray To look for spot or mass on lungs.
CT scan To see in more detail of the shape , size, and tumour position
Sputum cytology Observing phlegm cells under microscope to see presence of cancer
cells
Needle biopsy A sample of mass is taken from the lungs by a needle for pathology
evaluation and observation under microscope
Bronchoscopy A fiberoptic lighted tube is passed via nose or mouth in to the bronchi to
find tumours that are centrally located or blockages & a collect tissue
samples or fluids to be observed under microscope6
Mediatinoscopy A cut made in the neck to collect tissue sample from lymph node along
the bronchial tube and windpipe to observe under microscope

13. TREATMENT
Treatment depends on factors such as:
• Type (NSLC or SLC)
• Stage
• Size and position of the cancer
• Overall health
Targeted therapy Immunotherapy
Figure 10 -14 :Treatments of Lung Cancer8

14. PREVENTION
 Quit smoking
 Reduce or eliminate radon exposure – test home for
radon
 Avoid exposure to known cancer-causing chemicals
 Follow a healthy diet
https://www.youtube.com/watch?v=03oOt_4uKGI

15. CURRENT RESEARCH
Identification of potential biomarker (SGLT2 protein) of early stage
NSCLC
Invasively diagnoses
 precancerous lung growths (lesions and nodules)
 early stage lung cancer
Distinguishes malignant lung growths from benign
Major Challenge in lung cancer screening - small lung lesions can’t be
diagnosed clearly whether its benign or cancerous.
Figure 15: cancerous lung nodule which, progressed over the
period of 11 months and was identified following a biopsy

16. CURRENT RESEARCH
Continued..
PET imaging used to identify glucose uptake by tumour cells doesn’t detect
SGLT2
Studies in mice showed me4FDG allows to identify glucose uptake in lung
nodules
Research on mice on SGLT2 function
Pilot study of 30 patients to test Me4FDG to do imaging in humans
Figure 16: Comparison amongst glucose
metabolism in normal and cancer cells

17. ACKNOWLEDGMENT
1. Dr. RaviTP (Principal ZMCTE)
2. Dinesh (Teacher)
3. All my friends (Classmates)

18. REFERENCES
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introduction/ [Accessed 15 Feb. 2019].
2. Cheng, T., Cramb, S., Baade, P.,Youlden, D., Nwogu, C. and Reid, M. (2016).The International Epidemiology of Lung Cancer: Latest
Trends, Disparities, and Tumor Characteristics. Journal ofThoracic Oncology, 11(10), pp.1653-1671.
3. Cancer Research UK. (2018). Lung cancer incidence statistics. [online] Available at: https://www.cancerresearchuk.org/health-
professional/cancer-statistics/statistics-by-cancer-type/lung-cancer/incidence#heading-Zero [Accessed 15 Feb. 2019].
4. Shepard, J. (2014). Smoking-related lung disease in 3D: not your standard lecture. [online] SlideServe. Available at:
https://www.slideserve.com/jenna/smoking-related-lung-disease-in-3d-not-your-standard-lecture [Accessed 15 Feb. 2019].
5. Minna, J., Roth, J. and Gazdar, A. (2002). Focus on lung cancer. Cancer Cell, [online] 1(1), pp.49-52. Available at:
https://www.sciencedirect.com/science/article/pii/S1535610802000272?via%3Dihub [Accessed 15 Feb. 2019].
6. Meawela (2011). Lungcancer. [online] Slideshare.net. Available at: https://www.slideshare.net/Himesharo/lungcancer [Accessed 15
Feb. 2019].
7. Asiancancer.com. (2012). Lung Cancer | Modern Cancer Hospital Guangzhou, China. [online] Available at:
http://www.asiancancer.com/cancer-topics/lung-cancer/ [Accessed 15 Feb. 2019].
8. Mayoclinic.org. (n.d.). Lung cancer - Diagnosis and treatment - Mayo Clinic. [online] Available at:
https://www.mayoclinic.org/diseases-conditions/lung-cancer/diagnosis-treatment/drc-20374627 [Accessed 15 Feb. 2019].
9. National Cancer Institute. (2019). New Biomarker,TreatmentTarget for Early-Stage Lung Cancer?. [online] Available at:
https://www.cancer.gov/news-events/cancer-currents-blog/2019/early-stage-lung-cancer-biomarker [Accessed 15 feb. 2019].