Lung cancer is an epidemical disease, annually there are 1.4 million deaths and about 1.6 million new cases. More people die of lung cancer than of colon, breast, and prostate cancers combined. Lung cancer mainly occurs in older people. About 2 out of 3 people diagnosed with lung cancer are older than 65. Fewer than 3% of all cases are found in people under the age of 45. The average age at the time of diagnosis is about 71. The chance that a man will develop lung cancer is about 1 in 13, for a woman, the risk is about 1 in 16, These numbers include both smokers and non-smokers. For smokers the risk is much higher, while for non-smokers the risk is lower. Lung cancer incidence rates were around twice as high in more developed countries compared with less developed countries

1. Lung Cancer
Done by: Rana Abdulnaser AL-Hakimi

2. .

3.  Lung cancer is an epidemical disease, annually there are
1.4 million deaths and about 1.6 million new cases.
 More people die of lung cancer than of colon, breast, and
prostate cancers combined.
 Lung cancer mainly occurs in older people. About 2 out of
3 people diagnosed with lung cancer are older than 65.
 Fewer than 3% of all cases are found in people under the
age of 45. The average age at the time of diagnosis is about
71.
 The chance that a man will develop lung cancer is about
1 in 13, for a woman, the risk is about 1 in 16, These
numbers include both smokers and non-smokers. For
smokers the risk is much higher, while for non-smokers the
risk is lower.
 Lung cancer incidence rates were around twice as high in
more developed countries compared with less developed
countries
LUNG CANCER
STATICAL IN THE
WORLDE

4. LUNG CANCER IN THE ARAB
WORLD
 15/22 (68.1%) of the Arab countries have lung
cancer as one of the most frequent five types of
cancer, for both sexes.
 In 2008 about 9,537 new cases was reported in
ages below 65 for both sexes, and 7,059 cases for
ages above 65.
Lung cancer are about 15 fold higher in Tunisia
than in Sudan for men, and about 10 fold higher in
Bahrain than in Yemen for females.

5. In 2020 there is expected to be 14,788 new lung cancer
cases in the Arab countries for ages below 65, and 14,788
cases for ages above 65 in both males and females.
By the year 2025, 85% of the world’s smokers will live in
less developed countries.
It is estimated that by 2030 lung cancer will be the sixth
most common cause of death, compared with its current
ranking of ninth.
By 2030 it is expected that around 70% of all tobacco-
related deaths (including lung cancer) will occur in the
world’s poor and middle income nations, compared with
the current estimate of 50%.31,109.
.
LUNG CANCER IN THE
FUTURE

6. .Lung cancer have 2 major types
Non-small cell lung
cancer
small cell lung
cancer

7. .
Squamous cell (epidermoid) carcinoma:
About 25% to 30% of all lung cancers
It start in early versions of squamous cells, which
are flat cells that line the inside of the airways in the
lungs.
It often linked to a history of smoking
It found in the middle of the lungs, near a bronchus
Adenocarcinoma:
About 40% of lung cancers
Start in early versions of the cells that would normally secrete
substances such as mucus.
Occurs mainly in people who smoke (or have smoked), it is also
the most common type of lung cancer seen in non-smokers.
 It is more common in women than in men
It is more likely to occur in younger people than other types of
lung cancer.
Non-small cell lung
cancer

8. .
Named for the small cells that make up these cancers.
SCLC often starts in the bronchi near the center of the
chest.
It tends to spread widely through the body fairly early in the
course of the disease.
 The cancer cells can multiply quickly and spread to lymph
nodes and other organs, such as the bones, brain, adrenal
glands, and liver.
 Sometimes the areas of cancer spread are seen as large
tumors on x-rays and other imaging tests, but early on
these areas may not be visible.
SCLC spreads early, so removing the tumor in the lung
rarely cures the cancer. This is why surgery is rarely used
to treat SCLC . On the other hand, chemotherapy, which
can reach cancer cells throughout the body, is the main
treatment for small cell lung cancers.
Small cell lung
cancer
Small cell lung
cancer

9. Gene
mutations
Chronic
inflammatory
lung diseases
Exposure to non-
tobacco
carcinogens
Air pollution
Asthma
COPD
(Chronic obstructive
pulmonary disease)
 Tuberculosis
Mutations
in (RTKS(
 Radon
 Asbestos
Chemical carcinogens
 5% of all deaths
due to air pollution.
Smoking is the most common etiological
factor, accounting for nearly 85% of patients
with lung cancer.
Heavy alcohol consumption
increase lung cancer risk in
smokers
Vegetables and Fruit
reduce lung cancer
risk in smokers

10. Primary
tumor
Locoregional
metastases
Distant
metastases
Bone metastases
Brain metastases
Headaches
 Dizziness,
A change inconsciousness
Pain.
 loss of mobility.
loss of skeletal
Fractures.
 Hypercalcaemia.
 Spinal cord
compression.
Malignant pleural
effusion
Superior vena
cava obstruction
Dyspnoea
Orthopnoea
 Cough
 Chest discomfort
Pain
Haemoptysis
Pain
Cough
Dysponea
Symptoms

11. T
N
M
The TNM staging
system
Indicates the size of the main (primary) tumor
and whether it has grown into nearby areas.
Describes the spread of cancer to nearby
(regional) lymph nodes. Cancers often
spread to the lymph nodes before going
to other parts of the body.
Indicates whether the cancer has spread
(metastasized) to other organs of the body.
)The most common sites are the brain,
bones, adrenal glands, liver, kidneys, and the
other lung.)
M: Metastasis
T: Tumor
N: Lymph nodes

12. Cancer cells are seen in a sample of
sputum or other lung fluids, but the
cancer isn't found with other tests, so
its location can't be determined.
Stage
0Occult
cancer

13. The cancer is no larger than 3 cm
across
It has not reached the membranes
that surround the lungs
It does not affect the main
branches of the bronchi.
It has not spread to lymph nodes
or distant sites
The main tumor is between 3 and
5 cm across.
It has grown into a main
bronchus , the visceral pleura ,and
partially clogging the airways.
 The cancer has not spread to
lymph nodes or distant sites.
Stage IAStage IA
Stage IBStage IB

14. The cancer is
no larger than
3 cm
The main tumor is
between 3 and 5 cm
The main tumor
is between 5 and
7
A main bronchus It has not
spread
Spread (but is not
within 2 cm of the
carina(
Spread (but is not
within 2 cm of the
(carina
Lymph nods within
the lungs
Spread Spread It has not spread
Around area where
the bronchi enters
the lung (hiler lymph
nodes(
Spread Spread It has not spread
The visceral pleura It has not grown Spread Spread
The airways It has not
spread
partially clogging partially clogging
Distant sites It has not spread It has not spread It has not spread
Distances Sites
Three combinations of
categories make up the
IIA stage.

15. It has grown into a main bronchus.
 It has grown into the visceral pleura.
Partially clogging the airways.
 It has spread to lymph nodes within
the lung.
It has spread around the area where the
bronchus enters the lung .
It has grown into the diaphram, the
visceral pleura, the parietal
Pericardium and it invades a main
bronchus and is closer than 2 cm to the
carina, but it does not involve the carina
it self.
It has grown into the airways enough
to cause an entire lung to collapse or to
cause pneumonia in the entire lung .
Two or more separate tumor nodules
are present in the same lobe of a lung .
The cancer has not spread to lymph
nodes or distant sites
The main tumor is
between 5 and 7 cm
across.
It is larger than 7
cm across.
IIB STAGE

16. The main tumor can be any size.
The cancer has spread only to lymph
nodes around the carina or in the
space between the lungs .
It is larger than 7 cm across.
It has spread and grown in :
the chest wall
 the diaphragm
 the mediastinal pleura
 the parietal pericardium.
the airways
a main bronchus
lymph nodes within the lung
Lymph nodes around the area where the
bronchus enters the lung. These lymph
nodes are on the same side as the cancer.
Two or more separate tumor nodules
are present in the same lobe of a lung.
It has not spread to distant sites.
A tumor of any size has grown
into:
the mediastinum , the heart, the
large blood vessels near the
heart , the windpipe , esophagus,
the backbone, or the carina,
lymph nodes within the lung
and/or around the area where the
bronchus enters the lung.
 Any affected lymph nodes are
on the same side as the cancer.
It has not spread to distant
sites.
Two or more separate tumor
nodules are present in different
lobes of the same lung.

17. Nearby
structures
Lung
collapse
Caused
pneumonia
Mediastin
al
Lymph
nodes
The cancer has not
spread to distant
sites.
Near the
collarbone on
either side
Hilar
Lymph nodes on the side
opposite the primary
tumor
The backbone
Mediastinu
m
The
windpipe
The large blood vessels
near the heart, the heart.
Near the
collarbone on
either side
Esophagus
Lymph nodes on the side
opposite the primary tumor
The carina and
around the
carina
The carina Two or more
separate tumor nodules are
present in different lobes of
the same lung.

18. .
Stage IV
The cancer can be any size
It may or may not have grown into nearby
structures or reached nearby lymph nodes.
The cancer has spread to the other lung.
Cancer cells are found in the fluid around the
lung (called a malignant pleural effusion).
Cancer cells are found in the fluid around the
heart (called a malignant pericardial effusion).
The cancer can be any size
It may or may not have grown into
nearby structures or reached nearby
lymph nodes.
 It has spread to distant lymph nodes
or to other organs such as the liver,
bones, or brain.

19. Diagnosis
Magnetic resonance
imaging (MRI) scan
Chest x-ray
Computed tomography (CT)
scan
Positron emission
tomography (PET) scan
CT guided needle biopsy
Bone scan
Imaging tests

20. Bronchoscopy
Endoscopic esophageal
ultrasound
Endobronchial ultrasound
Mediastinoscopy
Tests to diagnose lung
cancer
Thoracentesis
Mediastinotomy
Thoracoscopy

21. .
Sputum cytology
Fine needle
aspiration (FNA)
biopsy
Immunohistochemis
try
Molecular tests
Blood tests
Pulmonary function
tests
Sampling
tissues and
cells
Lab tests of
biopsy and
other samples

22. .Treatment
Chemo (sometimes along with radiation
therapy) may be used to try to shrink a
tumor
 Before surgery:
This is known as neoadjuvant therapy.
 After surgery: to try to kill any cancer cells
that may have been left behind..This is
known as adjuvant therapy.
For more advanced cancers or for some
people who aren't healthy enough for
surgery.
Surgery
Pneumonectomy
·Lobectomy
Segmentectomy
(wedge resection)
External beam
radiation therapy
Brachytherapy
(internal radiation
therapy).
Chemotherapy
 Monoclonal
antibodies
 tyrosine kinase
inhibitors
Targeted
therapy
Radiation
therapy