Small cell lung cancer (SCLC) accounts for 13% of lung cancers and is strongly linked to smoking. SCLC typically presents as a large mass in the mediastinal lymph nodes. It is classified as limited stage, confined to one lung, or extensive stage with distant metastases. Treatment involves chemotherapy with cisplatin and etoposide, and sometimes radiation therapy. For limited stage SCLC, surgery may be an option for early tumors. While initial response rates are high, most patients experience relapse. Prophylactic cranial irradiation can reduce the risk of brain metastases. Even with optimal treatment, the 5-year survival rate remains low at 5-10% for extensive stage and 30-40% for limited stage disease
Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Histologically, NSCLC is divided into adenocarcinoma, squamous cell carcinoma (SCC) (see the image below), and large cell carcinoma. Small cell lung cancer (SCLC), previously known as oat cell carcinoma, is considered distinct from other lung cancers, which are called non–small cell lung cancers (NSCLCs) because of their clinical and biologic characteristics.
Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Histologically, NSCLC is divided into adenocarcinoma, squamous cell carcinoma (SCC) (see the image below), and large cell carcinoma. Small cell lung cancer (SCLC), previously known as oat cell carcinoma, is considered distinct from other lung cancers, which are called non–small cell lung cancers (NSCLCs) because of their clinical and biologic characteristics.
Evaluation and management of Stage III Non-Small Cell Carcinoma Lung including Radiotherapy planning. On a Radiation Oncologist Perspective. MD Radiotherapy discussion - CMC, Vellore
It is unclear whether the administration of radioiodine provides any benefit in low-risk cases after a complete surgical resection, and radioiodine is not recommended in patients with disease that is categorized as consisting of a tumor less than 1 cm in diameter and clinical stage N0. Therefore, radioiodine should be used with great care to minimize harm, administer the minimal amount of radioactivity, and involve the best tolerated methods.
This Presentation gives a concise summary of the various aspects related to Lung cancer. it will be more helpful for the Clinical Pharmacy student as well as other medical student.
An Overview: Treatment of Lung Cancer on Researcher Point of ViewEswar Publications
Cancers is defined as the uncontrolled cell divisions. Cell does not grow maturely and destined to uncontrolled cell growth. When these cells of lungs grow uncontrolled it is called lung cancer. Nowadays mortality rate due to lung cancer is increasing day by day. Many treatment and diagnoses are now a day’s available to deal with lung cancer. Here we disused different method for diagnosis the common types of lung cancer Non-Small Cell Lung Cancer, Small Cell Lung Cancer, Small Cell Lung Cancer Limited Stage, Small Cell Lung Cancer - Extensive Stage, Lung Adenocarcinoma, Squamous Cell Carcinoma,Bronchioloalveolar carcinoma (BAC), Metastatic lung cancer.
How useful are advance directives in directing end of life care and do people really understand or want to know the true status of their health as the end nears?
Understanding how intermittent fasting may not only help weight loss but have multiple other health benefits including life prolongation, preventing cancer and dementia
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. Types of Lung Cancer
Non-small cell carcinoma (NSCC) (87%)
◦ Adenocarcinoma (38%)
◦ Squamous cell (20%)
◦ Large cell (5%)
Small cell carcinoma (13%)
3. Small cell lung cancer is virtually always caused
by smoking and as smoking has decreased the
incidence of this cancer has declined
Percent of Lung Cancers that were Small
Cell:
1978: 20-25%,
1986: 17%,
2002: 13%
NCDB Data for 2000-2010 small cell was 15%
4. Since women have
not cut back on smoking as much as men,
the frequency of small cell in women has
increased
Women accounted for 28% in 1973 and in
6. Small Cell Lung Cancer
• These are classified as a neuroendocrine
cancer
• These are fast growing cancers and only 1/3
are still confined to the chest
• Most patients are treated with chemotherapy
and radiation but a small number (2- 5%)
with early stage I may benefit from surgical
resection
• 95% of small cell cancers start in the lung
but 5% arise from outside the lung (e.g.
Nasopharynx, gastrointestinal or
genitourinary sites
7. Biopsy - confirm the cancer and
determine the type
Bronchoscopy CT directed biopsy
8. Pathology
• Cancer cells should stain positive for
keratin, epithelial membrane antigen and
TTF-1
• Since they are neuroendocrine they should
also stain for: chromogranin A, neuron
specific enolase, NCAM and synaptophysin
“special stains”
15. CT Small Cell
Usually large mass in the mediastinal lymph nodes and
may compress the superior vena cava
16. Stages of Lung Cancer
Stage I – small spot no nodes
Stage II – larger or nodes on the
side of the lung (hilar or N1 nodes)
Stage III – very large tumor or
lymph nodes in the middles of the
chest (mediastinum or N2 nodes)
Stage IV – metastases to other
organs
18. Stages for Small Cell
Veterans Affairs Lung Study Group defined limited
stage (LS disease) as that confined to the ipsilateral
hemithorax which could be safely encompassed within
a tolerable radiation field and extensive stage (ES
disease) as disease beyond the ipsilateral
hemithorax, including malignant pleural or pericardial
effusion or hematogenous metastases.
Patients with contralateral hilar or supraclavicular
lymph nodes were excluded from some studies of LS
disease, even though modern RT techniques can allow
for high-dose RT to be delivered in selected cases.
19. Small Cell Stages
• Limited Stage: confined to
the chest and regional nodes
(1/3)
• Extensive Stage: distant
metastases (2/3)
20. Small Cell Carcinoma of the Lung usually
presents with a large central tumor (hilar/mediastinal lymph
node mass
21. Symptoms of Small Cell
• Because of the large lymph node swelling in
the chest the patient may have shortness of
breath, trouble swallowing, hoarseness, facial
swelling (superior vena cava syndrome)
• Many present with symptoms of spread or
metastases: headaches (brain met) bone pain
(bone mets) or eating problems (liver mets)
• Some present with neurologic or endocrine
paraneoplastic syndrome (e.g. low sodium or
elevated calcium)
22. PET scan
showing a
typical small cell
cancer with a
large
mediastinal
mass making it
hard to even
see the heart on
the left side
Small Cell Lung Cancer
26. Treatment for Small Cell
Lung Cancer
Limited Stage: consider surgery
resection for early stage followed by
chemotherapy +/-
radiation, otherwise most patients
get chemotherapy plus radiation
Extensive Stage: unless very weak
consider chemotherapy +/- radiation
27. The role of surgery in the treatment of limited
disease small cell lung cancer: time to
reevaluate.
J Thorac Oncol. 2008 Nov;3(11):1267-71.
We identified 59 patients who underwent
complete resection with nodal dissection for
SCLC.
overall survival at 1 year of 76%
and 5 years 52%
Only 2 to 5% are candidates for
28. Various chemotherapy schemes have
been evaluated for SCLC;
however, Cisplatin and Etoposide is
widely considered as the standard, with
observed response rates of 80–85%
and approximately 25% of patients
obtaining a complete response
However, most patients experience
disease relapse. Attempts to improve
the outcome using different or more
dose-intensive chemotherapy
regimens or maintenance
chemotherapy have not led to
improved outcomes.
30. Carboplatin- or Cisplatin-Based Chemotherapy in
First-Line Treatment of Small-Cell Lung Cancer: The
COCIS Meta-Analysis of Individual Patient Data
JCO May 10, 2012 vol. 30 no.
14 1692-1698
31. Radiation for Small Cell
• Adding radiation to chemotherapy
will lower the risk of lung relapse by
25 to 30% and increase the
survival by 5 to 7%
• Radiation dose to the lung can be
twice a day to 45Gy or daily to 60 –
70 Gy
32. Twice-Daily Compared with Once-Daily Thoracic
Radiotherapy in Limited Small-Cell Lung Cancer
Treated Concurrently with Cisplatin and Etoposide
N Engl J Med 1999; 340:265-271
total dose of thoracic radiotherapy was 45 Gy for each patient, 1.8 Gy daily
in 25 treatments over a period of five weeks or Accelerated twice-daily
thoracic radiotherapy involved the administration of 1.5 Gy in 30 treatments
over a period of three weeks.
33. • Low dose prophylactic cranial irradiation (PCI)
reduced the risk of brain mets from 58% to 33% and
increased 2y survival from 15% to 21% and another
study showed a decreased risk of brain mets from 49%
down to 14% and improved 1 year survival from 13%
up to 27%
• Brain dose of 24 to 30Gy
34. Benefits of PCI (prophylactic cranial
irradiation) of extensive stage small cell
in lowering the risk of developing brain
metastases
35. Small cell cancer may shrink so
quickly, it may be necessary to adjust
the radiation target
Daily CT images
on Tomo will
allow for the
physician to
adjust the
radiation target if
the cancer
changes in size
or position
38. Results with Chemoradiation
Stage Response Survival Survival
Limited
Stage
70 – 90% 14 to 20
months
40%/2y
Extensiv
e
60 – 70% 9 to 11
months
< 5%/2y
39. Stage 2 Year 5 Year
I 41.1% 21.5%
II 34.4% 17.2%
III 23.4% 9.5%
IV 5.9% 1.6%
Observed Survival for Small Cell Lung Cancer
NCDB Data (cases diagnosed in 2003 – 2005)