and prostate cancer combined in the year 1999(American Cancer Society, 1999).
Every smoker is at risk for getting lung cancer. It is estimated that 87 per cent
of all lung cancers are directly from smoking (www.oncolink.com). The longer you smoke the higher the risk becomes of getting cancer. But it doesn’t matter
if you quit after ten days or ten years of smoking as soon as you stop the
risk of getting cancer lowers and lowers the longer you go with out a
cigarette. But for people who do smoke and don’t intend on quitting they can
still lower the risk of getting cancer by decreasing the amount of
cigarettes smoked a day, by inhaling the smoke into the lungs less deeply. But this does not help stop cancer it just slows how long it takes for the body to develop cancer(www.oncolink.com). People who don’t smoke are also at risk from other smoking. Second hand smoke, or smoke inhaled from smoke around you from other smokers is also a risk factor for getting lung cancer. It is estimated that 17 per cent of
lung cancer cases in non-smokers are caused from second hand, passive smoking, smoke being inhaled in the air. Although there are lots of rumours about marijuana not causing cancer and being better for the body then cigarettes its not true(www.oncolink.com). Smoking marijuana can also cause lung cancer because it has the same chemicals and thus has the same effects as a normal cigarette.
Lung cancer happens when cells inside the lung start to grow out of control
and this can lead to them blocking the blood supply to other cells or it can
block the breathing way to the lungs. This means that you can’t breathe and
you suffocate from your own tissue killing you. Large collections of this
out-of-control tissue are called tumours. Any of the tissues in the lung can
become cancerous, but most commonly, lung cancer comes from the lining of
the bronchi.
Most diseases are just one single thing that lead on to other things, cancer
is different. Cancer is thought of as a collection of diseases that are
characterised by the cell type that makes them up, how the behave and how
they are treated. Lung cancer is divided into two main categories:
• Small cell lung cancer (SCLC) is the rarer of the two types (about 20
per cent of all lung cancers), small cell lung cancer is more aggressive
than non small cell lung cancer because it grows quicker and is more likely
to spread to other organs in the body.
• Non small cell lung cancer (NSCLC) is the more common of the two types (
about 80 per cent of all lung cancers), non small lung cancer is generally
slower growing than small cell lung cancer and is divided into three
different types based on how the cells look that make it up –
adenocarcinoma, large cell carcinoma and the squamous cell carcinoma.
(www.oncolink.com)
Small Cell Lung Cancer is divided into two stages.
1.Limited Stage – means the cancer is on one side of the lung, so it could
be reasonably treated with a radiation field.
2.Extended Stage – means the cancer is on both side of the chest (both
lungs) or has spread out of the lungs to different parts of the body, so it
could not be reasonably treated with a radiation field.
Non Small Cell Lung Cancer is divided into four main stages.
1.Stage IA- the tumor is less than 3 cm, isn't in a main bronchus and
hasn't spread to any lymph nodes
Stage IB - the tumor doesn't invade any organs, isn't too close to the
trachea if it is in the main bronchus, doesn't cause obstruction of the lung
and hasn't spread to any lymph nodes
2.Stage IIA- the tumor is less than 3 cm, isn't in a main bronchus and has
spread to lymph nodes on the same side as the tumor
Stage IIB - the tumor doesn't invade any organs, isn't too close to the
trachea if it is in the main bronchus, doesn't cause obstruction of the
entire lung but has spread to hilar lymph nodes on the same side as the
tumor OR the tumor hasn't spread to any lymph nodes but doesn't invade any
vital organs
3.Stage IIIA - the tumor can have spread to different types of lymph nodes
than Stage II (called mediastinal or subcarinal), but they are still on the
same side as the tumor and it hasn't invaded any vital organs
Stage IIIB - the tumor has either invaded vital adjacent organs and/or
spread to lymph nodes on the other side of the mediastinum as the tumor or
specific lymph nodes called scalenes or supraclavicular. Also, the patient
may have tumor spread to the fluid surrounding the lung
4.Stage IV- the tumor has spread (metastasized) to other organs in the body
outside the lungs (like the bones, brain or liver)
(www.oncolink.com).
The early symptoms of lung cancer are hard to spot but as the tumour
grows in size it can produce a variety of symptoms including:
• Cough (especially one that doesn’t go away after a while or seems to be
getting worse in character).
• Chest pain.
• Shortness of breath.
• Coughing up blood and bloody phlegm.
• New onset of hoarseness or wheezing.
• Recurrent problems with pneumonia and bronchitis.
• Weight loss.
• Loss of appetite.
• Fatigue.
• Bone pain.
• Dizziness or double vision.
• Numbness or tingling in your arms and legs.
• Turning yellow in the skin (jaundice).
(www.oncoclink.com).
Diagnosis issue/problems.
There are problems with these symptoms because these are not direct effects
from lung cancer. Many of these can be caused by totally different things
that have nothing to do with cancer. For example, weight loss. People can
lose weight from many different things not just cancer. Loss of appetite can
be a form of anorexia not cancer and a loss of appetite leads to weight loss
because of lack of eating. Fatigue can be caused by lack of sleeping not due
to cancer. Although these problems are symptoms that can occur when you have
a cancerous lung it doesn’t mean you have cancer if you have these symptoms.
But if a smoker does have these symptoms especially a cough or chest pain,
that is a good sign for a doctor that the patient has lung cancer.
Now a days there are lots of ways to find out if someone has lung cancer.
But finding it doesn’t necessarily mean that it will be cured or destroyed,
it just means that the chance of it being cured increases. There are a few
ways of finding the cancer. When a patient has the symptoms representing a
tumour they usually have a chest X - Ray first. If the chest X –Ray isn’t
very clear then the person usually goes and has something called a CT scan
(these are 3-D x – rays that are much more sensitive than the standard chest
x – rays)(see pic. 2). With a CT scan the cancer is much easier to find because of the
3D image it gives. One other test that a doctor could do to determine if you
have cancer of the lung is to test your phlegm for cancerous tissue. This is
called sputum cytology. Depending on the results the chest X- ray, 3D CT
scan and the sputum cytology a doctor may do a biopsy. A biopsy is the best
and only way to know for sure if someone have a cancerous lung, because it
allows the doctor to take cells from inside the lung and look at them under
a microscope. This would allow him to be 100 per cent sure if a person has
or hasn’t got lung cancer.
(google search, 2003)
Biopsy.
A biopsy can be done many different ways. A doctor might do what is called a fiberoptic bronchoscopy, this is where the doctor puts a very thin tube, which has a light and a camera at the beginning of it, down either your nose or your mouth and in to the lungs to look at the tumour and take samples of it for examination. One other way of performing a biopsy is to take a needle and placing it through the skin of the tumour. This is called a needle biopsy. If your type of cancer is producing fluid in the lungs, the final way is to collect the fluid from the lung by puncturing it. This is called a thoracentesis. Once the tissue is removed a doctor called a pathologist will look at it and he will be able to determine if it is in fact a cancer or if it isn’t. Information on treatment for a patient with lung cancer is staged in to different groups. But the staging is different for the two main types of lung cancer, small cell lung cancer (SCLC) and non small cell lung cancer (NSCLC). This staging is done in a limited fashion before the surgery taking into account of the size of the tumour from the chest x – ray or the 3D CT scan, where it is and any evidence of it spreading to other organs.
Cures.
There are a few ways that cancer can be cured or removed from the body.
But the best way to prevent lung cancer is to quit smoking or to not have smoked in the first place or not to be around any people who do smoke. There has been some suggestion that a diet high in fruits and vegetables may be a good way of lowering your risk of lung cancer. This has yet to be definitively proven. Many substances,
including antioxidants like vitamin A, vitamin E, and beta-carotene, have
been suggested to decrease your risk of getting lung cancer. None of these
has been shown to be beneficial in randomised controlled trials and cannot
be recommended for this purpose. (www.livingtreecommunity.com). In
fact, large clinical trials have shown an increased risk of lung cancer in
patients that take increased quantities of vitamin E, vitamin A, and
beta-carotene. (www.oncolink.com).
The best ways to destroy or get rid of cancer is through radio therapy,
using a high power doze of x – ray, cut it out, chemo therapy, the use of
anti-cancer drugs that go throughout the entire body. These drugs may be
given through a vein or with pills by mouth, and a fairly new idea is to cut
the blood supply to the tumour, this will starve it and it die because of
not having any oxygen. (www.oncolink.com).
These two different people have said different things. One of them thinks
that natural things found on earth are the best and the other thinks that
new modern drugs are the most effective. The one with the best results is by
far the new modern drugs. As you can see even the people from
(www.oncolink.com) think that these natural substances can actually cause and
help cause cancer.
Surgery.
The purpose of surgery is to basically remove all the cancer if possible.
If the tumor is small and in a good location or the person has little lung
function, the surgeon may choose to remove the tumor with a small section of
lung, this is called a wedge resection. Most times the surgeon will choose
to remove the entire lobe of the involved lung, this is known as a
lobectomy. Some times the surgeon must remove the entire lung affected by
the cancer, and this is known a pneumonectomy. Because it tends to behave
differently, surgery is generally not used for small cell lung cancer at any
of the stage. Small cell lung cancer is usually treated with chemotherapy
and radiation therapy. Despite the fact that the tumors are often removed by
surgery, there is always a risk of them coming back because there may be
microscopic cancer cells left that the surgeon cannot remove. Also, some
patients can’t have surgery or choose not to have surgery.
For non small cell lung cancer, the higher the stage of cancer you have,
the more likely it is that you will have chemotherapy. But chemotherapy has
problems though. It doesn’t just kill the cancerous cells it also kills all
the other cells on the way so this means that you can get very sick from it.
Patients usually lose their hair, skin colour loss and vomiting. But
chemotherapy has been known to be very reliable for killing off cancerous
tissue. There are many different chemotherapy drugs, and they are often
given in combinations. Patients will usually have to go to a clinic to get
the chemotherapy because many of the drugs have to be given through a vein.
Different chemotherapy regimens are used for different purposes. Some of the
drugs used in lung cancer chemotherapy include: Etoposide (and Teniposide),
Cisplatin (and Carboplatin), Ifosfamide, Cyclophosphamide, Vincristine,
Doxorubicin, Paclitaxel, Docetaxel, Gemcitabine (Gemzar®) and Vinorelbine
(Navelbine).
Lung cancer patients are usually and most commonly treated with radiation
therapy. It comes from an external source, and it requires patients to come
in 5 days a week for up to 6-8 weeks to a radiation therapy treatment
center. The treatment takes a few minutes, and it is painless. Radiation
therapy is often combined with surgery and is important in the treatment of
all types of lung cancer. It may be recommended before surgery to shrink a
tumor to make it easier for the surgeon to remove. Radiation may be used
after surgery if there are risk factors that make it likely for a tumor to come back in the lungs. Sometimes radiation is used instead of surgery in patients who can not have surgery.
The best way to get rid of lung cancer or not to have it is to quit
smoking or to have never smoked before. If you quit or have never smoked the
chances of getting lung cancer are dramatically reduced.
Bibliography
1. Christopher Dolinsky, May 31, 2002, ‘Lung Cancer: The basics.’ The University of Pennsylvania Medical School, .
2. Jesse Shwartz, 2003, Without Drugs, Living tree community,