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Lung Cancer
1. Running head: LUNG CANCER 1
Lung Cancer
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I. Abstract
Lung 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 of
lung 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 the
lungs (Falk and Williams, 2010). Cigarette smoking has been identified as the leading cause
of lung cancer (Falk and Williams, 2010). Other causative agents of lung cancer include air
pollution, exposure to cancer-causing materials and chemicals, exposure to radiation
uncontrollably and drinking water whose arsenic levels is very high. General symptoms that
accompany lung cancer include chest pains, fatigue, persistent cough, wheezing, loss of
appetite, and weight loss. Other symptoms depend on the type of lung cancer that one may be
suffering from. In diagnosis of lung cancer, biopsy is the commonest type of diagnostic
method 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 at
the early stages of tumor development. Chemotherapy and radiation therapy are used when
tumor 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), cigarrete
smoking, biopsy, surgery, chemotherapy and radiation therapy, World Health Organization
(WHO).
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Table of Contents
I. Abstract ……………………………………………………………. 2
II. 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……………………7
III. References……………………………………………………………10
II. Lung Cancer
(a). Types of Lung Cancer
Lung cancer is the abnormal growth of cells in the lungs especially in the bronchi
lining (Driscoll, 2003). There are two major types of lung cancer namely; Non-small cell lung
cancer (NSCLC) and cell lung cancer (CLC). One suffers from mixed small and large cells
lung cancer if both NSCLC and CLC are present. Another, less commonly known, type of
lung cancer is the metastatic lung cancer, which spreads from other parts of the body to the
lungs (Falk and Williams, 2010).
Non-small cell lung cancer is the most common type of lung cancer that spreads in the
lungs in a slow manner than the small cell lung cancer (Falk and Williams, 2010). NSCLC
occurs in various forms namely adenocarcinomas, which is mostly found in the outer parts of
the lungs; squamous cell carcinomas, which is found at the center of the lungs (next to
bronchus); and the large cell carcinomas, which is found in any section of the lungs and
grows at a faster rate than the other two forms of lung cancer (Falk and Williams, 2010).
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Small cell lung cancer represents 15-20% of all lung cancer problems that are
reported in health centers (Driscoll, 2003). SCLC is slightly less commonly found in women
than in men. Driscoll (2003) points out that SCLC is 100% associated with smoking and it is
very rare to find a case where people who have never engaged in smoking, suffering from
SCLC. It is the most dangerous type of lung cancer as it starts from the bronchi, which are
situated 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, which
metastasizes to other parts of the body including bones, liver, and the brain (Falk and
Williams, 2010). SCLC is classified as either limited, where chest cancer that is curable
through radiotherapy; or extensive, where cancer has spread to other body organs, beyond the
chest region (Falk and Williams, 2010).
Statistics from World Health Organization (WHO) indicate that, more people are
dying 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 more
widespread 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 and
CLC). The risk of getting cancer through smoking of cigarette is dependent on the age of the
smoker at the time he or she started smoking and the number of cigarettes that one smokes in
a day (Falk and Williams, 2010). Passive smokers, who inhale second-hand smoke or rather
smoke from active smokers, also have high chances of getting lung cancer (Falk and
Williams, 2010). According to study conducted by American Cancer Society, 3000 passive
smokers are estimated to die from lung cancer (Walker, 2006).
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It has not yet been proven that low-tar cigarretes reduces the risk of getting lung
cancer but research has proven that smoking of marijuana may lead to the growth of
cancerous 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 lung
cancer. For instance; NSCLC is also caused by drinking water whose arsenic levels are very
high and by high level of air pollution (Falk and Williams, 2010). Having a medical history
of radiotherapy may also increase the chances of NSCLC through the abnormal growth of
cells in the bronchi lining or by working in an environment that is heavily polluted with
cancer-causing materials and chemicals such as coal products, asbestos, uranium, gasoline,
chloromethyl ethers, beryllium, gasoline, vinyl chloride, mustard and radon gas, nickel
chromates, diesel exhausts, alloys, preservatives, pigments, paints and compounds containing
heavy metal chlorides and formaldehydes. SCLC is mostly caused by cigarrete smoking (Falk
and Williams, 2010).
(c). Common Symptoms of Lung Cancer
Early symptoms of early lung cancer include; pain in the chest, coughing blood
persistently, fatigue, appetite loss, wheezing, and breathe shortness due to limited supply of
air. Symptoms of NSCLC include; pain in bones, joints, and shoulders, fragile, and weak
bones, paralysis in facial muscles leading to facial swelling, change in tonal voice, loose and
discolored nails and difficulty in swallowing (Driscoll, 2003). Symptoms of SCLC include
phlegm (bloody sputum), chest pain, coughing persistently, loss of appetite, wheezing, breath
shortness, 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 is
being run for another purpose (Walker, 2006). In the diagnosis of NSCLC, questions
concerning your medical and smoking history are usually asked and a physical examination
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is carried out. By using the stethoscope, during the physical exam, a doctor can hear fluid
around the chest region that could suggest the possibility of having lung cancer. In some
cases, a biopsy is usually performed to confirm the diagnosis of NSCLC. This involves the
removal 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 usually
incorporated in this technique. These include; bronchoscopy combined with biopsy, pleural
biopsy, CT-scan-directed needle biopsy, open lung biopsy, and endoscopic esophageal
ultrasound with biopsy and mediastinoscopy with biopsy (Walker, 2006).
If the biopsy results indicate that lung cancer is present, imaging processes are
implemented to determine the cancer stage, that is how big the growth or tumor is and how
fast has it spread from the origin. NSCLC is therefore divided into five stages namely: Stage
0 when cancer is just beneath the lung’s inner lining; Stage I when cancer has not reached the
lymph nodes; Stage II when cancer has reached the lymph nodes in the vicinity of the original
tumor; Stage III when cancer is past the lymph nodes and is spreading to the surrounding
tissues; and Stage IV when cancer has spread to other organs of the body (Kernstine and
Reckamp, 2011).
Other tests that may be performed in the diagnosis of lung cancer or to see how much
it 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 sputum
test(Kernstine and Reckamp, 2011).
Diagnosis of SCLC is similar to that of NSCLC in all aspects. In addition to the methods that
are incorporated in biopsy, in order to enhance it efficiency and effectiveness, video-assisted
thoracoscopy is also utilized in enhancement of the biopsy process.
(e). Lung Cancer Treatment Methods
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Treatment of NSCLC depends on the stage at which the cancer has reached. There are
various treatment methods for NSCLC. Notable among these is surgery. It is performed when
NSCLC is at stage I, that is, when it has not reached the lymph nodes. There are three forms
of surgery namely lobectomy, removing one of the lung lobes; pneumonectomy, where the
entire lung is removed; and segment or wedge removal, which involves removal of a part of
the lung (Walker, 2006).
Chemotherapy is another form of treatment that involves the use of drugs to stop the
growth of new cancer cells and to kill them too. Chemotherapy is usually performed when
NSCLC has reached the fourth stage. Chemotherapy that is administered before surgery in
order to increase the effectiveness of those treatments, is known as neoadjuvant therapy while
the one administered after the surgery in order to kill the remaining cancer cells, is known as
adjuvant therapy. An important thing to remember when administering chemotherapy, is to
be very careful in preventing further complications from taking place and controlling any
symptoms that would further arise from this form of treatment.
Radiation therapy uses radiations, especially X-rays, to kill e cancerous cells. It may
be used along with chemotherapy to treat cancer when surgery is impossible. Radiation
therapy is mostly used to reduce symptoms such as swelling and problems in breathing and to
reduce pain due to cancer that has spread up to the bones (Walker, 2006). It is important to
note that controlling symptoms when radiation therapy is underway and after the therapy, is
of great paramount.
Other forms of therapy that are employed in relieve NSCLC symptoms include
photodynamic therapy, which activates a drugs using a special type of light in order to kill the
cancerous cells; and laser therapy which uses a small light beam to kill the cancerous cells
through burning.
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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 most
commonly used drug is known as etoposide, which can be in combination with either
carboplatin or cisplatin(Kernstine and Reckamp, 2011). The use of surgery may be of very
little use since the tumor has already spread by the time diagnosis is done. If there is a tumor
that has not spread significantly at the time of diagnosis, then , surgery can be done followed
by radiation therapy or chemotherapy. A combined radiation therapy and chemotherapy is
usually administered to patients whose SCLC has reached the fourth stage, to help reduce the
symptoms of SCLC and not curing it.
III. References
Driscoll, 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 to
diagnosis
and management. New York: Demos Medical.
Walker, J. (2006). Lung cancer: Current and emerging trends in detection and treatment.New
York:
Rosen Pub. Group.