LUNG CANCER

HPE 4010
Tara Wahoff
What it is

uncontrolled growth of abnormal

cells in one or both lungs

These abnormal cells do not carry

out the functions of normal lung
cells and do not develop into
healthy lung tissue.1

As they grow, the abnormal cells

can form tumors and interfere
with the functioning of the lung
(lack of oxygen to blood and rest
of the body).1

Must be a series of mutations to

DNA to create a lung cancer cell.1



Symptoms
In Lungs
1
Elsewhere in the body
1

Coughing, especially if it persists or
becomes intense
Pain in the chest, shoulder, or back
unrelated to pain from coughing
A change in color or volume of sputum
Shortness of breath
Changes in the voice or being hoarse
Harsh sounds with each breath
(stridor)
Recurrent lung problems, such as
bronchitis or pneumonia
Coughing up phlegm or mucus,
especially if it is tinged with blood
Coughing up blood

Loss of appetite or unexplained
weight loss
Muscle wasting (also known as
cachexia)
Fatigue
Headaches, bone or joint pain
Bone fractures not related to
accidental injury
Neurological symptoms, such as
unsteady gait or memory loss
Neck or facial swelling
General weakness
Bleeding
Blood clots


History
Before the 20
th
century, Lung Cancer was a very rare
disease
Dramatic increase occurred
in 1929 the German physician, Fritz Lickint published a
paper in which he showed that lung cancer patients were
particularly likely to be smokers.
5

Before this, the only suggested possible etiologic factors
were: increased air pollution by gases and dusts, caused by
industry; the asphalting of roads; the increase in
automobile traffic; exposure to gas in World War I; the
influenza pandemic of 1918.
5

The link between the smoking of cigarettes and lung cancer
began to be suspected by clinicians in the 1930s when they
noted the increase of this unusual disease. Publications
began to appear and about 2 decades later the role of
smoking as causative agent had been firmly established.
5

Link between smoking & lung cancer
Austin Bradford Hill and Sir Richard Doll were
part of the team that provided concrete
evidence linking smoking and lung cancer.
5


Because of this research, the Surgeon General
of the United States recognized smoking as the
cause of lung cancer in 1964 and started to
advice against it.
5

Smoking as a
Risk Factor
Smoking is the #1 risk factor. It increases the risk of
getting lung cancer by 15-30x
2

According to the CDC, even a few cigarettes a day or
smoking occasionally increases the risk of lung
cancer The more years a person smokes and the
more cigarettes smoked each day, the more risk
goes up
2

Second-hand smoke is a risk factor too
2/5 adults and of children exposed to second-hand
smoke
2

3,000 die per year from lung cancer from second-
hand smoke
2

Other
Risk Factors
Radon exposure
Causes about 20,000 cases a year
1/15 homes in U.S. is expected to have high radon levels
Asbestos
Diesel exhaust
Chromium
Arsenic
Family history may increase your risk
Radiation chest therapy
Some scientists suggest diet may cause it but there is still
much to research
2

Two Major Types of Lung Cancer:
NSCLC & SCLC
non-small cell lung cancer (NSCLC)
NSCLC accounts for 85% of lung cancers
Tumor types:
Adenocarcinoma is the most common form of
lung cancer in the United States among both men
and women.
1

Squamous cell carcinoma (which is also called
epidermoid carcinoma) forms in the lining of the
bronchial tubes.
1

Large cell carcinomas refer to non-small cell lung
cancers that are neither adenocarcinomas nor
epidermoid cancers
1



Stages of NSCLC
Stage I: The cancer is located only in the lungs and
has not spread to any lymph nodes.
1

Stage II: The cancer is in the lung and nearby
lymph nodes.
1

Stage III: Cancer is found in the lung and in the
lymph nodes in the middle of the chest, also
described as locally advanced disease. Stage III has
two subtypes:
If the cancer has spread only to lymph nodes on
the same side of the chest where the cancer
started, it is called stage IIIA.
1

If the cancer has spread to the lymph nodes on the
opposite side of the chest, or above the collar
bone, it is called stage IIIB.
1

Stage IV: This is the most advanced stage of lung
cancer, and is also described as advanced disease.
This is when the cancer has spread to both lungs,
to fluid in the area around the lungs, or to another
part of the body, such as the liver or other organs.
1






Small cell lung cancer...
Makes up remaining 15%
Limited stage: In this stage, cancer is found
on one side of the chest, involving just one
part of the lung and nearby lymph nodes.
1

Extensive stage: In this stage, cancer has
spread to other regions of the chest or other
parts of the body.
1

Results from smoking more so than NSCLC
1

Metastases
At a later stage of disease, some cells may
travel away from the original tumor and start
growing in other parts of the body. This
process is call metastasis and the new distant
sites are referred to as metastases.
1



Lung Cancer causes more
deaths than these cancers

Statistics
According to the CDC
In 2010, 201,144 people in the United States
were diagnosed with lung cancer, including
107,164 men and 93,980 women.
158,248 people in the United States died from
lung cancer, including 87,698 men and 70,550
women
2

Distribution in U.S.
The countries with the top 20 highest incidence of lung
cancer in 2012 are given in the table below
Rank Country Age-Standardised Rate per 100,000 (World)
1 Hungary 51.6
2 Serbia 45.6
3 Korea, Democratic
Republic of
44.2
4 FYR Macedonia 40.8
5 New Caledonia 40.1
6 Montenegro 39.6
7 Denmark 39.2
8 United States of
America
38.4
9 Poland 38.0
10 Canada 37.9
11 The Netherlands 37.2
12 French Polynesia 37.1
13 Belgium 36.8
14 China 36.1
15 Armenia 35.9
16 France (metropolitan) 35.0
17 Guam 34.7
17 Turkey 34.7
Methods for prevention
You can visit the CDCs website to see more on
what the CDC is doing about lung cancer
http://www.cdc.gov/cancer/lung/what_cdc_is_doin
g/index.htm

CDC's OSH created the National Tobacco Control
Program in 1999 to reduce tobacco-related
diseases through community interventions,
counter-marketing, program policy and regulation,
surveillance, and evaluation.
3

Methods for prevention
NIOSH. CDC's NIOSH is the federal agency
responsible for conducting research and making
recommendations for the prevention of work-
related injury and illness, including lung cancer
caused by workplace exposures.
3


NCEH and the ATSDR. ATSDR and CDC's NCEH
support environmental health tracking programs
and conduct activities to prevent or control
exposures and diseases related to the environment.
For lung cancer, examples include exposures to
asbestos or radon at home or at work.
3


Preventing tobacco use
Watch this video from the CDC about tips
from a former smoker
https://www.youtube.com/watch?v=kyLhO4vG
cGY



Control methods
Recent guidelines from the American Society of Clinical
Oncologists suggests annual screening with low-dose
computed tomography (LDCT) for smokers and former
smokers at high risk for developing lung cancer.
1

High risk factors include:
being between the age of 55 to 74
having smoked for 30 years or more
and either continuing to smoke or having quit within the
past 15 years.
1


Healthy People 2020
Healthy People provides science-based, 10-year
national objectives for improving the health of all
Americans.
4


States that many cancers are preventable by
reducing risk factors such as:
Use of tobacco products
Physical inactivity and poor nutrition
Obesity
Ultraviolet light exposure
4


Healthy People 2020
Healthy People 2020 provides a framework for action to
reduce tobacco use to the point that it is no longer a public
health problem for the Nation.
4

OBJECTIVES:
Tobacco Use Prevalence: Implementing policies to reduce
tobacco use and initiation among youth and adults.
4

Health System Changes: Adopting policies and strategies to
increase access, affordability, and use of smoking cessation
services and treatments.
4

Social and Environmental Changes: Establishing policies to
reduce exposure to secondhand smoke, increase the cost of
tobacco, restrict tobacco advertising, and reduce illegal
sales to minors.
4


References
1. CancerCare. (n.d.). Retrieved from
http://www.lungcancer.org/find_information/publications/163-
lung_cancer_101/269-non-small_cell_lung_cancer_treatment
2. Centers for Disease Control and Prevention. (n.d.). Retrieved
from website:
http://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm
3. (n.d.). Retrieved from
http://www.cdc.gov/cancer/lung/what_cdc_is_doing/index.htm
4. U.S. Department of Health and Human Services. (n.d.).
Retrieved from website:
http://www.healthypeople.gov/2020/about/default.aspx
5. Witschi, H. (n.d.). Retrieved from
http://toxsci.oxfordjournals.org/content/64/1/4.full