Lung Cancer PDF - Pathophysiology, Diagnosis, and Treatment

Lung Cancer Treatment Diagnostic criteria Clinical manifestations Pathophysiology  Lung Canc...

Lung Cancer Treatment Diagnostic criteria Clinical manifestations Pathophysiology  Lung Cancer Pathophysiology Leading cause of cancer deaths worldwide Smoking and environmental toxin exposures are implicated The 10 cancers with highest mortality in Australia, 2008 Craft AJ, Gordon C, Tiziani A. Understanding pathophysiology. 1st ed. Chatswood, Mosby; 2011  Lung Cancer There are two main types of lung cancer: 1. small-cell lung cancer (SCLC) 15%. 2. non-small cell lung cancer (NSCLC) 85%. Adenocarcinoma - the most common NSCLC subtype, occurs in the cells lining the alveoli https://bpspubs.onlinelibrary.wiley.com/doi/pdf/10.1002/prp2.528 Squamous cell carcinoma - generally found in the airways or bronchi Large cell carcinoma- in the edges of the lungs  Lung Cancer Pathophysiology Tumors growth is initiated by mutations that can Activate oncogenes Subdue tumor suppressor genes Lung cancer is the end stage of multiple mutations and cellular transformation 1. Tumor enlarge 2. Penetrate epithelial layer 3. Move into lung tissue, pleural cavity, chest wall (seeding) 4. Metastatic spread: lymph channels, blood vessel Lung cancer is tropic to bone, liver, brain Craft AJ, Gordon C, Tiziani A. Understanding pathophysiology. 1st ed. Chatswood, Mosby; 2011  Lung Cancer Pathophysiology Tumors growth is initiated by mutations that can Activate oncogenes Subdue tumor suppressor genes Lung cancer is the end stage of multiple mutations and cellular transformation Craft AJ, Gordon C, Tiziani A. Understanding pathophysiology. 1st ed. Chatswood, Mosby; 2011  Lung Cancer ClinicalManifestations Common clinical manifestations relates to location Persistent cough Hemoptysis (blood in sputum) Chest pain Shortness of breath Often ignored as “smoker’s cough” Common general manifestations are present Paraneoplastic manifestations are present  Lung Cancer Diagnostic Criteria History taking, physical examination Bronchoscopy Chest x-ray Tissue biopsy/cytology MRI/CT/Ultrasound Prognosis is based on Molecular characteristics of cancer cells Ability to remove tumor Lymph node involvement Presence of metastasis http://www.cancer.gov/types/lung/patient/small-cell-lung-treatment-pdq  Lung Cancer Staging Lung Cancer is usually staged using the TNM (Tumor, Nodes, Metastasis) staging system Specific combinations of the TNM system are then used to determine the cancer’s stage from 0 to IV, with lower stages being the least advanced.  Lung Cancer Treatment Overall 5-year survival rate: NSCLC= 24% (USA) SCLC= 6% (USA) 67.7% 32.3% 17.1% 3.2% https://www.cancer.org.au/assets/pdf/understanding-lung-cancer-booklet Treating Metastatic or advanced disease