lung cancer

Lung Cancer – An epithelial malignancy of the lungs, which accounts for 30% of all cancer deaths in the US, most of which are directly attributable to cigarette use Clinical Persistent cough, hemoptysis, chest pain, weight loss, nonresponsive pneumonia Types Non-small cell cancer–eg, squamous cell carcinoma, adenocarcinoma, bronchoalveolar; small cell (undifferentiated) carcinoma Epidemiology US, ±170,000 new cases, 1999; ±150,000 die/yr due to LC Sites of metastasis Brain, bone, liver, adrenal glands Etiology Most lung CA–83% is directly linked to cigarette smoking; the risk is higher with ↑ number of cigarettes smoked/day and earlier age of smoking; up to 3,000 lung CAs are attributable to second-hand smoke; other factors include high levels of pollution, radiation, and asbestos; cooks and chemists have an ↑ risk Diagnosis Cytology of sputum, biopsy by bronchoscopy, needle localization, or surgical excision Therapy Surgery for resectable non-small cell CA, based on the size of the primary tumor and extent of lymph node involvement and metastases; chemotherapy and/or RT for small cell CA Prognosis Once diagnosed, average Pt survives 1–2 yrs; 5-10% survive 5 yrs after diagnosis; Pts with small cell–undifferentiated carcinoma have a slightly better prognosis than those with squamous cell and bronchoalveolar carcinomas, if it responds to chemotherapy.

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