Lung Cancer

Lung Cancer

This article describes the impact of lung cancer on men’s health with an emphasis on prevention and early detection. Lung cancer should be a significant concern to all men in the United States as it remains the most common cause of death from cancer in the United States. Unfortunately, the US had a long history of promoting cigarette smoking in the mass media, pop culture and in the military. In 1970 the United States banned television advertisements for cigarettes. Since then public health efforts have helped to decrease rates of smoking. There are several different kinds of lung cancer but the most common risk factor for the most common types of lung cancer is unequivocally tobacco smoking. Smoking increases the risk of lung cancer by 22-fold. This highlights the importance of avoiding smoking and quitting. This article will discuss the different kinds of lung cancer, symptoms and treatment options; but the single biggest effect you can have to prevent lung cancer is to not smoke.

Often some (always a current smoker) will say, “But I know people who have smoked heavily for years and they NEVER got lung cancer!” There is a shard of truth in this sentiment; the actual risk of lung cancer is around 10% for very heavy smokers. What these people fail to recognize in their “logic” is that smoking affects every part of the body and dramatically increases risk for many other cancers such as bladder and pancreas cancer. Cigarette smoke is very damaging to the lining of arteries and increases risk of aneurysm, stroke and heart attack. Even without lung cancer, cigarette smoke causes serious permanent damage to the function of the lungs.

The lungs are often depicted in a cartoon fashion as two balloons. While they do inflate, their structure is far more complex. The entire airway system includes the connecting areas such as mouth, throat and the large bridging airways such as the trachea. The airways that connect the lungs to the central tube (trachea) undergo branches like a tree. There is usually 23 divisions or generations of airways before the air is able to reach the “business end” of the lung where the action occurs. The functional unit of the lungs is the alveoli which are microscopic sacs or divisions in the lung with thin membranes that allow diffusion of gas across it. This is where gases such as oxygen and carbon dioxide diffuse down their gradient. The lungs are divided among lobes; three on the right and two on the left. Each lobe has segments and each segment has clustered areas of bronchi, and so on. The many divisions of the lung account for its large surface area – about the size of a tennis court.

Irritation of the airways or difficulty with clearance of debris in the air can cause cough. Cough can also be produced from excessive production of mucus. Cough can also arise from excessive nasal secretions that can drip down stimulating the cough reflex. Asthma tends to cause cough also because of irritation of the airways.

Understanding the normal lung function allows insight into the broad range of symptoms that might occur with lung disease. There are literally hundreds of possible lung diseases, but many of these diseases have symptoms in common. There are several different cell types in the lung. This helps explain the different types of lung cancers that can arise from each of these cell types. The commonest type of lung tumors is called non-small cell (85%), with 15% being small cell. Subtypes can include:

  • adenocarcinoma
  • bronchoalveolar carcinoma
  • neuroendocrine tumors (carcinoid)

Lung cancer is a very important public health concern because it is the most common cause of death from cancer for men and women in the United States. Many lung cancers do not cause obvious symptoms and require screening with chest x-ray for early detection. Some signs or symptoms which can be present with lung cancer include:

  • weight loss (unexplained or unintentional)
  • cough, dry
  • cough, bloody (also known as hemoptysis)
  • chest pain
  • shortness of breath

Treatment options depend both on the type of cancer, amount of cancer present and the general health condition of the person with the cancer. Even with a potentially curable lung tumor, if someone has severe lung disease having to stay constantly on supplemental oxygen and having had a recent heart attack – they will not be a candidate for surgery. In order to be healthy enough to have aggressive surgical treatment, most people must be in reasonable health and have stopped smoking to have the best chance at a good outcome or even cure. Like all cancers, if caught early enough lung cancer is potentially curable unfortunately many people already have cancer that has spread by the time it is diagnosed.

After diagnosis, usually by some type of sample or biopsy, the stage of the cancer needs to be determined. The staging of lung cancer is very complex and even cancer specialists need to refer to the charts to keep it all straight. In a broad way there are four stages to lung cancer. Improved treatment is leading to longer survival, but lung cancer is still very difficult to treat. The five-year survival of all stages together is 17% for non-small cell cancer. When the disease is at an earlier stage, five-year survival is longer, as high as 53%.

The above statistics are very broad and do not apply to all lung tumors and situations. Treatment options for lung cancer are also quite diverse and might include chemotherapy, radiation, surgical removal of a lung or some combination of these.

REFERENCES:

  1. www.cdc.gov/cancer/lung/
  2. www.cancer.gov/cancertopics/types/lung
  3. Townsend Jr, CM; Beauchamp RD; Evers BM; Mattox KL. (2008) Townsend: Sabiston Textbook of Surgery, 18th ed. Chapter 59. New York, NY: Saunders.
  4. Goldman L, Schafer, AI; (2011) Goldman: Goldman’s Cecil Medicine, 24th ed. Chapter 85. New York, NY: Elsevier
  5. American Cancer Society. Cancer Facts & Figures 2011. Atlanta: American Cancer Society; 2011.
  6. This article was originally published on September 3, 2012 and last revision and update was 9/4/2015.