For better understanding, I recommend the viewers to download the ppt and please go through the following website : http://www.sign.ac.uk/pdf/pat80.pdf
www.lungcancerguidebook.org/lcguidebook_aug05/ch3_0605.pdf
If u have any doubts convey through comments.. Thanks to all...
4. AT MOLECULAR LEVEL
Genetic changes include mutation of key regulatory genes, changes
in protein products, and changes in gene expression.
As changes accumulate, cells become more abnormal and cancer progresses
There are over 100 genes known to be associated with the
development of lung cancer.
Ras
Myc
Rb retinoblastoma gene (Rb)
TP53
Epidermal Growth Factor Receptor (EGFR) , erbB1, HER1
5. HOW COMMON IS LUNG CANCER?
WHO reports OVER 1.1 million people die of lung
cancer each year.
6. RISK FACTORS Carcinogens
85%
Smokers Lung cancer Non smoker
60 6 1
Smoking 300,000 deaths each year
7. RISK FACTORS
Smoking
Ten years after quitting, lung cancer risk drops to a level that is only
20-50% of the risk experienced by those who continue to smoke.
8. RISK FACTORS side-stream smoke,
environmental tobacco smoke,
Second-Hand Smokepassive smoke.
The lungs of anyone who breathes in air that contains tobacco smoke are
exposed to its carcinogens.
EXPOSED RISK OF LUNG CANCER
Children
9. RISK FACTORS
Environmental Carcinogens
Asbestos
Radon
Radon is a naturally occurring, radioactive gas.
It is odourless and tasteless.
Formed from the radioactive decay of uranium.
Underground miners.
10. Arsenic (naturally)
organic inorganic (carcinogen)
Insecticides, weed killers, rat poison, Fungicides,
wood preservatives, Paints, leather industry.
Chromium
• Natural element, odourless and tasteless.
• Chromium (VI) or hexavalent chromium is
carcinogenic.
• Chrome plating, Stainless steel welding
11. Nickel
Polycyclic Aromatic Hydrocarbons (PAHs
A group of over 100 different chemicals that
are formed during the incomplete burning of coal,
oil, gas, garbage.
Diesel fuel exhaust is a prevalent source of PAHs.
Some PAHs are used to make medicines, dyes, plastics, and pesticides.
13. Among men, black men were diagnosed with lung cancer most
often, followed by white, American Indian/Alaska Native, Asian/Pacific
Islander, and Hispanic men
A
g
e
Genetic Factors
14. LUNG CANCER GROWTH Very Slow
In Average, it takes 8-15 years to grow 1 centimetre in diameter.
But, they have the ability to spread or metastasize to other parts of the
body early in their growth.
This process is called early micrometastasis, metastasis that is
not detectable by ordinary means.
15. LUNG CANCER SPREAD
Spread of the tumour can occur by the lymphatic vessels to lymph
nodes located within the lung, mediastinum and thorax.
Most cancer cells that enter the bloodstream die.
If spread by the blood stream, it can lead to deposits of tumour in the
liver, opposite lung, bone and brain.
The process of determining whether lung cancer
has spread beyond the original tumour is called
staging.
16. TYPES OF LUNG CANCER
A cancer arising in the
20% epithelial tissue of the
80%
skin or of the lining of
Non-small cell lung cancer (NSCLC)
Small cell lung cancer (SCLC)
the internal organs.
Squamous cell carcinoma Adenocarcinoma Large cell carcinoma
SCLC and NSCLC have different patterns of growth and spread.
They are also treated differently.
17. oat cell carcinoma
Small Cell Lung Cancer
Small cell undifferentiated carcinoma
Abnormally small
Grows faster
Spread faster
SCLC tumours are often located near the
centre of the lung.
18. Non-Small Cell Lung Cancer
Similar growth patterns and are treated similarly.
Each has variants or subtypes
Adenocarcinoma
Have a glandular appearance.
Most of these tumours produce a thick fluid called mucin.
Variants are
acinar adenocarcinoma, papillary adenocarcinoma,
bronchioloalveolar adenocarcinoma, and other mixed
subtypes.
Tumours are most often in the outer regions of the lungs.
Mostly associated with scarring of the lung tissue.
19. Non-Small Cell Lung Cancer
(Epidermoid carcinoma)
Squamous Cell Carcinoma
Squamous cells are large and flat.
These tumours often produce a substance called
keratin.
Variants of SCC include
Papillary SCC, clear cell SCC, small cell SCC,
and basaloid SCC.
Central area of the lung.
20. Non-Small Cell Lung Cancer
Large Cell Carcinoma (LCC) largest
The cells are generally highly undifferentiated or
immature in appearance.
Variants are
including clear cell LCC, basaloid LCC,
lymphoepithelioma-like carcinoma, and
large cell neuroendocrine carcinoma.
Any part of the lung.
unrecognizable
The prognosis for large cell carcinoma is generally
less favourable than for other forms of NSCLC.
21. Carcinoid Tumours
Arise from neuroendocrine cells. (specialized nerve cells that
produce hormones)
Although it is uncommon, they secrete high levels of
hormones which can lead to symptoms such as bouts of
diarrhoea.
TYPICAL(a) and ATYPICAL(b) variants.
Carcinoids account for 1-5% of all lung tumours.
They do not metastasize.
Tumours can often be cured by surgical removal.
Atypical carcinoid tumours are more aggressive with a greater
tendency for distant metastasis and recurrence than
typical carcinoid tumours.
22. Malignant Pleural Mesothelioma (MPM)
75% occur in the pleura of the lungs.
MPM is a rare form of primary cancer.
THREE TYPES
Epithelioid type
Sarcomatoid
Mixed/biphasic mesotheliomas.
Asbestos is the predominant cause of MPM.
Surgery is the mainstay of treatment for localized MPM.
23. Stages of non-small cell lung cancer
Stage 1
Stage 2
STAGESCaner is only in lungs not in lymph glands.
2A Cancer is small but it spreads to lymph glands.
2B
Stage 3
3A
3 Cancer is slightly larger and it spreads to lymph glands.
factors determine stage:
Caner cells have spread to the lymph glands furthest away from the
affected lung.
•
3B TheOne more tumor in the lung or other area in chest such as primary
size and characteristics of the original or heart
tumour.
(or)
Cancer cells are present in fluid around the lungs.
Stage 4 Cancer spread to various parts of body such as liver or bone.
• Spread of the cancer to regional lymph nodes.
Stages of Small cell lung cancer
Limited • TheCancer cells are present only inof distant metastases.
presence or absence one lung.
Extensive Cancer cells are spread to other parts of the body.
25. DIAGNOSIS
A chest X-ray is one of the most useful examination tools.
CT (computerized tomography)
MRI
PET (Positron Emission Tomography) scans can be used to look at lung
cancers
Cells must be examined under a microscope.
Cells may come from sputum samples, pleural fluid (fluid on the lungs),
brushings or washings of the bronchi
Bronchoscopy.
A needle biopsy may also be used for diagnosis.
Mediastinoscopy and mediastinotomy
Thoracotomy
26. TREATMENT
Standard treatments for lung cancer may include
Surgery
Radiation therapy (also called radiotherapy)
Chemotherapy.
Early lung cancers may be treated with a laser therapy.
Most patients have more than one type of treatment
(combination of therapies).
Photodynamic Therapy (PDT)
Photo chemotherapy or photo radiation therapy
PDT is the use of drugs that are sensitive to light (photo-sensitizing drugs).