Lung Cancer
Lung cancer is the most common cancer in men and women, approximately 220,000 diagnoses per year in the US. Somewhere between 1.5 and 2 million people are diagnosed worldwide with cancer, and it is an extremely lethal disease. It is the leading cause of cancer death, approximately 160,000 deaths per year in the U.S, and 1.3 million worldwide. We do a very poor job of being able to cure lung cancer, because by the time it's diagnosed, it is too far advanced to be treated locally for cure with surgery or radiation. It is a lethal disease. There are many sub types of lung cancer but 85% of them are called non-small-cell lung cancers or NSCLC. They come in various histologies. Adenocarcinoma is the most common, 40%. But then, there's squamous cell carcinoma and large cell carcinoma. By and large, although we have different histologies for these cancers, they are essentially treated very similarly. On the right you have a picture of lungs, you notice they're very brown. That's because this was a smoker, and you see a big white cancer in the middle of the lung field there.
What are the risk factors for lung cancer? Smoking, smoking, smoking. 87% of lung cancer deaths in men and 70% in women are likely caused by smoking. Risk of developing lung cancer is 25-times higher In smokers as compared to nonsmokers. Many other lung cancers are linked to secondhand smoke. Let me repeat, the number one risk factor for lung cancer is smoking, smoking, smoking. Primary smoking and secondary inhalation of smoke when you are exposed to it. This is why in the United States, smoking has been banned in restaurants and most public places because it is well-known that secondhand smoke is linked to a risk of lung cancer. Other risk factors include radon, asbestos, arsenic, radioactive ores like uranium, and inhaled chemicals. In other words, inhaled substances that damage the lungs.
This makes lung cancer prevention fairly straightforward. Stop smoking, do not let yourself be exposed to secondhand smoke. Stop smoking, do not let yourself be exposed to second hand smoke. If you can decrease exposures, for example wearing a air mask if you're a uranium miner, you can decrease your chance of developing lung cancer. So smoking cessation and decreased exposures are the way to prevent lung cancer.
Many studies have been done looking to try to understand, can we screen for lung cancer? Many things have been tried, including x-rays and computed tomography scans, and sputum tests. There was a large study, called the National Lung Screening Trial, that looked at men and women 55 to 74 years old who were otherwise in good health, who had at least a 30 pack-year smoking history. That means they smoked at least one pack of cigarettes per day for 30 years. That means they have a 30 pack-year smoking history. If they have smoked half a pack a day for 30 years they would have a 15 pack-year smoking history. If you smoked two packs a day per year it would be a 60-pack year smoking history. The other way to be eligible for this trial was to be still smoking or to have quit smoking within the last 15 years. If a man or woman meets those criteria, it was noted that they could be screened with a CAT scan yearly for three years in a row to look for early lung cancers. And that this could actually detect lung cancers and remove them before they became lethal. So, this is the recommended lung cancer screening but only if you have these characteristics. We do not know how to screen for lung cancer in other populations or for people that potentially have less of a pack year smoking history.
Lung cancer is the most common cancer in men and women, approximately 220,000 diagnoses per year in the US. Somewhere between 1.5 and 2 million people are diagnosed worldwide with cancer, and it is an extremely lethal disease. It is the leading cause of cancer death, approximately 160,000 deaths per year in the U.S, and 1.3 million worldwide. We do a very poor job of being able to cure lung cancer, because by the time it's diagnosed, it is too far advanced to be treated locally for cure with surgery or radiation. It is a lethal disease. There are many sub types of lung cancer but 85% of them are called non-small-cell lung cancers or NSCLC. They come in various histologies. Adenocarcinoma is the most common, 40%. But then, there's squamous cell carcinoma and large cell carcinoma. By and large, although we have different histologies for these cancers, they are essentially treated very similarly. On the right you have a picture of lungs, you notice they're very brown. That's because this was a smoker, and you see a big white cancer in the middle of the lung field there.
What are the risk factors for lung cancer? Smoking, smoking, smoking. 87% of lung cancer deaths in men and 70% in women are likely caused by smoking. Risk of developing lung cancer is 25-times higher In smokers as compared to nonsmokers. Many other lung cancers are linked to secondhand smoke. Let me repeat, the number one risk factor for lung cancer is smoking, smoking, smoking. Primary smoking and secondary inhalation of smoke when you are exposed to it. This is why in the United States, smoking has been banned in restaurants and most public places because it is well-known that secondhand smoke is linked to a risk of lung cancer. Other risk factors include radon, asbestos, arsenic, radioactive ores like uranium, and inhaled chemicals. In other words, inhaled substances that damage the lungs.
This makes lung cancer prevention fairly straightforward. Stop smoking, do not let yourself be exposed to secondhand smoke. Stop smoking, do not let yourself be exposed to second hand smoke. If you can decrease exposures, for example wearing a air mask if you're a uranium miner, you can decrease your chance of developing lung cancer. So smoking cessation and decreased exposures are the way to prevent lung cancer.
Many studies have been done looking to try to understand, can we screen for lung cancer? Many things have been tried, including x-rays and computed tomography scans, and sputum tests. There was a large study, called the National Lung Screening Trial, that looked at men and women 55 to 74 years old who were otherwise in good health, who had at least a 30 pack-year smoking history. That means they smoked at least one pack of cigarettes per day for 30 years. That means they have a 30 pack-year smoking history. If they have smoked half a pack a day for 30 years they would have a 15 pack-year smoking history. If you smoked two packs a day per year it would be a 60-pack year smoking history. The other way to be eligible for this trial was to be still smoking or to have quit smoking within the last 15 years. If a man or woman meets those criteria, it was noted that they could be screened with a CAT scan yearly for three years in a row to look for early lung cancers. And that this could actually detect lung cancers and remove them before they became lethal. So, this is the recommended lung cancer screening but only if you have these characteristics. We do not know how to screen for lung cancer in other populations or for people that potentially have less of a pack year smoking history.
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