INTRODUCTION

What

Why

How

WHAT IS LUNG CANCER

Genetic damageDEATH

(Bronchogenic)Cancer

OrCarcinoma

AT MOLECULAR LEVELGenetic 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

HOW COMMON IS LUNG CANCER?

reports OVER1.1 million people die of lung

cancer each year.

WHO

RISK FACTORS Carcinogens

Smokers

60Lung cancer

6Non smoker

1

85%

Smoking 300,000 deaths each year

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.

RISK FACTORS

Second-Hand Smoke

The lungs of anyone who breathes in air that contains tobacco smoke are

exposed to its carcinogens.

EXPOSED RISK OF LUNG CANCER

side-stream smoke, environmental tobacco smoke, passive smoke.

Children

RISK FACTORSEnvironmental Carcinogens

Asbestos

Radon

Radon is a naturally occurring, radioactive gas.

It is odourless and tasteless.

Formed from the radioactive decay of uranium.

Underground miners.

Arsenic (naturally)

inorganicorganic (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

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.

Other Environmental Lung Carcinogens

bis(chloromethyl)ether,chloromethyl methyl ether, ionizing radiation (x-rays), gamma radiation, mustard gas, soots, tars, mineral oils,vinyl chloride.

Suspected lung carcinogens include acrylonitrile,

cadmium, beryllium,

lead,ferric oxide dust.

Age

Genetic Factors

Among men, black men were diagnosed with lung cancer most often, followed by white, American Indian/Alaska Native, Asian/Pacific Islander, and Hispanic men

LUNG CANCER GROWTH

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.

Very Slow

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.

TYPES OF LUNG CANCER

Small cell lung cancer (SCLC) Non-small cell lung cancer (NSCLC)

80%20%

Large cell carcinomaAdenocarcinomaSquamous cell carcinoma

SCLC and NSCLC have different patterns of growth and spread. They are also treated differently.

A cancer arising in the epithelial tissue of the skin or of the lining of

the internal organs.

Small Cell Lung Canceroat cell carcinoma

Small cell undifferentiated carcinoma

Abnormally small

Grows faster

Spread faster

SCLC tumours are often located near the

centre of the lung.

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.

Non-Small Cell Lung Cancer

Squamous Cell Carcinoma (Epidermoid 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.

Non-Small Cell Lung CancerLarge 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.

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.

Malignant Pleural Mesothelioma (MPM)

75% occur in the pleura of the lungs.

MPM is a rare form of primary cancer.

Asbestos is the predominant cause of MPM.

Surgery is the mainstay of treatment for localized MPM.

Epithelioid typeSarcomatoid Mixed/biphasic mesotheliomas.

THREE TYPES

STAGES

3 factors determine stage:

• The size and characteristics of the original or primary tumour.

• Spread of the cancer to regional lymph nodes.

• The presence or absence of distant metastases.

Stages of non-small cell lung cancerStage 1 Caner is only in lungs not in lymph glands.

Stage 2

2A Cancer is small but it spreads to lymph glands.

2B Cancer is slightly larger and it spreads to lymph glands.

Stage 3

3A Caner cells have spread to the lymph glands furthest away from the affected lung.

3B One more tumor in the lung or other area in chest such as heart (or) Cancer cells are present in fluid around the lungs.

Stage 4 Cancer spread to various parts of body such as liver or bone.

Stages of Small cell lung cancerLimited Cancer cells are present only in one lung.

Extensive Cancer cells are spread to other parts of the body.

SYMPTOMS

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

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)

PDT is the use of drugs that are sensitive to light (photo-sensitizing drugs).

Photo chemotherapy or photo radiation therapy

CONCLUSION

Thanks to All