Definition:

Lung cancer is the leading cause of cancer deaths in the world.  There are several types of lung cancer, and the most important risk factors are smoking and radon/asbestos exposure

• Small-cell lung cancer - linked heavily with cigarette smoke exposure, can cause paraneoplastic syndromes, and commonly presents with metastasis (invasion of other organs)
• Non-small cell lung cancer (NSCLC) - does not metastasize as much
  • Adenocarcinoma - most common, seen with chronic lung tissue irritation
  • Bronchoalveolar carcinoma - usually causes increased sputum production with lots of nodules
• Squamous cell carcinoma - mostly seen in smokers
• Large cell/neuroendocrine carcinoma - i.e. mesothelioma, least common with poor prognosis

Symptoms:

• Chronic cough
• Shortness of breath
• Hemoptysis (coughing up blood)
• Sputum production
• Weight loss
• Chest pain
• Horner's syndrome - triad of constricted pupils, drooping eyelids, and absent sweating from one side of face; seen in tumors at top of lungs
• Paraneoplastic syndrome - tumor cells producing another substance a body can react to

Diagnosis:

• Chest X-Ray - screening tool, can see tumor in lungs
• CT scan of chest - to clearly visualize tumor and spread
• Fine-needle aspiration - to get tumor cells to determine cell type
• Bronchoscopy with biopsy/brushing - to get tumor cells to determine cell type
• Mediastinoscopy - to obtain mediastinal lymph nodes for staging and determine cell type

Treatment:

• Small-cell lung cancer
  • Usually cannot perform surgery
  • Radiation and chemotherapy used initially
• NSCLC
  • Can do surgery at early stages
    • Wedge resection (take out tumor and local lung tissue)
    • Lobectomy (take out tumor with lung lobe)
    • Pneumonectomy (take out tumor with entire lung)
  • Radiation and chemotherapy for later stage or metastatic disease