肺癌Lung Cancer Overview.pptVIP

Lung Cancer Overview Lung Cancer: What is it? Uncontrolled growth of malignant cells in one or both lungs and tracheo-bronchial tree Arises from protective or ciliated cells in the bronchial epithelium Begins as a result of repeated carcinogenic irritation causing increased rates of cell replication Proliferation of abnormal cells leads to hyperplasia, dysplasia or carcinoma in situ Lung Cancer: Incidence in US 173,770 new cases yearly (2004 statistics) 160,440 deaths yearly (2004 statistics) More deaths from lung cancer than prostate, breast and colorectal cancers combined Closely correlated with smoking patterns Decreasing incidence and deaths in men; continued increase in women Incidence and mortality rates higher for African Americans than white Americans Lung Cancer: What Causes It? Smoking Radiation Exposure Environmental/ Occupational Exposure Asbestos Radon Passive smoke Lung Cancer: Smoking Facts Tobacco use is the leading cause of lung cancer 87% of lung cancers are related to smoking Risk related to: amount smoked (pack years- # cigs/day x # yrs) age of smoking onset product smoked (tar/nicotine content, filters) depth of inhalation gender Lung Cancer: Screening No proven effective screening tool Chest X-ray commonly used Clinical trials: Low dose spiral chest CT scan Sputum analysis Chest X-ray Lung Cancer: Clinical Presentation Local Symptoms cough dyspnea hemoptysis recurrent infections chest pain Lung Cancer: Clinical Presentation Syndromes/Symptoms secondary to regional metastases: Esophageal compression ? dysphagia Laryngeal nerve paralysis ? hoarseness Symptomatic nerve paralysis ? Horner’s syndrome Cervical/thoracic nerve invasion ? Pancoast syndrome Lymphatic obstruction ? pleural effusion Vascular obstruction ? SVC syndrome Pericardial/cardiac extension ? effusion, tamponade Lung Cancer: Clinical Presentation Symptoms secondary to distant metastases pain organ-related General Symptoms weight loss fatigue Lung Cancer: Metastatic Sites Lymph