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Lung cancer

Changed by Ayush Goel, 19 Nov 2017
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Updates to Article Attributes

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Lung cancer, or frequently, if somewhat incorrectly, known as bronchogenic carcinoma, is the most common cause of cancer in men, and the 6th most frequent cancer in women worldwide. It is the leading cause of cancer mortality worldwide in both men and women and accounts for approximately 20% of all cancer deaths 1.

Epidemiology

Lung cancer is the most common fatal malignancy worldwide both in male and female. 

Clinical presentation

Patients with lung cancer may be asymptomatic in up to 50% of cases. Cough and dyspnoea are rather non-specific symptoms that are common amongst those with lung cancer.

Central tumours may result in haemoptysis and peripheral lesions with pleuritic chest pain.

Pneumonia, pleural effusion, wheeze, lymphadenopathy are not uncommon. Other symptoms may be secondary to metastases (brain, liver, bone) or to paraneoplastic syndromes.

Pathology

The term bronchogenic carcinoma is somewhat loosely used to refer to primary malignancies of the lung that are associated with inhaled carcinogens 1 and includes four main histological subtypes. These are broadly divided into non small-cell carcinoma and small cell carcinoma as they are differ clinically in terms of presentation, treatment and prognosis:

Other malignant pulmonary neoplasms include lymphoma and sarcoma (rare).

Each subtype has a different radiographic appearance, demographic, and prognosis:

Risk factors

The major risk factor is cigarette smoking which is implicated in 90% of cases and increase the risk of lung cancer, which can be divided by histological subtype 10:

  • squamous cell lung cancer: 11x (men), 15x (women)
  • small cell lung cancer: 10x (men), 25x (women)
  • large cell lung cancer: 7x (men), 8x (women)
  • lung adenocarcinoma: 4x (men and women)

Other risk factors:

Staging
Associations

Various paraneoplastic syndromes can arise in the setting of lung cancer:

Treatment and prognosis

Treatment and prognosis variesvary not only with stage, but also with cell type. In general, surgery, chemotherapy, and radiotherapy are offered according to the stage, resectability, operability, and functional status.

Non small cell carcinoma
  • treatment
    • operable disease (stage I to IIIA): surgery
    • unresectable disease: neoadjuvant chemotherapy, radiotherapy
    • advanced disease: palliative combined chemotherapy
  • prognosis (5 year survival rates):
    • local (stage I): 55-67%
    • locally advanced (stages II-IIIA): 23-40%
    • advanced (stages IIIB and IV): 1-3%
Small-cell carcinoma
  • treatment
    • limited disease: chemoradiotherapy
    • extensive disease: palliative combined chemotherapy
  • prognosis: poor
    • limited: 5 year survival rate 15-25%
    • extensive: 2 year survival 20% (with palliative combined chemotherapy and supportive care)

See also

  • -<p><strong>Lung cancer</strong>, or frequently, if somewhat incorrectly, known as <strong>bronchogenic carcinoma</strong>, is the most common cause of cancer in men, and the 6<sup>th</sup> most frequent cancer in women worldwide. It is the leading cause of cancer mortality worldwide in both men and women and accounts for approximately 20% of all cancer deaths <sup>1</sup>.</p><h4>Epidemiology</h4><p>Lung cancer is the most common fatal malignancy worldwide both in male and female. </p><h4>Clinical presentation</h4><p>Patients with lung cancer may be asymptomatic in up to 50% of cases. Cough and dyspnoea are rather non-specific symptoms that are common amongst those with lung cancer.</p><p>Central tumours may result in <a href="/articles/haemoptysis-1">haemoptysis</a> and peripheral lesions with pleuritic chest pain.</p><p>Pneumonia, pleural effusion, wheeze, lymphadenopathy are not uncommon. Other symptoms may be secondary to <a href="/articles/pulmonary-metastases">metastases</a> (brain, liver, bone) or to paraneoplastic syndromes.</p><h4>Pathology</h4><p>The term bronchogenic carcinoma is somewhat loosely used to refer to primary malignancies of the lung that are associated with inhaled carcinogens <sup>1</sup> and includes four main histological subtypes. These are broadly divided into non small-cell carcinoma and small cell carcinoma as they are differ clinically in terms of presentation, treatment and prognosis:</p><ul>
  • +<p><strong>Lung cancer</strong>, or frequently, if somewhat incorrectly, known as <strong>bronchogenic carcinoma</strong>, is the most common cause of cancer in men, and the 6<sup>th</sup> most frequent cancer in women worldwide. It is the leading cause of cancer mortality worldwide in both men and women and accounts for approximately 20% of all cancer deaths <sup>1</sup>.</p><h4>Epidemiology</h4><p>Lung cancer is the most common fatal malignancy worldwide both in male and female. </p><h4>Clinical presentation</h4><p>Patients with lung cancer may be asymptomatic in up to 50% of cases. Cough and dyspnoea are rather non-specific symptoms that are common amongst those with lung cancer.</p><p>Central tumours may result in <a href="/articles/haemoptysis-1">haemoptysis</a> and peripheral lesions with pleuritic chest pain.</p><p>Pneumonia, pleural effusion, wheeze, lymphadenopathy are not uncommon. Other symptoms may be secondary to <a href="/articles/pulmonary-metastases">metastases</a> (brain, liver, bone) or to paraneoplastic syndromes.</p><h4>Pathology</h4><p>The term bronchogenic carcinoma is somewhat loosely used to refer to primary malignancies of the lung that are associated with inhaled carcinogens <sup>1</sup> and includes four main histological subtypes. These are broadly divided into non small-cell carcinoma and small cell carcinoma as they differ clinically in terms of presentation, treatment and prognosis:</p><ul>
  • -<a href="/articles/siadh">SIADH</a> causing hyponatraemia: small-cell sub type</li>
  • -<li>ACTH secretion (<a href="/articles/cushing-syndrome">Cushing syndrome</a>): carcinoid and small-cell sub types</li>
  • +<a href="/articles/siadh">SIADH</a> causing hyponatraemia: small-cell subtype</li>
  • +<li>ACTH secretion (<a href="/articles/cushing-syndrome">Cushing syndrome</a>): carcinoid and small-cell subtypes</li>
  • -</ul><h4>Treatment and prognosis</h4><p>Treatment and prognosis varies not only with stage, but also with cell type. In general, surgery, chemotherapy, and radiotherapy are offered according to <a href="/articles/lung_cancer_staging">stage</a>, resectability, operability, and functional status.</p><h5>Non small cell carcinoma</h5><ul>
  • +</ul><h4>Treatment and prognosis</h4><p>Treatment and prognosis vary not only with stage but also with cell type. In general, surgery, chemotherapy, and radiotherapy are offered according to the <a href="/articles/lung_cancer_staging">stage</a>, resectability, operability, and functional status.</p><h5>Non small cell carcinoma</h5><ul>
  • -</ul><h4>See also</h4><ul><li>
  • -<a href="/articles/benign-lung-tumours">​</a><a href="/articles/ct-guided-thoracic-biopsy">CT guided thoracic biopsy</a>
  • -</li></ul>
  • +</ul><h4>See also</h4><ul><li><a href="/articles/ct-guided-thoracic-biopsy">CT guided thoracic biopsy</a></li></ul>

Systems changed:

  • Oncology

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