Clin Med 2 - Lung Cancer (Pulm 7)
-rare prior to 1900s
-WWI free cigarettes to soldiers
-1930s suspected link between smoking/lung cancer
-1964 surgeon general's report declared cigarette smoking a health hazard
-1970 number one cancer killer
✅✅
-1987 surpassed breast cancer for #1 death in women
-2023 - more lung cancer deaths than breast + prostate + CRC - -brief history
of lung cancer
-smoking (85-90%)
-occupation or environment (radon)
-genetics/family hx
-benign lung diseases
✅✅
-radiation exposure
-second/third-hand smoke - -risk factors for lung cancer development
smoking and radon - ✅✅-top 2 risk factors for developing lung cancer
radon - ✅✅ -radioactive gas from decay of uranium in rocks, can lead to lung
cancer; seeps into home via running water, cracks in foundation
secondhand smoke - ✅✅ -smoke inhaled involuntarily from tobacco being smoked
by others; contains 250 toxic gasses, chemicals, metals
cotinine -✅✅ -a major metabolite of nicotine; can be measured in pts waiting for
lung transplants to ensure they're no longer smoking
✅✅
declining in non-smokers - 1988/91 was 87.9%, in 2007/08 it was 40.1% -
-amount of cotinine levels in non-smokers
third hand smoke - ✅✅ -tobacco smoke that lingers after a cigarette is
extinguished, can cling to walls, ceilings, carpets, draperies, furniture
young children; put hands in mouths after touching surfaces - ✅✅-population most
at risk from third-hand smoke
✅✅-2 major groupings of lung cancers
1. small cell
2. non-small cell -
small cell lung cancer - ✅✅-group of lung cancers that includes classic small cell,
large cell neuroendocrine, and combined
, non-small cell lung cancer - ✅✅ -a group of lung cancers that includes squamous
cell carcinoma, adenocarcinoma, and large cell carcinoma
-classic small cell carcinoma
✅✅
-large cell neuroendocrine
-combined - -types of small cell lung cancer
-adenocarcinoma
✅✅-types of non-small cell lung cancer
-squamous cell carcinoma
-large cell undifferentiated carcinoma -
NSCLC 82% - ✅✅-most common type of lung cancer
adenocarcinoma - ✅✅-most common type of NSCLC
large cell undifferentiated carcinoma - ✅✅-malignant epithelial neoplasm lacking
glandular or squamous differentiation, typically presents as large peripheral mass
with prominent necrosis
squamous cell carcinoma - ✅✅ -malignant tumor that occurs centrally, classically
associated with hx of smoking; may show extensive central necrosis and cavitation
(most frequent type until filtered cigarettes invented)
✅✅
filtered cigarette invention -> allowed deeper breaths with smoking -> toxins able to
permeate deeper into lung tissue - -switch from squamous cell to
adenocarcinoma as most common lung cancer
adenocarcinoma of the lung - ✅✅ -most common type of lung cancer typically
found in lung periphery, shows as hazy densities/opacities
adenocarcinomas - ✅✅
-lung cancer becoming more frequent in young females
who have NEVER smoked - maybe due to estrogen as tumor promoter in lung
cancer
-adenocarcinoma in-situ
✅✅
-minimally invasive adenocarcinoma
-invasive adenocarcinoma - -types of adenocarcinoma of the lung
1. aggressive biology of the disease
2. lack of effective screening test
✅✅
3. absence of symptoms until locally advanced or metastatic disease present -
-3 reasons why lung cancer is so deadly
-cough
-rare prior to 1900s
-WWI free cigarettes to soldiers
-1930s suspected link between smoking/lung cancer
-1964 surgeon general's report declared cigarette smoking a health hazard
-1970 number one cancer killer
✅✅
-1987 surpassed breast cancer for #1 death in women
-2023 - more lung cancer deaths than breast + prostate + CRC - -brief history
of lung cancer
-smoking (85-90%)
-occupation or environment (radon)
-genetics/family hx
-benign lung diseases
✅✅
-radiation exposure
-second/third-hand smoke - -risk factors for lung cancer development
smoking and radon - ✅✅-top 2 risk factors for developing lung cancer
radon - ✅✅ -radioactive gas from decay of uranium in rocks, can lead to lung
cancer; seeps into home via running water, cracks in foundation
secondhand smoke - ✅✅ -smoke inhaled involuntarily from tobacco being smoked
by others; contains 250 toxic gasses, chemicals, metals
cotinine -✅✅ -a major metabolite of nicotine; can be measured in pts waiting for
lung transplants to ensure they're no longer smoking
✅✅
declining in non-smokers - 1988/91 was 87.9%, in 2007/08 it was 40.1% -
-amount of cotinine levels in non-smokers
third hand smoke - ✅✅ -tobacco smoke that lingers after a cigarette is
extinguished, can cling to walls, ceilings, carpets, draperies, furniture
young children; put hands in mouths after touching surfaces - ✅✅-population most
at risk from third-hand smoke
✅✅-2 major groupings of lung cancers
1. small cell
2. non-small cell -
small cell lung cancer - ✅✅-group of lung cancers that includes classic small cell,
large cell neuroendocrine, and combined
, non-small cell lung cancer - ✅✅ -a group of lung cancers that includes squamous
cell carcinoma, adenocarcinoma, and large cell carcinoma
-classic small cell carcinoma
✅✅
-large cell neuroendocrine
-combined - -types of small cell lung cancer
-adenocarcinoma
✅✅-types of non-small cell lung cancer
-squamous cell carcinoma
-large cell undifferentiated carcinoma -
NSCLC 82% - ✅✅-most common type of lung cancer
adenocarcinoma - ✅✅-most common type of NSCLC
large cell undifferentiated carcinoma - ✅✅-malignant epithelial neoplasm lacking
glandular or squamous differentiation, typically presents as large peripheral mass
with prominent necrosis
squamous cell carcinoma - ✅✅ -malignant tumor that occurs centrally, classically
associated with hx of smoking; may show extensive central necrosis and cavitation
(most frequent type until filtered cigarettes invented)
✅✅
filtered cigarette invention -> allowed deeper breaths with smoking -> toxins able to
permeate deeper into lung tissue - -switch from squamous cell to
adenocarcinoma as most common lung cancer
adenocarcinoma of the lung - ✅✅ -most common type of lung cancer typically
found in lung periphery, shows as hazy densities/opacities
adenocarcinomas - ✅✅
-lung cancer becoming more frequent in young females
who have NEVER smoked - maybe due to estrogen as tumor promoter in lung
cancer
-adenocarcinoma in-situ
✅✅
-minimally invasive adenocarcinoma
-invasive adenocarcinoma - -types of adenocarcinoma of the lung
1. aggressive biology of the disease
2. lack of effective screening test
✅✅
3. absence of symptoms until locally advanced or metastatic disease present -
-3 reasons why lung cancer is so deadly
-cough
