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Small cell cancer is a neuroendocrine tumor (this refers to the type of cell that a tumor grows from not the location) characterized by rapid growth, early metastasis (spread via lymphatic or blood vessels) and overall poorer chance for cure when compared to non-small cell lung cancer.
The category of non-small cell lung cancer is often divided into four separate cell types: Squamous cell, Adenocarcinoma, Large cell and Bronchioloalveolar cell.
Adenocarcinoma is more commonly found on the outer part of the lung or bronchial tree, occurs more frequently in women and non-smokers, and has a less predictable pattern of growth. Among the various cell types of non-small cell cancer, patient survival is based on the stage of the disease at presentation rather than on the cell type or degree to which the cells of the tumor are abnormal. Smoking is the number one risk factor for lung cancer accounting for 80-90% of lung cancers. Second hand or environmental tobacco smoke has been linked with an increased risk for lung cancer.
The most common signs and symptoms of lung cancer are cough, weight loss, shortness of breath, chest pain, increased sputum (phlegm) production and hemoptysis (coughing up blood). Because of the high number of patients presenting with advanced disease, the 5-year survival rate in patients diagnosed with lung cancer is 15%. This late presentation and poor overall survival has caused doctors to take steps to identify ways of reducing the number of lung cancer cases and identify lung cancer at an earlier more curable stage when it does occur.
The best way to prevent lung cancer is to not start smoking and avoid second-hand tobacco smoke.
Statewide tobacco control programs, which involve a mix of public education, print media campaigns, preventing children from getting tobacco, limiting advertising, creation of smoke-free environments, anti-smoking programs at work, health professional training on cessation techniques to offer patients, and school-based smoking prevention lessons have had the most success. Currently in the United States about half of all those who have ever smoked are now former smokers. Unfortunately, most clinical trials for smoking cessation report only a 30-35% long-term success rate with motivated patients, drug intervention, and physician support.
In an attempt to reduce the death rate from lung cancer the National Cancer Institute sponsored three separate lung cancer screening trials in the 1970s.
These studies demonstrated an advantage for screening in detecting earlier stage lung cancer and more lung cancers that could be treated with surgery.
Currently, routine screening for lung cancer is not of proven benefit and is not recommended by the American Cancer Society.
In the mid-1990's several centers in Japan and the United States looked at the use of spiral computed tomography (CT) of the chest as a screening tool for lung cancer. The Early Lung Cancer Action Project performed a screening spiral CT scan of the chest on 1000 symptom-free volunteers considered at high risk for lung cancer. The Society of Thoracic Radiology published a consensus statement on screening for lung cancer with helical computed tomography. Members of the University of Cincinnati Thoracic Oncology Team are currently conducting a lung cancer screening trial using low-dose CT scans.
The best survival rates in non-small cell lung cancer are in patients treated with surgical resection for cure. The Lung Cancer Study Group performed a randomized prospective (high quality) study comparing lobectomy to segmentectomy (partial lobe) as a treatment for early stage lung cancers. Since smaller resections offer lower cure rates, thoracic surgeons have taken steps to reduce the complications and suffering from a lobectomy with an eye toward offering curative surgical resection to more patients with poor lung function and speeding the recovery of all patients. Thoracoscopic lobectomy involves removal of a lobe of the lung and the lymph nodes associated with that lobe using a videoscope, two small ports and a small (5-7cm) access thoracotomy thru which the lobe is removed without spreading the ribs.
Lung cancer remains a major public health problem as the number one cancer killer in both men and women. Current and future lung cancer screening trials will help identify patients with early stage disease and hopefully reduce the overall death rate from lung cancer in the screened groups.
In conclusion, the past has been bleak for lung cancer patients; the present is better but still disappointing, but the future is looking brighter every day. Provides accurate, up-to-date information on cancer to patients and their families, health professionals, and the general public. Lung cancer is the leading cancer killer in the United States, and the surest way to defeat it is to prevent it from ever happening. Chemotherapy - Chemotherapy refers to drugs that are used to kill microorganisms (bacteria, viruses, fungi) and cancer cells. Neoadjuvant Chemotherapy - Chemotherapy given alone or with radiation therapy before surgical resection of a cancer.
Adjuvant Chemotherapy - Chemotherapy given alone or with radiation after surgical resection. Local Control - Eradication of cancer from a specific area (by surgical resection or radiation).

Mediastinoscopy - A procedure that can help show whether the cancer has spread to the lymph nodes in the chest.
Staging of Non-Small Cell and Small Cell Lung Cancer - The stage of a cancer is based on the size of the cancer and how far it has spread. Thoracoscopy - Video-assisted thoracic surgery (VATS), also called thoracoscopy, may be done as an independent procedure, or before a thoracotomy.
Thoracotomy - A standard chest incision, typically to enter the chest along the side under the arm going between the ribs. Please note: only your personal physician or other health professional you consult can best advise you on matters of your health based on your medical history, your family medical history, your medication history, and how information from any of these databases may apply to you.
There are 2 major types of lung cancer: Small cell cancer (accounting for 15% of primary lung cancers) and Non-small cell lung cancer (in the remaining 85%).
Early stage small cell cancer can be treated by surgery in less than 10% of patients with this disease. This type of cancer is fairly slow growing and often follows a stepwise order, first to lymph nodes around the lung and then to other, more distant, organs in the body.
Bronchioloalveolar cell cancer and large cell cancer are considered types of adenocarcinoma of the lung. It may present as a single nodule, multiple nodules, or as a diffuse infiltrate (haziness) resembling pneumonia on chest x-ray.
Many large cell cancers will have neuroendocrine (interactions between the endocrine system and the nervous system) features. Lung cancer ranks second to prostate and breast cancer in terms of new cancer cases in men and women respectively.
Studies show a genetic tendency demonstrated by a 30% increased risk of developing lung cancer among brothers, sisters, and children of lung cancer patients and an even higher risk if the relative who developed lung cancer was a woman.
The strongest evidence comes from the much increased rate of lung cancer among lifetime non-smokers who are spouses of smokers.
These symptoms develop slowly and are often thought of by the patient as a typical smoker's cough or a common cold.
Historically, more than 60% of patients diagnosed with lung cancer are incurable when a patient consults a doctor about symptoms.
The overall 5-year survival rate of patients with localized lung cancer treated by surgical removal of the cancer with goal to cure is 60%.
The relative risk of developing lung cancer declines in former smokers to about twice that of those who never smoked after 20 years of not smoking. As more current smokers stop smoking, the lung cancer rates will go down and an increased number of lung cancer cases will occur in former smokers. This has lead to the study of using drugs or supplements to reduce the risk of lung cancer in current or former smokers. There are good quality clinical studies demonstrating that giving beta carotene alone or in combination with retinol to smokers increase the number of cases of, and deaths from, lung cancer. The Mayo Clinic, Johns Hopkins Medical Center, and Memorial Sloan Kettering Cancer Center each screened over 10,000 patients considered to be at risk for lung cancer. However, screening with chest x-ray and sputum tests did not decrease the death rate from lung cancer in the screened group when compared with the control group. However, individuals who may be at increased risk for lung cancer should discuss with their family doctor whether screening tests are appropriate for them. This new technology allows for a non-contrasted (no intravenous dye) single breath-hold (10 second) scan with radiation doses and costs similar to a standard chest x-ray. The consensus statement does not recommend mass screening for lung cancer at this time, but strongly encourages appropriate subjects to participate in trials so that the true effectiveness of lung cancer screening with low-dose helical CT can be determined in the earliest possible time.
Patients treated with less than a lobectomy had an increased rate of recurring cancer and decreased long-term survival. Several steps taken include pulmonary rehabilitation before surgery for patients with poor lung function, thoracic epidural analgesia for better pain control, and smaller incisions with less rib spreading.
This approach allows for quicker recovery and causes less pain while still maintaining the same lung and lymph node removal with the intent for cure.
Information specialists translate the latest scientific information into understandable language and respond in English, Spanish, or on TTY equipment. Contact your local American Lung Association® at 1-800-LUNGUSA to learn how you can help avoid lung cancer hazards.
Using a lighted viewing instrument, called a scope, the doctor examines the center of the chest (mediastinum) and nearby lymph nodes.
Most patients with stage I and II non-small cell tumors and some patients with stage III tumors can undergo surgery with the goal of cure.

This procedure involves inserting a long, thin, fiber-optic scope with a camera attached and instruments into the chest through small incisions made between the ribs. Surgery using this approach avoids areas in the chest containing the heart and the spinal cord.
Neither University of Cincinnati (NetWellness) nor any party involved in creating, producing or delivering this web site shall be liable for any damages arising out of access to or use of this web site, or any errors or omissions in the content thereof. It occurs more commonly in men and heavy smokers and is the cell type most likely to present with hemoptysis (coughing up blood). With an estimated 163,510 lung cancer deaths in 2005, lung cancer is the number one cancer killer in men and women.
Lung cancer rates among women are expected to exceed those among men within the next 2 to 3 decades. Patients with prior lung disease or smoking-related cancers are at increased risk for the development of primary lung cancer. This, along with the tendency of doctors to think at first that the symptoms are due to bronchitis, pneumonia or flu, often leads to a delay between the start of symptoms and establishing the diagnosis of lung cancer. Another study has shown that giving vitamin E to smokers has no effect on lung cancer rates. They used a combination of x-rays of the chest looking for lung nodules and sputum tests looking for cancer cells. The present recommendation is for all eligible patients to undergo at least a lobectomy for surgical treatment of non-small cell lung cancer. Along those lines a minimally invasive approach to early stage non-small cell lung cancers called Thoracoscopic Lobectomy is being offered at the University Hospital and selected centers around the country. Better methods for smoking cessation and ongoing research in chemoprevention should help in reducing lung cancer rates and deaths from lung cancer. Chemotherapy, as it refers to cancer treatment, is a generic term and includes many different drugs with a wide variety and severity of side effects. In mediastinoscopy, the scope is inserted through a small incision in the neck; in mediastinotomy, the incision is made in the chest. Radiotherapy may be applied to shrink a tumor that is later removed by surgery, to relieve symptoms, or to destroy malignant cells in a tumor that cannot be removed surgically.
In later stages, it may spread within the lungs or through the lymph nodes to other parts of the body. Stage IV denotes cancer that has spread to other sites in the body (most often bone, brain, or liver) and is, in most cases, not curable. A VATS procedure may be used to confirm the diagnosis of lung cancer or other chest diseases. A national trial giving selenium to patients surgically treated for stage IA (earliest stage) lung cancer to prevent second lung cancers is ongoing. Segmentectomy may be offered to patients with severely reduced lung function that would not tolerate a lobectomy. Surgeons continue to refine operative techniques to offer this treatment to more lung cancer patients while reducing patient suffering. This study along with the data from Japan has confirmed that spiral CT can detect early stage lung cancer. These patients and the surgeon should understand that this is a compromise operation with increased recurrence and reduced survival. Cancer chemotherapy kills or arrests the growth of cancer cells by targeting specific parts of the cell growth cycle.
Recent advances have allowed surgeons to apply the VATS approach to lobectomy for local control in small stage I lung cancers. However, normal healthy cells share some of these pathways and thus are also injured or killed by chemotherapy.
Many smaller chest procedures may be performed using VATS, rather than a standard thoracotomy. Some normal cells -- including blood cells, hair, and cells lining the gastrointestinal tract -- are also rapidly dividing and thus these are the normal cells most likely to be damaged. Newer cancer therapies, some of which have already been approved by the FDA, are more specifically targeted at growth pathways that are only found in cancer cells.

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