Lung Cancer

Lung is a vital organ of the human being, located near the backbone on either side of the heart with functions of inhaling oxygen from the air then transporting them to the bloodstream to nourish the body cells need and exhaling carbondioxide from the bloodstream.

Lung cancer is defined as a condition of the abnormal growth of the cells in the lung's tissue. Most common form of primary lung cancers are derived from epithelial cells. In Us, Lung cancer is the leading cause of cancer deaths, causing 158,683 people deaths, including 88,329 men and 70,354 women, according to 2007 statistic.

Types of lung cancer
A. Non small cell lung cancer
Non-small cell lung cancer is the most common type of lung cancer. It usually grows and spreads methodically and predictably.Most common types of lung cancers include
1. Squamous-cell carcinoma often found in an outer area of the lung,
2. Large-cell carcinoma found in the center of the lung by an air tube
3. Adenocarcinoma found in any part of the lung.

B. Small cell lung cancer
Small cell lung cancer is a fast-growing type of lung cancer, it can spread to distant parts of the body in a relatively early stage. Most common types of small cell lung cancer include
1. Small cell carcinoma in which the cells are small, round and resemble oats.
2. Mixed small cell/large cell carcinoma in which malignant tumor found in combining of components of small cell lung carcinoma with large cell lung carcinoma.
3. Combined small cell carcinoma in which malignant tumor found in combining of a component of small cell lung carcinoma with components of non-small cell lung carcinoma.


Causes and risk factors
1. Smoking
Smoking is a major cause of lung cancer as it enhances the oxidation stress as the lung inhales oxygen from the air by combining them with cancer causing chemical substances (carcinogens) in the cigarette, leading to the damage of lung's tissue. Normally, our body can withstand and repair this damage, but prolonged exposure your lung to these danger carcinogen can result in cancer development.

2. Second hand smoke
Prolonged exposure to second hand smoke can also increase the risk of lung cancer as mentioned above.

3. Exposure to certain chemicals
There are increased risk of lung cancer for people who inhale or exposing certain industrial chemical such as radon gas, arsenic, chromium, nickel, etc. in the work place.

4. family history
Risk of lung cancer increased if one of the members of your direct family has lung cancer.

5. Lung disease
Risk of ling can caner increase if you have or previous had certain types of lung disease

6. Excessive drinking
According to the study by Freudenheim et al., R. Curtis Ellison MD suggested that alcohol intake of more than 2 drinks per day is associated with a small increased risk of lung cancer. This study, like others, suggests a weak, positive association between consuming larger amounts of alcohol (>2 drinks a day) and lung cancer risk.

7. Etc.

Symptoms1. Shortness of breath.
Shortness of breath is one of most common symptoms of lung cancer, as the lung is now no longer function properly due to abnormal growth of some of its cell within it or cancer cells are growth larger enough to block the major airway, or due to fluid accumulation.

2. Coughing up blood.
Cough up blood is another symptoms of lung cancer, it can be caused by breaking off capillary due to cancer invasion or some of malignant cells. Rupture of the tumor can be extreme danger to the patient.

3. Pain
Pain also associated with the lung cancer if the cancer spread to the lung lining and suppress the nerve in the lung.

4. Fluid in the chest
Fluid in the chest may be resulted of blood or pus due to breaking of lung cancer or lung is no longer function properly in expelling mucus and phlegm, leading to shortness of breath.

5. Wheezing and hoarseness
May be due to blocking of major airway

6. Unintentional weight loss
Any unintentional weight loss over 10%

7. Bone pain
If cancer has spread to bone tissue

8. Hormones
Due to small cell lung cancer imitation of some of the body hormones, leading obesity, high blood pressure, nausea, etc.

9. Etc.

Diagnosis and tests
Family history and physical examination are always important for patient with some of above symptoms. Depending to the types of lung cancers, diagnosis and tests may include
1. Chest X ray
Chest X ray is a form of electromagnetic radiation to take image and check for any abnormality of the lung
2. CT Scan (computerized tomography)
A CT scan generates a large series of two-dimensional X-ray images taken around a single axis of rotation, to create a three-dimensional picture of the inside of the body in details.The pictures are viewed by your doctor to see the extent of the tumors abnormalities, such as spreading of cancer to the nearby structure and lymph nodes. CT scan can only review the existence of cancer . but can not tell it is a primary or secondary cancer.

3. MRI (magnetic resonance imaging)
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the metastasis of cancer in the lung and surrounding areas.

4. Sputum Cytology
Sputum Cytology is a test used to examine a sample of mucus under a microscope to check for any abnormal cell.

5. Bronchoscopy
Bronchoscopy is a procedure used to look inside the airways of the lung by inserting a thin, flexible tube called a bronchoscope with a light and small camera that allow your doctor to see the airways and take pictures to check for any abnormality in the trachea and airways, such as infection, inflammation, or malignant tumor, through nose or mouth, down into the airways.

6. Lung Biopsy
In lung biopsy, a sample of liver is taken by a thin, tube-like instrument to examine under microscopy to review the stage of the cancer.

7. Bone scan
With a small amount of radioactive substance, called a tracer injected into a vein, as it travels through the bloodstream it allows a special camera takes pictures of the tracer in your bones. If there is any abnormality in the bone, it will show up in the pictures.

8. Mediastinoscopy
Mediastinoscopy is a surgical procedure to examine the inside of the upper chest between and in front of the lung by inserting of a mediastinoscope through the opening made in the neck just above the breastbone to collect sample to test under microscope for signs of infection, inflammation, or malignant tumor.

9. Positron emission tomography (PET scan)
Positron emission tomography (PET scan) is a type of nuclear medicine imaging with the uses of small amounts of short-lived radioactive material, either injected into a vein, swallowed or inhaled as a gas which will appear in the area of the body being examined, where it gives off energy in the form of gamma rays detected by a camera of positron emission tomography that produces a three-dimensional image or picture of functional processes of the organ in the body.

11. Etc.

Grades of lung cancer
The Grade of lung cancer is depending to the tendency of spreading. Low grade cancers usually grow more slowly and are less likely to spread while high grade cancer indicates otherwise.

Stages of lung cancer
1. Stage 0
Lung caner is classified as Stage 0, if the cancerous cell have not penetrated in deeper tissue but in the surface of the lung lining.
2. Stage I
In stage I, The cancerous cells are no longer in the surface but have invaded into deep lung lining, but still completely inside the lung.
a. Stage IA1
The cancer is ≤ 3 mm (1/8 inch) deep and ≤ 7 mm (1/4 inch) wide.
a.1. Stage IA1: The spreading is < 3mm(1/8 inch) deep and & less than 7mm (1/4 inch) wide.
a.2. Stage IA2: The invasion area is ≥ 3 mm but ≤ 5 mm (about 1/5 inch) deep and & less than 7 mm (about 1/4 inch) wide.
b. Stage IB: The cancer in this stage have invaded the connective tissue, & less than 5mm (1/5 inch).
b.1. Stage IB1: Cancer is 4 cm large (1 3/4 inches).
b.2. Stage IB2: Cancer is ≥ 4 cm (1 3/4 inches) but & less than 5cm (1/5 inch)

3. Stage II
In stage II, the cancerous cells have spread to distant tissues, but is still within the lung.

4. Stage III
n this stage, cancerous cells has spread to the tissues immediately surrounding the lung.

5. Stage IV
In stage IV is the most advance stage of lung cancer as cancerous cells have spread to the distant parts of the body
In this stage, cancerous cells has spread to the tissues immediately surrounding the lung.

Prevention
A. How to avoid
1. Quit smoking
According to statistic, approximate 87% of lung cancer deaths are caused by smoking.
2. Eating more fruits and vegetables
This foods contain high amount of antioxidants which enhance the immune system against the forming of free radicals and prevent the alternation of cell DNA cause of abnormal cell growth.
3. Second smokes
Second smoke contains same amount of carcinogens, exposure to it can increase the risk of lung caner
4. Environment chemicals
avoid exposure to certain industrial chemical such as radon gas, arsenic, chromium, nickel, etc.. In the work place, deal with them by taking maximum pre-cautions and prevention.

5. Alcohol
Researcher found that increased risk of lung cancer for people who have more than 2 drinks a day.

6. Etc,

B. With diet
Traditional Chinese medicine link all foods with white color to lung tonification, taking them are associated reduced risk of lung cancer.
1. Cruciferous Vegetables
Cruciferous vegetables such as cauliflower, broccoli, cabbage, etc. beside contain high amount of antioxidants but also in a study of AACR FCPR 2008: Cruciferous Vegetables Reduce Lung Cancer Risk in Smokers, reseachers found that there is a significant inverse association between consumption of cruciferous vegetables and lung cancer was only seen for squamous or small cell carcinoma, which are the 2 subtypes most strongly associated with heavy smoking.

2. Pomegranate juice
In a recent issue of Cancer Research, researchers led by Hasan Mukhtar, co-leader of the Cancer Chemoprevention Program of the University of Wisconsin Paul P. Carbone Comprehensive Cancer Center, demonstrate that drinking pomegranate fruit extract helps slow the growth of lung cancer in mice found that pomegranate fruit continues to show great promise," says Mukhtar, professor of dermatology at the School of Medicine and Public Health and a member of the Carbone Cancer Center. "We have earlier shown that pomegranate fruit contains very powerful skin and prostate cancer-fighting agents. These recent findings expand the possible health benefits of the fruit to the leading cause of cancer death in the country and worldwide: lung cancer."

3. Turmeric
In Molecular Nutritional and Food Research, March 2008, researchers reported that naturally occurring polyphenols in curcumin offer a safer alternative treatment. Curcumin can directly scavenge free radicals such as superoxide anion and nitric oxide, and modulate important signaling pathways. These polyphenols also down-regulate expression of pro-inflammatory mediators, and up-regulate desirable gene expression in the lungs. Researchers concluded that curcumin is a potential therapeutic agent against chronic lung diseases.

4. Apple
In the Article: "Triterpenoids isolated from Apple Peels Have Potent Antiproliferative Activity and May be Partially Responsible for Apple's Anticancer Activity", Rui Hai Liu and Xiangjiu He pointed out that apple consumption has been linked to a reduced risk of chronic health problems such as lung cancer, heart disease, and stroke.

5. Garlic
An analysis of several case-controlled studies in Europe suggests an inverse association between garlic consumption and risk of common cancers.

6. Etc.

C. With nutritional supplements

1. Antioxidants
Antioxidants such free radical scavengers vitamin A, C, E enhance the immune system against the forming of free radicals and prevent the alternation of cell DNA cause of abnormal cell growth.

2. Quercetin
Quercetin is a type of phytochemical, also known as a flavonoid. In cell culture or animal studies, researchers found that quercetin has activity against some types of cancer cells and suggested it may be potential benefits in treating cancer.

3. Naringin
In s study of Intake of Flavonoids and Lung Cancer, researcger found that flavonoids, such as quercetin and naringenin (the aglycone derived from naringin), inhibit certain cytochrome P450 enzymes (CYP1A1 and CYP3A4, respectively) involved in the bioactivation of chemical carcinogens.

4. Selenium
In a study of selenium effects in skin cancer, researchers discovered that it might help prevent lung cancer instead according to the book of 1001 Home Health Secrets for Seniors.

5. Lycopene and 1,25-dihydroxyvitamin D3
In a study of Lycopene and 1,25-dihydroxyvitamin D3 cooperate in the inhibition of cell cycle progression and induction of differentiation in HL-60 leukemic cells, researchers found that The combination of low concentrations of lycopene with 1,25-dihydroxyvitamin D3 exhibited a synergistic effect on cell proliferation and differentiation and an additive effect on cell cycle progression. Such synergistic antiproliferative and differentiating effects of lycopene and other compounds found in the diet and in plasma may suggest the inclusion of the carotenoid in the diet as a cancer-preventive measure.

6. Etc.

Treatments
A. In conventional medicine
A.1. Non small cell lung cancer
1. Surgery
a. The aim of the treatment is to cure the cancer with surgery, if possible. Otherwise, treatments are focused to treat and control the symptoms as long as possible. If the cancer is located in the outer parts of the lung and has not spread to the lymph nodes, then surgery will be effective in curing it.
b. Risks and side effects
b.1. Surgical and anesthesia risks
b.2. Shortness of breath
Due to remove parts of the lung
b. 3. Etc.

2. Radiotherapy
By using high-energy x-rays or other types of radiation, radiation therapy kills lung cancer cells and keep them from growing or regrowing. Depending to stage or grade there are two types of radiation therapy.
a. External radiation
By using a machine outside the body to send direct high-energy x-rays or other types of radiation toward the cancer.
b. Internal radiation
By placing a radioactive substance direct into or near the cancer by a medical instrument with the aim to kill nearby cancer cells.
c. Side effects
c.1.. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.

3. Chemotherapy
a. Chemotherapy is most use to treat with advance stage of lung cancer, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

4. Biological therapy
a. Biological therapy with the use of Iressa, Taceva, target binding agents have contributed significantly in treating non small cell lung cancer by binding to the cancerous site and preventing its activity.
b. Risks and side effects
b.1. Weight gain
b.2. Neutropenia
b.3. Headache,
b.4. Thrombocytopenia
b.5. Anemia
b.6. Nausea
b.7. Rash
b.8. Etc.

A.2. Small cell lung cancer
Small cell ling cancer is behave differently than non small cell lung cancer as it is invasive and has tendency to spread to distant parts of the body, however, it often responds well to the treatments of chemo and radio therapies
1. Chemotherapy
a. Chemotherapy is most use to treat small cell lung cancer, as it has spread to a distant parts of the body by using drugs taken by mouth or injected into a vein or muscle of the patient to stop the growth of or to kill cancer cells.
b. Side effects
b.1. Nausea
b.2. Vomiting
b.3. Hair loss
b.4. Fatigue
b.5. Anemia
b.6. Mouth sores taste and smell changes
b.7. Infection
b.8. Etc.

2. Radiotherapy
By using high-energy x-rays or other types of radiation, radiation therapy kills lung cancer cells and keep them from growing or regrowing. Depending to stage or grade there are two types of radiation therapy.
a. External radiation
By using a machine outside the body to send direct high-energy x-rays or other types of radiation toward the cancer.
b. Internal radiation
By placing a radioactive substance direct into or near the cancer by a medical instrument with the aim to kill nearby cancer cells.
c. Side effects
c.1.. Fatigue
c.2. Chest pain
c.3. Heart problem
c.4. Short of breath
c.5. Skin discoloration or pinkness, irritation.
c.6. Etc.

3. Surgery
It is not very helpful to remove the primary lung tumor because of its spreading tendency, but it can be used to reduce certain symptoms such as enlarged lymph nodes, spleen, etc.

4. Etc.

B. Herbal medicine
1. Grape Seed
In a studies of grape seed extracts in test tubes, researchers suggested that it may prevent the growth of breast, stomach, colon, prostate, and lung cancer cells.

2. Green tea
In some clinical studies researchers suggested that the polyphenols in green tea, may play an important role in the prevention of cancer by killing cancerous cells and stoppimg their progression.

3. Aloe
in some studies, researchers suggest that some chemical compounds of aloe, such as acemannan, aloeride, and di(2-ethylhexyl)phthalate (DEHP) may have immunomodulating and anticancer effects.

4. Cat's claw
In vitro studies, researchers found that cat's claw demonstrated anticancer effects against several cancer cell lines.

5. Etc.

C. Traditional Chinese medicine
1. Huang Qi
In study of Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials, researchers found that astragalus may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.

2. Yun Zhi
In a study by by Dr. Kenneth Tsang at the University of Hong Kong's School of Medicine in 1999, on the polysaccharopeptide (PSP) treatment of patients with advanced non-small cell lung cancer, researchers found that after the four-week treatment, there was a significant increase in blood leckocyte and neutrophil levels and body fat compared with pre and post treatment of PSP. Serum IgG and IgM were significantly improved in the PSP treated group compared to the placebo group after four weeks In addition, there were less PSP treated patients who withdrew from the study due to disease progression. Therefore, this study suggests that PSP treatment may be of some benefit in patients with NSCLC.

3. Ling Zhi
In an study of Ling Zhi extracts tested them on three different types of cells: drug-sensitive small-cell lung cancer, drug-resistant small-cell lung cancer, and normal lung cells, researchers found that Ling Zhi killed lung cancer cells. Cancer cells responded to the herb much in the same way as they would react to chemotherapy drugs. Yet unlike chemotherapy drugs, which can also be toxic to healthy cells, herbal extracts were more deadly to cancer cells than to normal cells, indicating that they have some ability to specifically target cancer.

4. Yi Yi Ren
About 20 years ago, a young physician named Dr. Da-Peng Li observed that people in China who ate coix seed as a dietary staple had a surprisingly low incidence of cancer. Research in test tubes, animals and humans by Zhejiang Kanglaite Pharmaceutical Company indicated that The drug from the seed's oil, Kanglaite has been shown to induce apoptosis, or programmed cell death, in various kinds of human tumors, and has a powerful effect on angiogenesis (the formation of new blood vessels to feed the tumor).
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