Essay on Lung Cancer

Lung cancer occurs after repeated insults to the genetic material of the cell. Lung cancer is one of the most difficult forms of cancer to treat, and about 85 per cent of cases are non-small cell lung cancers. Non-smokers face a 24 per cent increased risk of developing lung cancer through passive smoking It takes an average of ten years for lung cancer cells to develop to a detectable level. Every 30 seconds someone somewhere in the world dies of lung cancer.

Help with Essay on Lung Cancer
Help with Essay on Lung Cancer

The most common reasons of lung cancer is tobacco smoke. There are differences between men and women in terms of cancer risk. Among smokers, studies suggest that women are at higher risk of lung cancer at every level of smoking. There is an increased relative risk of lung cancer in women as compared to men at the same levels of smoking. Research suggests that women are somewhat more likely than men to suffer from the more aggressive small cell lung cancer, while men are more likely to be diagnosed with non-small cell lung cancer. Within the larger group of those with non-small cell lung cancer, women are more likely to suffer from one particular form of this disease–adenocarcinoma. Among men, the numbers are more evenly split between adenocarcinoma and squamous cell lung cancer.  For men, relative risk is higher in those who begin smoking before the age of 19. In women, increased risk lasts until the age of 25. Other studies have shown that non-smoking women were at higher risk of developing lung cancer than non-smoking men . The higher risk of cancer among women was not due to differences in body size or lung size but was more plausibly related to differences in metabolic activation and detoxification of lung carcinogens.

The other carcinogens which  cause lung cancer are found in the workplace. These include bischloromethyl ether and chloromethyl ether in chemical workers, arsenic in copper smelting, and asbestos in shipbuilders and other asbestos workers. Radon poses a risk to uranium and fluorspar miners and may pose a risk in some private residences as well. Cancer is the most prominent adverse health effect associated with formaldehyde exposure, though the evidence of carcinogenicity is not nearly so conclusive as for radon and asbestos. Evidence on formaldehyde’s carcinogenicity, however, raised concern that the substance might also cause more common human cancers, such as lung cancer.

Most air pollutants cause lung cancer, which has a plethora of other potential causes. When lung cancer develops, it is impossible to be certain that it was caused by indoor air pollution as opposed to cigarette smoke, outdoor pollution, or other sources. We have relatively little knowledge of how and why cancer develops. As a result, it seems to be a disease of probabilistic risk. Virtually any exposure to a carcinogen may cause cancer, and no commonly present exposures produce anything approximating a certainty of cancer.

Thus, while thousands of Americans probably contract cancer from radon, volatile organic compounds, and other indoor air pollutants, each individual faces a risk of, for example, 1 in 1,000 of cancer. Thus very few individuals actually have a probability of cancer from indoor air pollution, and after a cancer is suffered, it is difficult to prove that indoor air pollution was the cause of this specific cancer. There are also differences between men and women in terms of exposure to, and the effects of, area-based pollution. For example, Pless-Mulloli et al. (1998) found that in areas with high levels of pollution, older women were more at risk of developing lung cancer than others in the same locality, regardless of their smoking history.

Lung cancers are classified according to the type of cell present in the tumor. Most of them are referred to non-small cell carcinomas. To these type belong: squamous cell or epidermoid carcinomas, adenocarcinomas, and large cell carcinomas. Small cell carcinoma often has metastasized by the time it is detected. Lung cancer most commonly spreads to the brain, bone, liver, or bone marrow. The primary symptoms of lung cancer are cough, shortness of breath, hoarseness, blood in the sputum, and pain. In some types, the cancer cells themselves produce hormones or other substances that can create an imbalance and result in various symptoms. Metastatic lung cancer also cause symptoms that impacts from its effect on the organ to which the cancer has spread.

Lung cancer can be diagnosed by:

  • a chest x-ray or CT scan to check for spots on the lungs
  • a microscopic analysis of phlegm cells
  • a bronchoscopy, which involves passing
  • a lighted tube through the tubes that carry air to the lungs to see if tumors or blockages exist
  • biopsy

Often the diagnosis is made after surgical specimens have been evaluated. Evaluation of suspected sites of metastasis may involve CAT scans or magnetic resonance imaging (MRI). A special CAT-scanning technique (helical low-dose CAT-scanning) has also been used for initial diagnosis detecting small tumours before they have spread. Analysis of types of cells contained in sputum, and fiber optic examination of the bronchial passages assist with diagnosis.

Unfortunately, in about 85 percent of patients, by the time lung cancer is diagnosed the disease has spread beyond the lungs. Lung cancers tend to spread more quickly than most other types of cancer because the lungs are richly supplied by the blood and lymph systems, which carry cells to other parts of the body. This makes lung cancers particularly difficult to treat.

The three main weapons doctors can wield against lung cancer  are surgery, radiation directed at the chest, and chemotherapy with anti-cancer drugs. The treatment is determined according to the location, size, cell type, spread, the state of health of the patient. Options include surgery, radiation therapy, and chemotherapy, with surgery usually being the treatment of choice. Photodynamic therapy is in the case if the cancer is still localized. In this therapy a substance that makes cells more sensitive to light is injected into the body. When it has passed out of most of the tissues, but remains in the cancer cells, the cancer is destroyed by a beam of laser light.  Some experimental treatments which have not yet been approved by FDA are used. For example and “immunotherapies” that use cancer vaccines, monoclonal antibodies, or other biologicals to boost or enhance the patient’s anti- cancer immune response or to more selectively direct anti- cancer drugs or radiation to tumors.

But the treatment itself impacts lots of complications.The risks are very different depending on the initial cancer. People treated for cancer show reduced bone mineral density. Hearing loss is relatively common following treatment with cisplatin and may be further aggravated by radiation. Consequently, hearing loss is commonly found following treatment for a brain tumor which can be metastasis of lunsg cancer. Evidence of cataracts in the eye may emerge 2–3 years after total-body irradiation. Dry eye is a consequence of damage to tear production and the cornea, and artificial tear drops may be prescribed.

Short and longer-term effects of cancer treatment on dentition have been documented. These complications can in themselves be painful, but also interfere with proper nutrition. Chemotherapy, especially bleomycin, as well as chest irradiation can both affect the lungs. Treatments can cause scarring that reduces lung capacity, restricts breathing, and reduces exchange of oxygen and carbon dioxide. Damage to kidneys may cause wasting of salts such as magnesium and potassium. Long-term use of some chemotherapeutic agents, especially ifosamide and cisplatin, can lead to kidney failure. Cycophosphamide and ifosamide can cause bladder irritation and bleeding both during and after treatment. Patients treated with pelvic irradiation are further at risk of urinary tract infections.

The impact of combination cytotoxic chemotherapy on gonadal function is dependent on gender and age of the patient undergoing treatment and the nature and dose of the drugs received. Both the testis and ovary are vulnerable to radiation damage, and survivors need to be assessed for infertility.

People who receive more than one course of radiotherapy (e.g., following relapse) are at greater risk of nerve system derivations. Highdose cisplatin is associated with nonreversible hearing loss. The eyes can also be affected, although cataracts may not appear for many years after the end of treatment. Peripheral neuropathy can also occur. This results in numbness, tingling, pain, and muscle weakness. These symptoms often resolve at the end of treatment.

Identification of physical late effects is important for a number of reasons. First of all, there are issues for the individual patient in terms of information, counseling, and advice. Clear information about lack of risk can be as important for one individual as identification of risk is to another. Fertility is an excellent example. The possible link between radiotherapy, chemotherapy, and loss of fertility is often highlighted in the popular press, with the result that some survivors can worry unnecessarily. Yet information that fertility is not compromised is important so that individuals adopt appropriate behavior if they do not want a child. At the same time, individuals who may have fertility problems have a right to sensitive counseling and advice about any available treatments. Early identification gives time for individuals to make rational decisions about alternative courses of action. Currently, these can include egg or sperm donation. Where these options are unsuccessful, individuals may wish to look into adopting a child.

Second, and of greater interest to clinicians, if certain treatments can be linked to specific physical late effects, then future treatments can be planned, as far as possible, to use treatments less frequently associated with side effects. Thus, identification of physical late effects is important as part of the development and evolution of new treatments. This rationale lies at the heart of large-scale epidemiological studies aimed at linking different treatment protocols with subsequent physical late effects. Thus, awareness of possible long-term complications is not only important for optimizing the health care for current survivors but also for modifying future protocols to reduce unacceptable treatment related morbidity or mortality in the future.

Bibliography :

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