Lung Cancer Risk Asbestos

Asbestos have become part of our life, it is exist among us, and we use it to build our house and many building. Asbestos can cause many types of lung disease, includes lung cancer. There is a synergistic effect between tobacco smoking and asbestos in the formation of lung cancer. In the UK, asbestos accounts for 2–3% of male lung cancer deaths. Asbestos can also cause cancer of the pleura, called mesothelioma (which is often mistaken with lung cancer).

In industrialized country, asbestos exposure is giving 4% to 12% of all lung cancer cases. The death number from asbestos exposure in the UK in 1929 to 1996 was reaching 18,000 for mesothelioma and 1,800 for lung cancer. . In a study of cancer mortality among about 5 100 asbestos factory workers in east London followed for over 30 years since first exposure10, the excess lung cancer to mesothelioma ratio was 1.55:1.

Emphysema Diagnosis

Emphysema is a long-term, progressive disease of the lung that primarily causes shortness of breath. Until now, emphysema treatment management that can cure emphysema completely has yet not found.

To detect emphysema there are various ways, but emphysema diagnosis usually confirmed by pulmonary function testing called spirometry. However, other diagnosis also used. To determine if you have emphysema, your doctor is likely to recommend certain tests, including:

Lung Cancer Risk Radon Gas

The main cause and risk factor of lung cancer and most of respiratory diseases are small particles that bring by air. One of them is radon gas.

Radon gas doesn’t have colors and odor, and it is generated by the breakdown of radioactive radium, which is often found in uranium mining, radon can found in the Earth's crust. Radon has a half-life of 3.8 days and decays into short-lived radioactive isotopes of bismuth, polonium and lead, known as radon progeny or radon daughters. When radon products decays and ionize genetic material that may lead mutations that sometimes turn into cancerous, including lung cancer. Radon gas exposure is the second major cause of lung cancer after smoking.

Smoking Lung Cancer

Smoking is renowned as the main cause of lung cancer, especially cigarettes. 90% of all lung cancer death cases are caused by smoking. In United States, smoking also caused most of lung cancer cases, counting over 80%. It contains more than 50 substances that have dangerous effect for our body, such as; radioisotopes from the radon decay sequence, nitrosamine, and benzopyrene. Additionally, nicotine appears to reduce our immune system. Despite how smoking can cause a lot of disease including lung cancer, some people still make smoking as lifestyle.

Lung Cancer Surgical Resection for Early Stage Non-small Cell Lung Cancer

Lung surgery is the main treatment for non-small cell lung cancer when it’s in early stage. Lung surgical resection has been shown to have the best treatment result in the best 5 year lung cancer survival rates compared to other non-small cell lung cancer treatment management. Dr Evarts Graham renown for the first doctors that successful pneumonectomy in 1933, since then doctor has developed pneumonectomy to perfect it. From refinements in patient selection, operative techniques and pre-operative management which have translated into better lung cancer survival rates with reduced postoperative morbidity and mortality.

Lung Cancer Surgery

Surgery is a lung cancer treatment that fit to remove the tumor when in early stage (1 or 2). It involves the surgical excision of cancer tissue from the lung. The result of lung surgery often remarkable, however, it not suitable to treat lung cancer late stage that have spread (metastasis). Surgery is mainly use for non-small cell lung cancer treatment.

Lung surgery is not suitable for all patients, such as those who have bad health before surgery. Just like what mention it above, lung surgery is very limit to early stage of lung cancer, the location of tumor and the cell type. Furthermore, the survival rate would be low for patients who have less pulmonary reserve.*

Emphysema Treatment

Emphysema is incurable disease. The treatment focus of prolonging the patient life and increase their quality of life. The most important and the first things to do in emphysema treatment is stop smoking. With this way, emphysema will progression will be slower and patient will be ready in treatment for emphysema.

Emphysema Treatment

Emphysema is also treated by supporting the breathing with:

• Pulmonary rehabilitation
  Pulmonary rehabilitation is the key of emphysema treatment, it can be very helpful to optimize the patient's quality of life and teach the patient how to actively manage his or her care.
  

Small Cell Lung Cancer treatment by stage

Typically, treatment for small cell lung carcinoma is dependent on what stage the cancer is at.

SCLC Stage	Optimal Small Cell Lung Cancer Treatment	If not appropriate
Limited Stage	Platinum based chemotherapy (4–6 cycles) combined with thoracic radiotherapy concomitant with first or second cycle Prophylactic cranial irradiation for complete responders	Palliative chemotherapy and/or radiotherapy
Extensive Stage	Combination chemotherapy (4–6 cycles) Prophylactic cranial irradiation for complete responders	Symptom control

Non-small Cell Lung Cancer treatment by stage

Lung Cancer Stage	Lung Cancer Treatment option	If not suitabble for treatment option, treat depending on symptoms and performance status
Lung Cancer Stages 1 and 2	Surgical resection	Radical radiotherapy and/or chemotherapy or Palliative management or Observation if not symptomatic
Lung Cancer Stage 3A	Induction chemotherapy Surgical resection and/or Mediastinal radiotherapy or Radical combination chemoradiotherapy	Palliative radiotherapy or chemotherapy or Observation if not symptomatic
Lung Cancer Stage 3B	Radical combination chemo-radiotherapy
Lung Cancer Stage 4	Chemotherapy and Palliative radiotherapy for specific sites of disease (brain, bone pain). Some patients with solitary brain metastases may be suitable for surgical excision	Palliative radiotherapy or Supportive care alone

Small Cell Lung Cancer Staging

Small cell lung cancer (SCLC) is less common compared to non-small cell lung cancer and comprises up to 25% of all lung cancers. The difference between SCLC and NSCLC is the rapid tumour doubling time and high growth fraction.

Just like non-small cell lung cancer, staging in SCLC play an important role because it guides treatment and helps to predict outcomes. However, the TNM staging system is useless in SCLC because at presentation more than 90% of SCLC have either locally invasive Mediastinal disease or metastases. However, in the few patients who do present with much localized SCLC and undergo surgical resection, the TNM staging system is important.

TNM Staging for Non-small Cell Lung Cancer

Knowing lung cancer stage is an important part of the assessment of patients with non-small cell lung cancer. These patients undergo staging as part of the process of considering prognosis and treatment.

• T Staging (Primary Tumor)
  This staging show how big the tumor is.
  
  

Lung Cancer Staging

Lung cancer staging is important to determine lung cancer treatment and prognosis, it is also the assessment of the degree to which a lung cancer has spread from its original source. The more advanced stages of lung cancer indicate a poorer prognosis and are less amenable to treatment.

Lung Cancer Stages

Lung cancer Stage:

• Lung Cancer Stage 0:
• The tumor is still in situ, and not yet become cancerous tumor.
   
  
• Lung Cancer Stage 1A:
• Tumor size is small, only 3 cm or less, it doesn't show any metastasis.
  
  
• Lung Cancer Stage 1B:
• The tumor is bigger (more than 3 cm), but it still not metastasis, yet.
  
  

Lung Cancer Treatment

Lung cancer treatment successful rate may vary depend on various factors. The most important factors are the histopathology (diseased tissue) type of lung cancer and the stage of the cancer. However, these are lung cancer treatment methods that use, such as:

• Surgery
  Surgical removal of the tumor is generally performed for limited-stage (stage I or sometimes stage II) NSCLC and is the treatment of choice for cancer that has not spread beyond the lung.
• Chemotherapy
• Radiation
  Radiation therapy uses high-energy X-rays or other types of radiation to kill dividing cancer cells. It can be used to treat both small cell lung cancer and non-small cell lung cancer.
• Combination lung cancer treatment
  In an attempt to cure or palliate malignant neoplasm’s originating in lung tissue.

Lung Adenocarcinoma Subtypes

Adenocarcinoma has a vary tumors, and some of histological subtypes are currently recognized:

1. Acinar adenocarcinoma
2. Papillary adenocarcinoma
3. Bronchioloalveolar adenocarcinoma
4. Solid adenocarcinoma with mucin production

Adenocarcinoma

Adenocarcinoma counts 40% of all lung cancer cases. Unlike small cell lung cancer and squamous cell lung cancer, which both tend to be more centrally located, adenocarcinoma usually is seen in peripheral lung tissue.  The peripheral location of adenocarcinoma in the lungs is due to the use of filters in cigarettes which prevent the larger particles from entering the lung. Generally, adenocarcinomas grow more slowly and form smaller masses than the other subtypes. However, they tend to form metastases widely at an early stage.

Adenocarcinoma also the most common type of lung cancer in women and non-smokers and in people under age 45, however, the incidence of adenocarcinoma has increased in the last two decades and it is now the most common histological subtype in both men and women. A subtype of adenocarcinoma, the bronchioloalveolar carcinoma, is more common in female never-smokers, and may have different responses to the lung cancer treatment option.

Non-small Cell Lung Cancer (NSCLC) Prognosis

Non-small cell lung cancer prognosis depend on the following:

• Lung Cancer Stage
  The size of the tumor and whether the tumor has spread (metastasis) or no.
• Lung Cancer symptoms
  such as coughing or trouble breathing.
• Patient health
  The treatment for lung cancer cannot done if the patient health is not in good condition.

Small Cell Lung Cancer (SCLC) Prognosis

In patients with small cell lung cancer, stage (limited versus extensive) and performance status are essential prognosis factors, and should be documented at diagnosis in every case.

The stage is an essential prognostic factor in small cell lung cancer, but is usually simplified as either limited or extensive. The definitions of these staging terms are not always consistent between institutions, as the distinction limited disease – defined as that which can be encompassed within an ‘acceptable’ radiotherapy field – is dependent on subjective assessment by a radiation oncologist. There is a case to be made for a more objective staging system, perhaps a return to TNM, to better refine prognostic categories and guide treatment. Additional disease related factors include serum LDH and the presence of brain metastases. Performance status is an essential host related actor, with age, sex and weight loss as additional factors.

Lung Cancer Prognosis

Lung cancer prognosis means the chance for cure or prolongation of life (survival). Lung cancer prognosis is depends on upon where the cancer is located, the size of the cancer, the presence of symptoms, the type of lung cancer, and the overall health status of the patient. For patients with inoperable lung cancer, prognosis is adversely affected by poor performance status and weight loss of more than 10%.

Non-small cell lung cancer prognosis include:

• Presence or absence of pulmonary symptoms 
• Tumor location
• The size of tumor
• Lung cancer stage and metastasis to lymph node
• and the overall health status of the patient.

Non-small Cell Lung Cancer (NSCLC) Types

There are three main types of non-small cell lung cancer:

1. Squamous cell lung cancer
   It's counting for 25% of lung cancers, squamous cell lung carcinoma usually starts near a central bronchus. Squamous cell lung cancers often grow more slowly than other cancer types.
2. Adenocarcinoma
   It is counts for 40% of lung cancers. Adenocarcinoma usually originates in peripheral lung tissue. Most cases of adenocarcinoma are associated with smoking; however, among people who have never smoked ("never-smokers"), adenocarcinoma is the most common form of lung cancer. A subtype of adenocarcinoma, the bronchioloalveolar carcinoma, is more common in female never-smokers, and may have different responses to treatment.
   
   

Small Cell Lung Cancer (SCLC)

Small cell lung cancer (SCLC) is less common compared with non-small cell lung cancer, it comprise 14-25% of all lung cancer. It characterized by small cells that multiply quickly and form large tumors that travel throughout the body. Almost all cases of SCLC are due to smoking.


Small cell lung cancer (SCLC) can distinguished from non-small cell lung cancer (NSCLC) by a rapid tumour doubling time and high growth fraction. Small cell lung cancer forms in the central airways in 80–90% of cases. At presentation up to 70% have already metastasized; most commonly to bone, liver, brain, bone marrow, retro-peritoneal lymph nodes, soft tissue and adrenals.

Non-small Cell Lung Cancer (NSCLC)

Non-small Cell Lung Cancer counts 75% of all lung cancer. Unlike small cell lung cancer, it grouped altogether because their prognosis and management are similar. There are three subtypes of non-small cell lung cancer adenocarcinoma, squamous cell carcinoma, and large cell lung cancer.

Adenocarcinoma is the most common of non-small cell lung cancer and counting 40% of all. Adenocarcinoma was previously known as the most common type of lung cancer in women and non-smokers, however, the incidence of adenocarcinoma has increased in the last two decades and it is now the most common histological subtype in both males and females. The reason for the increasing incidence of adenocarcinoma is not well understood, but may be related to changing patterns of smoking. Adenocarcinomas tend to be peripherally located, smaller and vary histological from well-differentiated tumours to solid masses with occasional mucin-producing glands and cells.

Asthma Classification

Asthma is clinically classified according to the frequency of symptoms, FEV1 and peak expiratory flow rate.[6] Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic).

	Symptoms	Night Symptoms	%FEV1 of Predicted	FEV Variability
Intermittent	more than 1 per week	more than 2 per month	less than 80%	more than 20%
Mild persistent	less than 1 per week but more than 1 per day	less than 2 per month	less than 80%	20–30%
Moderate persistent	Daily	less than 1 per week	60–80%	less than 30%
Severe persistent	Daily	Frequent	more than 60%	less than 30%

Main Article: Lung Disease: Asthma