Tan Xin Ning

Lung Cancer

28th August 2016

Cancer happens when the cells in our body grow uncontrollably and do not die. When apoptosis,the
programmed cell death, breaks down,cancer begins to form. Cancer cell is unlike regular cell,they do not
experience apoptosis and instead they continue growing. This leads to the uncontrolled growth of abnormal
cells in our body. Lung cancer develops when there is genetic mutations happen in the lung cells. Exposure to
carcinogens such as Tobacco,radiation and etc,may cause damage to the cell. The mutations happen inside the
genetic of the cell cause the formation of tumors which will block air passages and undermine the lung's ability.
Lung cancer can be broadly classified into two types:non small cell lung cancer,NSCLC and small cell lung
cancer,SCLC. However,there is also a chance for lung cancer to have the characteristics of both types,which is
called mixed small cell/large cell carcinoma. About 75% to 80% of lung cancers are NSCLC and they can be further
divided into three distinct types of lung cancer :squamous cell carcinoma, adenocarcinoma and large cell carcinoma.
Squamous cell carcinoma Is the most common type of NSCLC and the most common type lung cancer in men. It
forms in the lining of the bronchial tubes. Adenocarcinoma is the most common type of lung cancer in women and in
non-smokers. It forms in the mucus-producing glands of the lungs. Large cell carcinoma is a rapidly growing cancer
that occurs anywhere in the lung. SCLC represents 20% of all cases of lung cancer and almost all cases of SCLC are
due to smoking. It tends to multiply the cancer cells quickly and spread much faster than NSCLC and forms large
tumors that travel throughout the body. There are two types of tumor: benign tumors,known as the non-cancerous
one, and malignant tumors,knows as the cancerous one. Carcinoid tumors of the lung account for less than 5% of
lung tumors and most of it are slow growing tumors. Although some carcinoid tumors can spread, they usually have a
better prognosis than small cell or non-small cell lung cancer.
Carcinogens are a class of substance that can harm and damage DNA in our cell which aid cancer. The
examples of carcinogens are tobacco, asbestos, arsenic, radiation such as gamma and x-rays, the sun, and
compounds in car exhaust fumes. Tobacco smoke is recognized as the number one cause of lung cancer. Over 80%
of lung cancer is caused directly by smoking and the rest are due to the exposure to tobacco smoke. Other risk
factors for lung cancer include a family or personal history of lung cancer and exposure to cancer-causing agents in
the workplace or the environment. Lung cancers rarely result from inherited mutations of oncogenes or tumor
suppressor genes, there are still some people who cannot break down certain types of cancer-causing chemicals,
however.
Cancer symptoms can be quite diverse and usually depend on where the cancer is located,how much it
spreads and how big the tumor is. Lung cancer symptoms customarily take years before appearing,usually after the
disease is in an advanced stage. Lung cancer may cause a number of symptoms such as nagging cough,pain in
chest,shoulder or back from coughing,difficulty breathing and swallowing and blood in the sputum. Many of these
symptoms usually affect the chest and air passages. Sometimes there are symptoms that seem unrelated to the lungs
such as weight loss and fatigue. If the lung cancer metastases,additional symptoms can present themselves in the
newly affected area. For example,if the cancer spreads to the bones,your bones may become painful,brittle and
broken.

Tan Xin Ning

Lung Cancer

28th August 2016

Physicians use the information show by the symptoms to determine and diagnose lung cancer,as well as
several other procedures. The common imaging techniques include CT scans,MRI scans,PET scans,chest X-rays
and bronchoscopy. In addition,they will also conduct a physical examination,a chest examination, and an analysis of
blood in the sputum in order to determine where the tumor is located and to what extent does the cancer spread and
affect to the other additional organs. However, biopsy,the procedure of extracting cancer cells and looking at them
under a microscope,is the only absolute way to diagnose lung cancer. Once the diagnosis is made, an oncologist will
determine the stage of the cancer by the result of cancer spread. The stage determines which choices will be
available for treatment and informs prognosis. Yet, an early diagnosis can be difficult because one of the most
common symptoms of lung cancer, a persistent cough, is often mistaken for chronic bronchitis.
Lung cancer treatments are usually depending on the type of the cancer and the stage of the cancer. Also,
physicians will consider the patient's age,health status, and additional characteristics. Patients will often receive a
combination of therapies and palliative care. There are several types of treatments for lung cancer: surgery,
chemotherapy,and radiation. However,there are also some recent developments such as immunotherapy, hormone
therapy and gene therapy. Surgery is the primarily used to remove the cancerous tumor from the lung. If a cancer is
not metastasized, there is a possibility to completely cure the patient by removing the cancerous tumor and the
nearby lymph nodes. After removing the tumor and the surrounding margin of tissue,the margin is taken to do further
study to see if the cancer cells have fully removed. 'Negative margin' is considered when there is no more cancer cell
surrounding. A 'positive margin' may require to remove more of the lung tissue as the cancer cells are not fully
removed. Besides that, lung cancer surgery can be either curative or palliative. Curative surgery is to cure the patient
with the early stage of lung cancer by removing all of the cancerous cells. Palliative surgery is to remove an
obstruction or open an airway in order to make the patient comfortable without removing the cancer. Yet,surgery
carries side-effects like pain and infection. It may also cause harm to the surrounding body parts.
Another type of treatment is radiation,known as radiotherapy. Radiation therapy uses high-energy radiation
to destroy or smaller the size of the lung cancer tumors. The radiation causes damage to the molecules of the cancer
cell and leads them to commit suicide. Early radiation treatments caused severe side-effects because the radiation
would also damage the healthy tissue,yet technologies have improved so that the beams can be more accurately
targeted. Radiation therapy can be used as the main treatment of lung cancer,to kill the remaining cancer cells after
surgery or the metastasized cancer cells. In some cases, radiation therapy and chemotherapy are used together
instead of surgery. Chemotherapy refers to drugs that are used to treat cancer. Chemotherapy drug is taken to kill
cancer cells as they travel through the bloodstream and into all the organs of the body. However,as it travels
throughout your body,it will also affect to your healthy and normal tissues. These drugs control the growth and the
spread of the cancer cell since they divide faster than normal cells.
There are also some research in the area of lung cancer vaccines that use to transform cancer cell and
restore the immune system function by using the substances either made by the body or in laboratory. These targeted
therapies are called immunotherapy because the treatment changes the body's immune response. Moreover,

Tan Xin Ning

Lung Cancer

28th August 2016

researcher from The Institute of Cancer Research in London showed that approximately 50% of PARP inhibitors could
help those patients with NSCLC. PARP inhibitor is a combination of different proteins with different functions for DNA
repairing proteins. PARP inhibitors can affect the tumor cells while leaving the healthy ones alone. These are currently
used for treating patients with ovarian or breast cancer caused by mutated BRCA1 or BRCA2 genes.
The best way to prevent lung cancer is to quit smoking or be around people who do. Although we know
how to prevent over 80% of lung cancers, at this time, it is not possible to give advice on how to prevent all cases of
lung cancer. However,there are some recent developments on the lung cancer prevention by eating raw garlic. The
research team from the Jiangsu Provincial Center for Disease Control and Prevention in China suggested that garlic
may potentially serve as a chemo-preventive for lung cancer.

Tan Xin Ning

Lung Cancer

28th August 2016

References:
http://www.cancerresearchuk.org/about-cancer/type/lung-cancer/
http://www.cancerresearchuk.org/about-cancer/type/lung-cancer/about/the-lungs
http://www.healthline.com/health/lung-cancer/non-small-cell-lung-cancer-vs-small-cell#1
http://www.cancer.net/navigating-cancer-care/how-cancer-treated/immunotherapy-andvaccines/understanding-immunotherapy
http://www.medicalnewstoday.com/info/lung-cancer
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063418/
http://www.cancerresearchuk.org/about-cancer/type/lung-cancer/about/lung-cancer-symptoms
http://www.cancerresearchuk.org/about-cancer/type/lung-cancer/treatment/which-treatment-for-lung-cancer