$Unique_ID{BRK03555} $Pretitle{} $Title{Cancer, Lung} $Subject{Cancer Lung Bronchogenic Carcinoma Cancer of the Lung Carcinoma of the Lung Occupational Lung Cancer Pulmonary Neoplasms Squamous Cell Epidermoid Carcinoma Adenocarcinoma of the Lung Alveolar Cell Bronchoalveolar Carcinomas Undifferentiated Small Cell Oat Cell Carcinoma Undifferentiated Anaplastic Large Cell Carcinoma Benign Tumors} $Volume{} $Log{} Copyright (C) 1990, 1991 National Organization for Rare Disorders, Inc. 804: Cancer, Lung ** IMPORTANT ** It is possible that the main title of the article (Lung Cancer) is not the name you expected. Please check the SYNONYM listing to find the alternate names and disorder subdivisions covered by this article. Synonyms Bronchogenic Carcinoma Cancer of the Lung Carcinoma of the Lung Occupational Lung Cancer Pulmonary Neoplasms Disorder Subdivisions: Squamous Cell (or Epidermoid) Carcinoma Adenocarcinoma of the Lung (Including Alveolar Cell and Bronchoalveolar Carcinomas) Undifferentiated Small Cell (or Oat Cell) Carcinoma Undifferentiated (Anaplastic) Large Cell Carcinoma Information on the following disorders can be found in the Related Disorders section of this report: Benign Tumors of the Lung General Discussion ** REMINDER ** The information contained in the Rare Disease Database is provided for educational purposes only. It should not be used for diagnostic or treatment purposes. If you wish to obtain more information about this disorder, please contact your personal physician and/or the agencies listed in the "Resources" section of this report. Lung Cancer is the most common form of cancer among both men and women in the United States. Those most at risk are smokers, especially heavy smokers. Cancer is a disease in which malignant cell development occurs, causing destruction of healthy cells. Major symptoms of lung cancer may include persistent coughing, chest pain, shortness of breath, coughing up blood from the lungs (hemoptysis), or weight loss. Ninety-five percent of lung cancers are caused by four main types: squamous cell, adenocarcinoma, small (or oat) cell, and large cell lung cancer. Symptoms A common symptom of lung cancer is a persisting cough. Other symptoms may include chest pain, difficulty breathing (dyspnea), shortness of breath, wheezing, coughing up blood from the lungs (hemoptysis), or weight loss. Difficulty in swallowing (dysphagia), hoarseness, weakness, fever, spinal cord or bone pain, or swelling of the head, neck, or breast are other possible symptoms. Squamous cell carcinoma generally develops in the central area of the lung and is the only type of lung cancer that can be detected in a precancerous stage. Squamous cell is the most treatable of the four main types of lung cancer; it does not travel as fast as the other three types and responds well to treatment. In adenocarcinoma of the lung, tumors tend to form in glands lining the smaller bronchi (tubes that conduct air to and from the lungs). Small cell, or oat cell carcinoma is very aggressive and travels quickly; chemotherapy especially benefits these patients. The name "oat cell" refers to the shape of the cells which resemble oat grains. Large cell lung carcinoma is the rarest form of lung cancer and may actually be a different type of squamous cell carcinoma and/or adenocarcinoma. Generally, this type is very similar to adenocarcinoma in both symptoms and treatment. Lambert-Eaton Syndrome (LES) may occur in two-thirds of patients having malignant tumors, especially patients with small cell carcinoma of the lung. In some patients, LES occurs up to three years before a tumor is detected. LES is a neuromuscular disorder that may be an autoimmune disease. Major symptoms include muscle weakness and fatigue especially of the pelvic and thigh muscles. Other symptoms may include dryness of the mouth, impotence, pain in the thighs, and a pricking, tingling or creeping sensation on the skin (paresthesias) around the affected areas. (For more information on this disorder, choose "LES" as your search term in the Rare Disease Database). Many lung cancer patients also have heart or lung problems which may be linked to age, smoking, or both. Causes Like most forms of cancer, the exact cause of lung cancer is not known. Those most at risk are cigarette smokers, especially heavy smokers. Smoking is linked to lung cancer in 85% of patients. Other cancer-causing agents (carcinogens) linked with lung cancer are arsenic, asbestos, beryllium, cadmium, chloromethyl ether, chromates, coal tars, coke-oven emissions, iron oxide, isopropyl oil, metallic iron, mustard gas, nickel, radon gas and uranium. Job-related exposure to these carcinogens, such as a miner exposed to uranium, increases the risk of developing lung cancer. If a person exposed to these carcinogens is a smoker as well, the risk of lung cancer is even higher. Affected Population Lung cancer is the most common form of cancer among both men and women in the United States. Those most at risk are smokers, especially heavy smokers. Lung cancer is usually discovered in people aged 45 and over. The average age at the time of diagnosis, especially in men, is 70-74. In women, adenocarcinomas may occur earlier (age 50-59) than in men. Related Disorders Symptoms of the following disorder can be similar to those of lung cancer. Comparison may be useful for a differential diagnosis: Benign (noncancerous) tumors of the lung may resemble malignant tumors. Testing is necessary for a correct diagnosis. Therapies: Standard Testing for lung cancer includes chest x-ray, bronchoscopy, and/or biopsy. Treatment of lung cancer varies from patient to patient. It is important to determine which type of lung cancer a person has and how far the disease has spread since these factors determine the appropriate treatment program. First, physicians determine what "stage" the disease is in. The stage depends on the number and location of malignant sites, and if the cancer has traveled. Treatment of lung cancer may include surgery, radiotherapy and/or chemotherapy. Radiotherapy (radiation therapy) destroys cancer cells, shrinks enlarged lymph nodes, and aids in prevention of further cancer. Chemotherapy involves the use of anticancer drugs. There are several drug regimens now in use. The drug combinations of cyclophosphamide, methotrexate, and lomustine (CCNU), or cyclophosphamide, doxorubicin, and vincristine, or the drug combination of cyclophosphamide, doxorubicin, and etoposide (VP-16) may be prescribed. All these drugs may produce adverse side effects and must be carefully monitored by a specialist physician (oncologist). Other treatment is symptomatic and supportive. Therapies: Investigational The drug Ricin (blocked) conjugated murine monoclonal antibody (N901) has been approved by the FDA for testing in the treatment of Small Cell Lung Cancer. The drug is manufactured by Immunogen, Inc., Cambridge, MA. The National Cancer Institute conducts clinical trials on new drugs being tested for lung cancer and other forms of cancer. To learn about locations of these investigations, contact the Cancer Information Service listed in the Resources section of this report. This disease entry is based upon medical information available through March 1991. Since NORD's resources are limited, it is not possible to keep every entry in the Rare Disease Database completely current and accurate. Please check with the agencies listed in the Resources section for the most current information about this disorder. Resources For more information on Lung Cancer, please contact: National Organization for Rare Disorders (NORD) P.O. Box 8923 New Fairfield, CT 06812-1783 (203) 746-6518 American Cancer Society 1599 Clifton Rd., NE Atlanta, GA 30329 (404) 320-3333 NIH/National Cancer Institute 9000 Rockville Pike, Bldg. 31, Rm. 1A2A Bethesda, MD 20892 1-800-4-CANCER The National Cancer Institute has developed PDQ (Physician Data Query), a computerized database designed to give the public, cancer patients and families, and health professionals quick and easy access to many types of information vital to patients with this and many other types of cancer. To gain access to this service, call: Cancer Information Service (CIS) 1-800-4-CANCER In Washington, DC and suburbs in Maryland and Virginia, 636-5700 In Alaska, 1-800-638-6070 In Oahu, Hawaii, (808) 524-1234 (Neighbor islands call collect) References CECIL TEXTBOOK OF MEDICINE, 18th Ed.: James B. Wyngaarden, and Lloyd H. Smith, Jr., Editors; W.B. Saunders Co., 1988. Pp. 457-463, 2364. THE COLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS COMPLETE HOME MEDICAL GUIDE: Donald F. Tapley, M.D., et al., eds; Crown Publishers, Inc., 1985. Pp. 404. INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and Co., 1987. Pp. 627-630. WORLD BOOK MEDICAL ENCYCLOPEDIA: Erich E. Brueschke, M.D., et al., eds; World Book, Inc., 1988. Pp. 148-149.