Transcript PLWC Slide Deck Series: Understanding Lung Cancer

Presents
PLWC Slide Deck Series:
Understanding Lung Cancer
2006
What is Cancer?
A group of 100 different diseases
The uncontrolled, abnormal growth of cells
Cancer may spread to other parts of the body
What is Lung Cancer?
The leading cause of cancer death among men and
women
Begins when cells in the lung grow out of control and
form a tumor
There are two main types of lung cancer: non-small cell
and small cell
What is the Function of the Lungs?
The lungs consist of five lobes,
three in the right lung and two in
the left lung
Most cells in the lung are
epithelial cells, which line the
breathing passages and produce
mucus, which lubricates and
protects the lungs
The main function of the lungs is
to allow oxygen from the air to
enter the bloodstream for delivery
to the rest of the body
What Are the Risk Factors
for Lung Cancer?
Tobacco and second-hand smoke
Asbestos
Radon
Most people who develop lung cancer today have either
stopped smoking years earlier or have never smoked
Lung Cancer and Early Detection
No tests are recommended for screening the general
population
A low-dose helical computerized tomography (CT or
CAT) scan is currently being studied for this purpose
Any person who is at increased risk due to smoking or
asbestos exposure should discuss the benefits and
limitations of a screening CT scan with his or her doctor
What Are the Symptoms of Lung Cancer?
Fatigue (tiredness)
Cough
Shortness of breath
Chest pain
Loss of appetite
Coughing up phlegm
Hemoptysis (coughing up blood)
If cancer has spread, symptoms include bone pain,
difficulty breathing, abdominal pain, headache,
weakness, and confusion
How is Lung Cancer Evaluated?
Because almost all patients will have a tumor in the lung, a
chest x-ray or CT scan of the chest is performed
The diagnosis must be confirmed with a biopsy
The location(s) of all sites of cancer is determined by
additional CT scans, PET (positron emission tomography)
scans, and MRI (magnetic resonance imaging)
It is important to find out if cancer started in the lung or
somewhere else in the body. Cancer arising in other parts of
the body can spread to the lung as well
How is Lung Cancer Treated?
Treatment depends on the stage and type of lung cancer
Surgery
Radiation therapy
Chemotherapy (options include a combination of drugs)
Targeted therapy
Lung cancer is usually treated with a combination of therapies
Cancer Treatment: Surgery
The tumor and the nearby lymph nodes in the chest are
typically removed to offer the best chance for cure
For non-small cell lung cancer, a lobectomy (removal of
the entire lobe where the tumor is located), has shown to
be most effective
Surgery may not be possible in some patients
Cancer Treatment: Chemotherapy
Drugs used to kill cancer cells
A combination of medications is often used
May be prescribed before or after surgery, or before,
during, or after radiation therapy
Can improve survival and lessen lung cancer symptoms
in all patients, even those with widespread lung cancer
Cancer Treatment: Radiation Therapy
The use of high-energy x-rays or other particles to
destroy cancer cells
Side effects include fatigue, malaise (feeling unwell), loss
of appetite, and skin irritation at the treatment site
Radiation pneumonitis is the irritation and inflammation
of the lung; occurs in 15% of patients
It is important that the radiation treatments avoid the
healthy parts of the lung
Lung Cancer Staging
Staging is a way of describing a cancer, such as the size of
the tumor and where it has spread
Staging is the most important tool doctors have to
determine a patient’s prognosis
The type of treatment a person receives depends on the
stage of the cancer
Staging is different for non-small cell lung cancer and
small cell lung cancer
Stage I Non-Small Cell Lung Cancer
Cancer is found only in
the lung
Surgical removal
recommended
Radiation therapy
and/or chemotherapy
may also be used
Stage II Non-Small Cell Lung Cancer
The cancer has spread to
lymph nodes in the lung
Treatment is surgery to
remove the tumor and
nearby lymph nodes
Chemotherapy
recommended;
radiation therapy
sometimes given after
chemotherapy
Stage III Non-Small Cell Lung Cancer
The cancer has spread to the lymph
nodes located in the center of the chest,
outside the lung
Stage IIIA cancer has spread to lymph
nodes in the chest, on the same side
where the cancer originated
Stage IIIB cancer has spread to lymph
nodes on the opposite side of the chest,
under the collarbone, or the pleura
(lining of the chest cavity)
Surgery or radiation therapy with
chemotherapy recommended for stage
IIIA
Chemotherapy and sometimes
radiation therapy recommended for
stage IIIB
Stage IV Non-Small Cell Lung Cancer
The cancer has spread to
different lobes of the lung
or to other organs, such as
the brain, bones, and liver
Stage IV non-small cell
lung cancer is treated with
chemotherapy
Small Cell Lung Cancer–All Stages
Patients with limited stage (confined to one area of the chest)
small cell lung cancer are treated with simultaneous radiation
therapy and chemotherapy
Patients with extensive stage (not confined to one area of the
chest) small cell lung cancer are treated with chemotherapy
only
Because small cell lung cancer can spread to the brain,
preventative radiation therapy to the brain is routinely
recommended to all patients whose tumors disappear
following chemotherapy and radiation therapy
Living With Lung Cancer
Patients with lung cancer face the risk of cancer growing back or the
development of a new lung cancer. All patients must follow up with
their doctors for regular x-rays, scans, and check-ups
Many people with lung cancer feel that they will not receive as much
support or help from people around them because they believe
others will think that their behavior caused the disease
Doctors and other members of the health-care team can help
patients and families cope with a diagnosis of lung cancer
Patients can take comfort knowing that the advances being made in
the diagnosis and treatment of lung cancer will provide more and
more patients with a chance for cure
The Role of Clinical Trials for the Treatment of
Lung Cancer
Clinical trials are research studies involving people
They test new treatments and prevention methods to
determine whether they are better than the best known
treatment
The purpose of a clinical trial is to answer a specific medical
question in a highly structured, controlled process
Clinical trials evaluate methods of cancer prevention,
screening, diagnosis, treatment, and/or quality of life
Clinical Trials: Patient Safety
Informed consent: Participants should understand why
they are being offered entry into a clinical trial and the
potential benefits and risks
Informed consent is an ongoing process. Participants are
constantly updated as new information becomes available
Participation is always voluntary, and patients can leave
the trial at any time
Clinical Trials: Phases
Phase I trials determine safety and dose of a new treatment in
a small group of people
Phase II trials provide more detail about the safety of the new
treatment and determine how well it works for treating a given
form of cancer
Phase III trials take a new treatment that has shown promise
when used to treat a small number of patients with cancer and
compare it with the best treatment available for that disease;
phase III trials involve a large number of patients
Clinical Trials Resources
Coalition of Cancer Cooperative Groups
(www.CancerTrialsHelp.org)
CenterWatch (www.centerwatch.com)
National Cancer Institute
(www.cancer.gov/clinical_trials)
Coping With the Side Effects of Cancer
and its Treatment
Side effects are treatable; talk with the doctor, nurse, and
pharmacist
Fatigue is a common, treatable side effect
Pain is always treatable; non-narcotic pain relievers are
available
Medications and extra oxygen can improve breathing
Radiation therapy or surgery can be used to treat
metastases that are causing pain or other symptoms
For more information, visit www.plwc.org/sideeffects
Follow-Up Care
Quitting smoking helps recovery and health. Patients
who have developed lung cancer who then stop live
longer. It is never too late to stop smoking
Your doctor will outline a program of tests and visits to
monitor your health
Where to Find More Information:
PLWC Guide to Lung Cancer
(www.plwc.org/lung)
Overview
Medical Illustrations
Risk Factors and
Prevention
Symptoms
Diagnosis
Staging With Illustrations
Treatment
Side Effects of Cancer and
Cancer Treatment
Living With Lung Cancer
Questions to Ask the
Doctor
Current Research
Patient Information
Resources
Clinical Trials Resources
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