lung%20cancer
LUNG CANCER
Lung cancer is having a malignant tumor in the lungs especially in the cells lining air passages.
Primary tumor-related signs and symptoms are cough, dyspnea, hemoptysis, and chest discomfort.
Signs and symptoms due to intrathoracic spread may involve the nerves (hoarseness, dyspnea, muscle wasting of upper limb, Horner's syndrome), chest wall and pleura (chest pain, dyspnea) and vascular structures (facial swelling, dilated neck veins, cardiac tamponade) & viscera (dsyphagia).
The signs and symptoms due to metastatic spread are bone pain with or without pleuritic pain, neurologic symptoms, limb weakness, unsteady gait, cervical lymphadenopathy, and skin nodules.

Definition

Lung cancer is the presence of a malignant tumor in the lungs especially in the cells lining air passages.

Signs and Symptoms

Primary Tumor-Related
Cough, dyspnea, hemoptysis, chest discomfort

Due to Intrathoracic Spread
May involve the nerves (hoarseness, dyspnea, muscle wasting of upper limb, Horner’s syndrome), chest wall & pleura (chest pain, dyspnea), vascular structures (facial swelling, dilated neck veins, cardiac tamponade) & viscera (dysphagia)

Due to Metastatic Spread
Bone pain with or without pleuritic pain, neurologic symptoms, limb weakness, unsteady gait, cervical lymphadenopathy, skin nodules

Paraneoplastic Syndromes

  • Hypercalcemia (nausea or vomiting, abdominal pain, constipation, polyuria, thirst, dehydration, confusion, irritability)
  • Syndrome of inappropriate antidiuretic hormone (SIADH) production (confusion, seizures, decreased level of consciousness, coma)
  • Cushing’s syndrome (weakness, muscle wasting, decreased level of consciousness, confusion, psychosis, dependent edema, hypokalemic alkalosis, hyperglycemia)
  • Others (digital clubbing, hypertrophic osteoarthropathy, Lambert-Eaton myasthenic syndrome, peripheral neuropathy, cortical cerebellar degeneration)

Other Symptoms
Malaise, loss of appetite & weight loss

Risk Factors

History

Risk Factor Assessment

  • Smoking cigarettes increases the risk of developing lung cancer
    • Number of packs of cigarettes smoked per day & the years spent smoking is directly related to the development of lung cancer
  • Passive smokers have 24% increased risk of developing lung cancer
  • Occupational & environmental exposures
    • Asbestos
    • Arsenic
    • Beryllium
    • Chloromethyl ether
    • Chromium
    • Nickel
    • Polycyclic aromatic hydrocarbons
    • Vinyl chloride
    • Radon
    • Cadmium
  • Previous lung disease (eg chronic obstructive pulmonary disease with FEV1 ≤70% predicted)
  • History of any cancer or thoracic radiation
    • Risk of cancer due to radiation is proportional to the dose received & usually starts approximately 20 years after exposure
  • Family history of lung cancer
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