When it is first detected, lung cancer can be in any of a number of stages. Lung cancer staging is important for determining how a particular case of lung cancer should be treated, since therapies are geared toward specific stages. Staging of a cancer is also critical in estimating the prognosis of a given patient, with higher-stage cancers generally having a worse prognosis than lower-stage cancers.
Doctors may use several tests to accurately assess the stage of lung cancer, including laboratory (blood chemistry) tests, X-rays, CT scans, bone scans, and MRI scans. Abnormal blood chemistry tests may signal the presence of metastases in bone or liver, and radiological procedures can document the size of a cancer as well as possible spread to other organs. The following is a list of stages for non-small cell lung cancer:
Stage 1 Lung Cancer
Stage 1 lung cancer is localized. This means that there are no cancerous cells in any lymph nodes. All tissue surrounding the lung is also normal. Sometimes, stage 1 lung cancer is divided into 1A and 1B depending on the size of the tumor and whether or not a main bronchus is involved. Stage 1A tumors are small (3cm or less), and stage 1B tumors are larger OR they are growing into the main airway of the lung. Stage 1B also includes cancers that have grown into the inner covering of the lung and may have caused a partial collapse of the affected lung. Possible treatments for stage 1 lung cancer are: surgery, radiation therapy, and/or chemotherapy
Stage 2 Lung Cancer
Stage 2 lung cancer is starting to spread. It will be found in the lymph nodes near the lungs. Stage 2 lung cancer is further subdivided depending on it severity. Stage 2A is simply the same as stage 1A (small tumor), but the cancer is affecting the lymph node closest to the affected lung. Stage 2B can either be tumors more than 3cm plus affected lymph nodes OR no cancer in the lymph nodes but the cancer has grown into the outer covering of the lung, the chest wall, the diaphragm, or the outer covering of the heart. Possible treatments for stage 2 lung cancer are: surgery, radiation therapy, and/or chemotherapy.
Stage 3 Lung Cancer
Stage 3 lung cancer has multiple stages. Stage 3A can mean 2 things. There is cancer only in lymph nodes nearest to the affected lung but the cancer has also spread to either the chest wall or the covering of the lung (pleura) or the middle of the chest (mediastinum). Or, There is cancer in nodes further away from the affected lung, but still on the same side of the chest.
In stage 3B, the cancer as spread to lymph nodes on the opposite side of the chest. It could also have spread to the lymph nodes above your collarbone or you could have more than one tumor in the affected lobe of your lung. If there is a fluid collection around your lung that contains cancerous cells (malignant pleural effusion) or, if the tumor has grown into another major structure in your chest (main blood vessel, heart, windpipe, etc) it is also considered stage 3B lung cancer. Possible treatments for stage 3 include radiation therapy, surgery, combinations of chemotherapy, and/or other targeted therapies.
Stage 4 Lung Cancer
Stage 4 lung cancer has spread to the other lung or other areas of the body, and cannot be removed with surgery. It may show up in your liver or bones, or may have simply affected another lobe of your lung. Possible treatments for stage IV lung cancer are: radiation therapy, combinations of chemotherapy, and/or other targeted therapies.
Small Cell Lung Cancer Stages
The staging system for small cell lung cancer is the same system as the one used for non-small cell lung cancer. But, in practice small cell cancers are generally only divided into 2 groups. This is due to the fact that small cell lung cancer generally spreads very early. Even if there is no proof of this on your scans, it is very likely that cancerous cells have already spread via your lymphatic system or bloodstream. To err on the side of caution, most doctors prefer to treat all small cell lung cancer as if they have already spread.
The 2 stages of small cell lung cancer are limited disease and extensive disease. Limited disease can only be seen in 1 lung, nearby lymph nodes, or in fluid surronding the lung. Extensive disease on the other hand has already spread outside the lung to the chest cavity or other parts of the body. Surgery is normally not used for cases of small cell lung cancer unless it is caught very early. You doctor will most likely suggest chemotherapy and may or may not add radiation therapy.
The stages of lung cancer will tell you and your doctor how far a cancer has spread. The tests and scans you have to diagnose your cancer will shed some light about the stage the disease is in. All lung cancer staging includes information on the tumor size, whether there is cancer in the lymph nodes, and if the cancer has spread anywhere else.
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About Lung Cancer
Lung cancer is the number one cause of cancer deaths among men and women in the United States. There are two major types of lung cancer: small cell lung cancer and non-small cell lung cancer. Non-small cell lung cancer makes up about 80 to 90 percent of the cases; small cell lung cancer, approximately 10 to 12 percent. Both arise from lung epithelial cells. This article may not answer all of your lung cancer questions
, but it should provide you with a good base of information if you or a loved one is diagnosed with this awful disease.
Symptoms of lung cancer can include a cough that won’t go away, chest pain, hoarseness, shortness of breath, bloody or rust-colored sputum and recurring infections such as bronchitis and pneumonia. There are several publications that offer lung cancer facts and will help you separate the real information from the myths.
Lung Cancer Statistics
An estimated 163,510 individuals will die from the disease – about 29 percent of all cancer deaths. Among all patients with lung cancer, 42 percent are alive after one year – an increase from 37 percent in 1975. Still, the relative five-year survival rate for all lung cancers combined is only 15 percent. While 49 percent of individuals live at least five years when their cancer is diagnosed early and remains only in the lungs, very few cancers – about 16 percent – are detected at this stage.
In 1987, lung cancer surpassed breast cancer as the leading cause of cancer death each year in women. Lung cancer death rates in women have recently leveled off after decades of continual increase. In contrast, death rates in men have dropped by about 1.9 percent a year since 1991.
In 2005, an estimated 172,570 new cases of lung cancer will be diagnosed, making it the second most commonly diagnosed cancer in the United States and accounting for 13 percent of all cancer diagnoses. In men, the incidence rate has declined significantly, going from 102.1 cases per 100,000 in 1984 to 77.7 in 2001. The incidence rate in women has also declined for the first time after a long period of increase, from 52.8 cases per 100,000 in 1998 to 49.1 in 2001.
Detecting and Diagnosing Lung Cancer
It is extremely difficult to detect early symptoms of lung cancer. If lung cancer is suspected, a chest X-ray or a spiral CT (computed tomography) scan will be taken to look for a spot or mass on the lungs, or for lung tumors or metastatic disease. Improvements in computer imaging and particularly spiral CT allow physicians to see a more detailed cross-sectional view of the lungs, and have improved detection of early stage lung cancer. If something suspicious is found, then a bronchoscopy, which involves a lighted scope being placed into the lungs, may be performed to confirm the diagnosis. Innovative technologies involving fiber optics are being developed that uses laser light with bronchoscopy to identify early lung cancer and as well as precancerous changes in cells; the technology can be used as a research tool for diagnosis and prevention. A lung tissue biopsy may be performed to look for cancer cells in the phlegm and lung tissue as well.
A large, randomized clinical trial called the National Lung Screening Trial is trying to determine whether taking spiral CT scans of people at high risk will save lives. The trial, which started in 2002, involves some 50,000 people. The International Early Lung Cancer Action Project involves 27,000 individuals enrolled in a clinical trial at 30 sites on three continents. Preliminary results from the first 20,000 enrollees found a stage I lung cancer detection rate of 82 percent. Some 96 percent of the patients were cancer-free up to 100 months after surgery.
In 2004, the U.S. Preventive Services Task Force, on the basis of results of several studies, upgraded its recommendations regarding the use of spiral CT in routine screening. The group said that there was not enough evidence to date (March 2005) to recommend for or against routine screening in individuals who do not have symptoms.
Once you have been diagnosed, there are several things you can do to survive lung cancer. The most important of which are to arm yourself with good information and take action.
Prevent Lung Cancer and Lower Your Lung Cancer Risk
Approximately 85 to 87 percent of all cases of lung cancer are caused by tobacco use, making lung cancer one of the most preventable cancers. Another several percent stems from radon exposure. Individuals who have been smokers and asbestos workers (such as workers who installed asbestos attic insulation, built ships, or worked with asbestos insulated boilers) have a much higher risk of dying of lung cancer.
In the last decade, researchers have identified many of the genes involved in the development of lung cancer. They have found that turning off the activity of certain cancer-blocking genes called tumor suppressor genes such as p53 and Rb, and turning on various cancer-promoting genes such as c-myc, ras and bcl-2 may play roles in triggering lung cancer. More recently, scientists have identified a gene associated with a cluster of inherited lung cancer. The challenge remains for researchers to turn this knowledge into advances in diagnosis, therapy or prevention.
Latest Lung Cancer Research
Scientists are beginning to further develop and refine tools such as spiral CT that allow physicians to more routinely detect lung cancer. Innovations in radiation therapy for small volume lung cancers is one area that will continue to be explored, while the development of molecularly targeted, low toxicity adjuvant therapy for early cancers will be extremely important to manage such lung cancers.
Targeted therapies such as Iressa (gefitinib) and Tarceva (erlotinib) have shown some promise in clinical testing. These drugs are called EGFR (epidermal growth factor receptor) inhibitors, and they work by blocking a signaling pathway that cancer cells need to grow.
Iressa was approved by the FDA in May 2003 for patients with advanced non-small cell lung cancer whose tumors continue to grow despite chemotherapy. A randomized study last year by the National Cancer Institute of Canada Clinical Trials Group showed that patients given Tarceva (approved by the FDA in November 2004) after chemotherapy for advanced NSCLC lived longer than those who didn’t receive the drug. Patients with advanced disease generally only live a few months.
Scientists have known it is effective in only 10 to 15 percent of individuals who take it. A series of studies last year showed that certain mutations in EGFR tumors were associated with higher response rates to drugs such as Iressa and Tarceva.
Lung Cancer Treatments
Lung cancer is notoriously difficult to treat effectively. There are three standard ways to treat lung cancer: surgery, radiation therapy and chemotherapy. Tumor type, size and location determine the necessary treatment. While the most common type, NSCLC, is treated with surgery whenever possible, lung cancer is usually diagnosed after it has spread to other areas in the body, making a cure nearly impossible. Despite surgery that apparently removes all of the cancer, it nearly always comes back in the lung or elsewhere, such as the bone or liver.
Early-stage (stages I and II) NSCLCs are usually treated with surgery and often followed by chemotherapy. In some cases, radiation is used. In stage III, where some cancer cells have traveled to the lymph nodes, chemotherapy is typically required. But such patients are at risk for having the cancer return, and doctors may delay surgery until they can see if the chemotherapy has been effective in shrinking the tumor.
Individuals with lung cancer deemed inoperable (stage IIIB) may receive both chemotherapy and radiation if the cancer has not spread to other areas. Most patients with stage IV lung cancer or stage IIIB in which cancer cells are in the fluid around the lung – are very likely to have disease that has spread to other areas in the body and are treated with chemotherapy. They are rarely “cured.”
Some recent important advances have been made in treating early-stage NSCLC. In 2004, a pair of clinical trials by the National Cancer Institute of Canada and the Cancer and Leukemia Group B, respectively, showed that adding chemotherapy after surgery in early-stage NSCLC helped individuals live significantly longer. Similarly, two recent randomized trials of adjuvant chemotherapy after surgery for early-stage lung cancer also showed the importance of adding chemotherapy for the first time in lung cancer, and have changed the standard of care for such disease.
One innovation in the clinical trial setting is the so-called window of opportunity trial. In such studies, investigators give experimental therapeutics to lung cancer patients who have a two-to-four week period of time prior to surgery. Such drugs have already shown some favorable results and low toxicity. Researchers then can evaluate the drug’s effects on tumor size and biology.
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Granite countertops, that are found in the home of many people across the U.S., have been found to actually pose a health risk. It has been found that these granite countertops let out radioactive gas which can cause cancer.
The report comes from the New York Times, and focuses on granite countertops, which have become a popular staple in the home of many people in the U.S. and abroad.
The Environmental Protection Agency (EPA) has come out and stated that the gas emitted by the granite countertops is a radioactive noble gas, radon. It has no taste, no odor, etc. They are urging all consumers with granite countertops to pick up an inexpensive radon test kit to protect themselves. They also added that in some cases adding a radon detector could be a very good investment.
This gas affects indoor air quality, and is the leading cause of lung cancer in non-smokers.
The EPA put out a statement late Friday saying “While natural minerals such as granite may occasionally emit radon gas, the levels of radon attributable to such sources are not typically high. EPA believes the principal source of radon in homes is soil gas that is drawn indoors through a natural solutioni process.”
The EPA did state that construction materials such as granite, as well as concrete, cinder blocks, etc can contain small radioactive materials.
The New York Times article states that homeowners are recommended to “bring fresh air in and exchange it with the air in the kitchen.”
According to the Seattle P-I, “A radon measurement and mitigation technician was brought in to find the source and while passing what the reporter describes as “richly grained cream, brown and burgundy granite countertop” his Geiger counter indicated radiation levels 10 times higher than those he had measured elsewhere in the house.”
The Marble Institute of America told the Times that such claims are “ludicrous.” The Houston Chronicle cites Rice University physics professor W.J. Llope and he says that some granite countertops “contain high levels of uranium, which, by generating gamma radiation and radon gas, can endanger human health.”
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It looks like there is a new inhalable form of gene therapy - loosely based on technology that was recognized in the 2006 Nobel medicine prize - that shows increasing promise for treating lung cancer, infectious diseases and inflammatory lung disease, scientists have concluded after an exhaustive review of worldwide research on the topic.
In the released article, Niamh Durcan, Charlotte Murphy, and Sally-Ann Cryan focus on research efforts to develop an inhalable form of RNA interference (RNAi), a gene-therapy technique that interferes with or “silences” genes that make disease-causing proteins. These authors explain that RNAi has several advantages over other gene therapies. Among them are: it is very potent, it’s specific, and it appears to have a very low risk of side effects.
They also cite encouraging results with RNAi in laboratory studies in cells and animals with a range of lung diseases, including lung cancer, certain respiratory infections and inflammatory lung disease. The keys to successful therapy in humans include careful design of the gene-silencing agents, determining the most effective doses of the new drug, and then developing better ways of delivering RNAi agents to the lungs, the scientists say.
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This was just sent over from America’s Watchdog. Seems there is a new mesothelioma victims center. This is an organization dedicated to providing free assistance to victims of mesothelioma and their families. They are available 24 hours a day, 7 days a week. If anyone you know has been affected by this horrible disease, please do not hesitate to contact the mesothelioma victims center.
Three thousand US citizens will be diagnosed with mesothelioma in 2008. Of this number roughly 1/3rd will be veterans of the US Navy. Americas Watchdog is one of the best known private consumer groups in the United States, and in 2006 they knew very little about mesothelioma. Mesothelioma is a lethal form of cancer caused by exposure to asbestos attic insulation. It was also used in many other forms of insulating materials and in glues, tiles, and more. According to Americas Watchdog, “in 2006 we discovered a close family member was diagnosed with mesothelioma and we were sadly forced to become experts at what a mesothelioma victim or their family needs to do. We also found out nothing is easy, like finding the right law firm, helping to get VA or social security benefits, so we had to get the crash course in doing all of this”. As a result of their experience in getting help for a loved one with Mesothelioma, the group now offers 100% free help and advice for all victims of Mesothelioma and their families or loved ones. A mesothelioma victim or their family can call Americas Watchdog for free mesothelioma help and advice anytime at 866-714-6466 or they can visit the groups web site at http://MesotheliomaVictimsCenter.Com
According to Americas Watchdog,”aside from the fact that we are the absolute best free resource in the US on mesothelioma; we want people to know what makes us different from an Internet law firm offering help for mesothelioma victims. Number one, a mesothelioma victim, a family member, or loved one of a mesothelioma victim calls 866-714-6466, and they will get the President of Americas Watchdog, not a telephone answering service. The mesothelioma victim or family member/loved one will be provided with the actual names of the best mesothelioma law firms in the nation, and we will help with everything else including VA benefits for veterans, Social Social Security, etc. What ever they need, we will try our best to get for them”.
If you or a loved one has been diagnosed with mesothelioma, Americas Watchdog encourages them to call 866-714-6466 for some honesty, and some reality. The Mesothelioma Victims Center is not just the best place to discover the best law firms, its actually the best place to get unconditional help, and very honest free advice. US Navy Mesothelioma victims are especially encouraged to call the group.
Veterans groups, labor unions, and health care professionals are especially encouraged to share this information with your members, your colleagues or your patients. According to Americas Watchdog, “we are in this to be the best thing that ever happened to a mesothelioma victim, their family or their loved ones. We created the Mesothelioma Victims Center to provide the best free help available, for some very special people. This includes hero’s who served in our nations US Navy or armed forces. There is nothing close to our service in the world”. For more information mesothelioma victims, family members of mesothelioma victims or loved ones can call the group the Mesothelioma Victims Center anytime at 866-714-6466. Their web site is located at http://MesotheliomaVictimsCenter.Com
Americas Watchdog’s Mesothelioma Victims Center is all about consumer protection, corporate resonsibility and being their for precious souls in a time of need.
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