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Lung Cancer

 

Lung cancer is a condition in which lung cells multiply uncontrollably to form growth (called tumors) that invade and destroy normal tissue. These malignant cells have the potential to migrate to other sites of the body causing metastasis and symptoms related to the invaded organ.

Lung cancer is the second most common cancer in men (after prostate cancer) and in women (after breast cancer), however is the number one in cancer mortality in the United States accounting for one third of all cancer-related deaths (150,000 each year) in men and women.

The most important risk factor for lung cancer is tobacco smoking. Eighty-five percent of all lung cancer cases occur in active or former smokers; making smoking cessation the most crucial factor for preventing lung cancer. Additional risk factors include second hand smoking, environmental exposures such as asbestos and radiation, chronic obstructive pulmonary disease (COPD) and family history of lung cancer.

Lung cancer is usually asymptomatic until is in advanced stages. This is one reason why most of the cases are diagnosed late during the disease. Symptoms include cough (in some cases with blood), shortness of breath, chest pain, fatigue, loss of appetite, weight loss, headaches, confusion, and bone pain.

A definitive diagnosis of lung cancer requires the presence of malignant cells in tissue biopsy or cytology. These specimens can be collected through diverse diagnostic procedures that include sputum cytology, bronchoscopy, thoracentesis, CT-guided lung biopsies or surgery.

Staging of lung cancer may include different imaging procedures involving the chest, abdominal and brain and include CTs, CT-PETs, and brain MRIs.  In addition, more invasive procedures such as Endobronchial Ultrasound Bronchoscopy (EBUS), Endoscopic Ultrasound Endoscopy (EUS), or surgical procedures such as mediastinoscopy are employed to make the diagnosis of lung cancer. In some cases biopsies of possible metastatic sites may be required in order to stage the tumor, which is important for deciding upon the best treatment option.

Treatment of lung cancer includes surgical resection for early stages if the patient is a good surgical candidate. Radiation therapy and chemotherapy are used for advance stages or for non-surgical candidates in early stages. An important advance in the treatment of lung cancer is the use of molecular markers in tissue samples that can identify patients who will respond better to specific chemotherapy agents.

Lung cancer screening with low dose CT has recently shown encouraging results; however there are potential risks with this approach that need to be discussed in detail with your treating physician.

At Tulane we are committed to provide the best care possible in lung cancer, which includes a fast diagnostic approach and accurate staging using state of the art technologies such as endobronchial (EBUS) and endoscopic ultrasound (EUS) techniques.  Moreover,  we use state-of-the-art molecular pathology techniques to detect EGFR mutations and ALK-fusion gene rearrangements, that identify patients who will respond to new potent treatments for lung cancer. Our pulmonary specialist are part of  a multi-disciplinary team that also includes oncologists, radiation oncologists, pathologists, interventional radiologists and thoracic surgeons in order to provide the best treatment or palliation to every patient.

The Tulane Lung Center is a comprehensive clinical program that can quickly and accurately evaluate patients with abnormal chest X-rays that may represent lung cancer,and can assist patients in selecting the best treatment options if lung cancer is identified.  You can make an appointment with our physicians by calling 504-988-5800.

Useful Links

Lung Cancer Alliance

American Lung Association

American Thoracic Society

Lung Cancer Staging

Fiberoptic Bronchoscopy (ATS)

Lung Cancer Prevention

Advanced Lung Cancer (ACCP)

International Association For The Study Of Lung Cancer (IASLC)

IASLC Statement On CT Screening For Lung Cancer

Louisiana Smoking Cessation

The Louisiana Campaign For Tobacco-Free Living

 

Tulane School of Medicine  504-988-3541 cestevez@tulane.edu