THE CORRELATION BETWEEN

SMOKING AND LUNG CARCINOMA

Definition
Smoking is the inhalation of the smoke of
burning tobacco encased in cigarettes, pipes,
and cigars. Casual smoking is the act of
smoking only occasionally, usually in a social
situation or to relieve stress. A smoking habit is
a physical addiction to tobacco products. Many
health experts now regard habitual smoking as
a psychological addiction, too, and one with
serious health consequences
Description
Cigarettes and smokeless tobacco should be
considered nicotine delivery devices
Depending on the circumstances and the amount
consumed, nicotine can act as either a stimulant or
tranquilizer
Nicotine, increases the risk of heart disease
Besides tar, nicotine, and carbon monoxide, tobacco
smoke contains 4,000 different chemicals. More than
200 of these chemicals are known be toxic.
smoke , inhales and then breathes out leaves harmful
deposits inside the body


Health Risks of Cigarette Smoking
By 2001, an estimated 450,000 Americans
died annually from diseases related to
cigarette smoking
In addition to those health risks, smokers are
at a higher risk for the development of many
types of cancer
Definition
Lung cancer is a disease of uncontrolled
cell growth in tissues of the lung. This
growth may lead to metastasis, which is
the invasion of adjacent tissue and
infiltration beyond the lungs.
Classification
Non-small cell lung carcinoma (NSCLC):
Small cell lung carcinoma (SCLC)



Others : In infants and children, the most
common primary lung cancers are
pleuropulmonary blastoma and carcinoid
tumor.




Classification
Secondary cancers: The lung is a common
place for metastasis from tumors in other parts
of the body
Staging: Lung cancer staging is an
assessment of the degree of spread of the
cancer from its original source. It is an
important factor affecting the prognosis and
potential treatment of lung cancer
Signs and symptoms
dyspnea (shortness of breath)
hemoptysis (coughing up blood)
chronic coughing or change in regular coughing pattern
wheezing
chest pain or pain in the abdomen
cachexia (weight loss), fatigue, and loss of appetite
dysphonia (hoarse voice)
clubbing of the fingernails (uncommon)
dysphagia (difficulty swallowing).

. Pathogenesis
Similar to many other cancers, lung cancer is
initiated by activation of oncogenes or
Inactivation of tumor suppressor genes.
Several genetic polymorphisms are associated
with lung cancer
Diagnosis
Chest radiograph




Chest radiograph showing a
cancerous tumor in the left lung.
Performing a chest radiograph is the
first step if a patient reports
symptoms that may be suggestive
of lung cancer.
Abnormal findings in cells ("atypia")
in sputum are associated with an
increased risk of lung cancer.

CT scan




CT scan showing a cancerous
tumor in the left lung.
The differential diagnosis for
patients who present with
abnormalities on chest
radiograph includes lung cancer
as well as nonmalignant
diseases.
Treatment
1. Surgery





Gross appearance of the cut
surface of a
pneumonectomy specimen
containing a lung cancer,
here a squamous cell
carcinoma (the whitish
tumor near the bronchi).


2. Chemotherapy
Small cell lung carcinoma is
treated primarily with
chemotherapy and radiation,
as surgery has no
demonstrable influence on
survival. Primary
chemotherapy is also given
in metastatic non-small cell
lung carcinoma.
The combination regimen
depends on the tumor type.
3. Adjuvant chemotherapy for NSCLC
Adjuvant chemotherapy refers to the use of chemotherapy
after surgery to improve the outcome.
Adjuvant chemotherapy for patients with stage IB cancer is
controversial, as clinical trials have not clearly demonstrated a
survival benefit. Trials of preoperative chemotherapy
(neoadjuvant chemotherapy) in resectable non-small cell lung
carcinoma have been inconclusive.

4. Radiotherapy
Radiotherapy is often given together with chemotherapy, and may be
used with curative intent in patients with non-small cell lung
carcinoma who are not eligible for surgery
For both non-small cell lung carcinoma and small cell lung carcinoma
patients, smaller doses of radiation to the chest may be used for
symptom control (palliative radiotherapy).
Brachytherapy (localized radiotherapy) may be given directly inside
the airway when cancer affects a short section of bronchus
Patients with limited stage small cell lung carcinoma are usually given
prophylactic cranial irradiation (PCI).

Recent improvements in targeting and imaging have led to the
development of extracranial stereotactic radiation in the treatment of
early-stage lung cancer.

5. Interventional radiology
Radiofrequency ablation should currently be
considered an investigational technique in the
treatment of bronchogenic carcinoma. It is done
by inserting a small heat probe into the tumor to
kill the tumor cells.

Prognosis
Prognostic factors in non-small cell lung cancer include
presence or absence of pulmonary symptoms, tumor size, cell
type (histology), degree of spread (stage) and metastases to
multiple lymph nodes, and vascular invasion. For patients with
inoperable disease, prognosis is adversely affected by poor
performance status and weight loss of more than 10%.
Prognostic factors in small-cell lung cancer include
performance status, gender, stage of disease, and involvement
of the central nervous system or liver at the time of diagnosis.
For non-small cell lung carcinoma, prognosis is generally poor
For small cell lung carcinoma, prognosis is also generally poor
According to data provided by the National Cancer Institute,
the median age of incidence of lung cancer is 70 years, and
the median age of death by lung cancer is 71 years.


Smoking, particularly of cigarettes, is by far the main
contributor to lung cancer. Across the developed world,
almost 90% of lung cancer deaths are caused by smoking
The length of time a person smokes (as well as rate of
smoking) increases the person's chance of developing lung
cancer.
Passive smokingthe inhalation of smoke from another's
smokingis a cause of lung cancer in nonsmokers. A
passive smoker can be classified as someone living or
working with a smoker as well. Studies from the U.S.,
Europe,the UK, and Australia have consistently shown a
significant increase in relative risk among those exposed to
passive smoke. Recent investigation of sidestream smoke
suggests that it is more dangerous than direct smoke
inhalation.

The most cost-effective means of fighting lung cancer.
Policy interventions to decrease passive smoking in
public areas such as restaurants and workplaces
Arguments cited against such bans are criminalisation
of smoking, increased risk of smuggling, and the risk
that such a ban cannot be enforced.
The long-term use of supplemental multivitamins
such as vitamin C, vitamin E, and folatedoes not
reduce the risk of lung cancer
The World Health Organization has called for
governments to institute a total ban on tobacco
advertising in order to prevent young people from
taking up smoking.