The Subject for this talk are Lung cancers
and lung tumours. Specifically lung cancer
itself which is a malignant cancer arising from respiratory
tract epithelium. But also lung metastases
that is secondary cancer spread from elsewhere in
the body to reach the lung. Mesothelioma which
is primary malignant cancer of the mesothelium
and particularly associated with asbestos
exposure and a little bit about rarer lung
tumours which is small benign or semi-malignant
tumours which are unusual but are sometimes
identified by radiology.
So Lung Cancer, it's difficult to emphasize
enough how important lung cancer is? It is
the commonest fatal cancer. It is
responsible for total of 13% of all cancers.
If you develop a lung cancer, there is a 90%
of chance of that cancer will kill you.
It is relatively rare if you are under 50.
But as you get over 50, the instance of lung
cancer increases, increases and increases
of a peak instance occurring around 75–79
years of age. Where 1 man in every 200 will develop
cancer each year and approaching 1 woman in
every 200 will develop a cancer each year.
If you look at the UK, the life time risk
for developing lung cancer for men is 1 in
14 and for women in 1 in 19. And for both
men and women it is the most fatal, it is
the commonest fatal lung cancer and in fact
it kills more people than the next three commonest
cancers put together.
There are two main histological characteristic
types of lung cancer. The first is called
non-small cell lung cancer and that accounts for
80% of the disease and this is further subdivided
into three categories. 1) Squamous cell cancer.
These tend to come from the large airways
in the centre of the lungs and therefore
presents with haemoptysis and blockage of
the airway. Adenocarcinoma which in contrast
to squamous cells tend to be peripheral tumours
and arise from mucosal glands in the smaller
airways distally and large cell cancers which
are the smaller proportionally 10% of these
cases which again is peripheral and histology
of the lung cancer is varied. The large cell
lung cancer is varied.
The other type of lung cancer is small cell
lung cancer. This accounts for 20% of all cases.
They like squamous cell cancers tend to be
central tumors arise in the peribronchial
epithelium and they grow rapidly and they metastasize
early. They are sensitive to chemotherapy
but because they grow so rapidly and because
even a presentation most patients have metastases
somewhere even if they are not detectable
by radiology. Surgery is not usually curative
and not offered and this is why there's such an important
distnction between small cell lung cancer and non-small cell
lung cancer. Because in non-small cell lung cancer,
your main aim is to identify patients who
can be cured by surgical resection where as
in small cell lung cancer that option is not
normally available and they will all get