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PLWC Slide Deck Series:PLWC Slide Deck Series:
Understanding Lung CancerUnderstanding Lung Cancer
PresentsPresents
20062006
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What is Cancer?What is Cancer?
A group of 100 different diseases
The uncontrolled, abnormal growth of cells
Cancer mayspread to other parts of thebody
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What is Lung Cancer?What is Lung Cancer?
The leading cause of cancer deathamong men andwomen
Begins when cells in the lung grow out of control andform a tumor
There are two main types of lung cancer: non-small celland small cell
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What is the Function of the Lungs?What is the Function of the Lungs?The lungs consist of five lobes,three in the right lung and two inthe left lung
Most cells in the lung areepithelial cells, which line thebreathing passages and producemucus, which lubricates andprotects the lungs
The main function of the lungs isto allow oxygen from the air toenter thebloodstream for deliveryto the rest of the body
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What Are the Risk FactorsWhat Are the Risk Factorsfor Lung Cancer?for Lung Cancer?
Tobacco and secondTobacco and second--hand smokehand smoke
AsbestosAsbestos
RadonRadon
Most people who develop lung cancer todayhave eitherMost people who develop lung cancer todayhave eitherstopped smokingyears earlier or have never smokedstopped smokingyears earlier or have never smoked
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Lung Cancer and EarlyDetectionLung Cancer and EarlyDetection
No tests are recommended for screening the generalNo tests are recommended for screening the generalpopulationpopulation
A lowA low--dose helical computerized tomography(CT ordose helical computerized tomography(CT orCAT) scan is currentlybeing studied for this purposeCAT) scan is currentlybeing studied for this purpose
Anyperson who is at increased risk due to smoking orAnyperson who is at increased risk due to smoking orasbestos exposure should discuss thebenefits andasbestos exposure should discuss thebenefits andlimitations ofa screening CT scan withhis or her doctorlimitations ofa screening CT scan withhis or her doctor
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What Are the Symptoms of Lung Cancer?What Are the Symptoms of Lung Cancer?
Fatigue (tiredness)Fatigue (tiredness)
CoughCough
Shortness ofbreathShortness ofbreathChest painChest pain
Loss ofappetiteLoss ofappetite
Coughing up phlegmCoughing up phlegm
Hemoptysis (coughing upblood)Hemoptysis (coughing upblood)If cancer has spread, symptoms includebone pain,If cancer has spread, symptoms includebone pain,difficultybreathing, abdominal pain, headache,difficultybreathing, abdominal pain, headache,
weakness, and confusionweakness, and confusion
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How is Lung Cancer Evaluated?How is Lung Cancer Evaluated?
Because almost all patients will have a tumor in the lung, aBecause almost all patients will have a tumor in the lung, achest xchest x--rayor CT scan of the chest is performedrayor CT scan of the chest is performed
The diagnosis mustbe confirmed withabiopsyThe diagnosis mustbe confirmed withabiopsy
The location(s) ofall sites of cancer is determinedbyThe location(s) ofall sites of cancer is determinedbyadditional CT scans, PET (positron emission tomography)additional CT scans, PET (positron emission tomography)scans, and MRI (magnetic resonance imaging)scans, and MRI (magnetic resonance imaging)
It is important to find out if cancer started in the lung orIt is important to find out if cancer started in the lung orsomewhere else in thebody. Cancer arising in other parts ofsomewhere else in thebody. Cancer arising in other parts ofthebodycan spread to the lung as wellthebodycan spread to the lung as well
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How is Lung Cancer Treated?How is Lung Cancer Treated?
Treatment depends on the stage and type of lung cancerTreatment depends on the stage and type of lung cancer
SurgerySurgery
Radiation therapyRadiation therapy
Chemotherapy(options include a combination of drugs)Chemotherapy(options include a combination of drugs)
Targeted therapyTargeted therapy
Lung cancer is usuallytreated witha combination of therapiesLung cancer is usuallytreated witha combination of therapies
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Cancer Treatment: SurgeryCancer Treatment: SurgeryThe tumor and the nearbylymph nodes in the chest areThe tumor and the nearbylymph nodes in the chest aretypicallyremoved to offer thebest chance for curetypicallyremoved to offer thebest chance for cure
For nonFor non--small cell lung cancer, a lobectomy(removal ofsmall cell lung cancer, a lobectomy(removal ofthe entire lobe where the tumor is located), has shown tothe entire lobe where the tumor is located), has shown tobe most effectivebe most effective
Surgerymaynotbe possible in some patientsSurgerymaynotbe possible in some patients
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Cancer Treatment: ChemotherapyCancer Treatment: Chemotherapy
Drugs used to kill cancer cellsDrugs used to kill cancer cells
A combination of medications is often usedA combination of medications is often used
Maybe prescribedbefore or after surgery, orbefore,Maybe prescribedbefore or after surgery, orbefore,during, or after radiation therapyduring, or after radiation therapy
Can improve survival and lessen lung cancer symptomsCan improve survival and lessen lung cancer symptomsin all patients, even those with widespread lung cancerin all patients, even those with widespread lung cancer
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Cancer Treatment: Radiation TherapyCancer Treatment: Radiation Therapy
The use ofhighThe use ofhigh--energyxenergyx--rays or other particles torays or other particles todestroycancer cellsdestroycancer cells
Side effects include fatigue, malaise (feeling unwell), lossSide effects include fatigue, malaise (feeling unwell), lossofappetite, and skin irritation at the treatment siteofappetite, and skin irritation at the treatment site
Radiation pneumonitis is the irritation and inflammationRadiation pneumonitis is the irritation and inflammation
of the lung; occurs in 15% of patientsof the lung; occurs in 15% of patients
It is important that the radiation treatments avoid theIt is important that the radiation treatments avoid thehealthyparts of the lunghealthyparts of the lung
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Lung Cancer StagingLung Cancer Staging
Staging is a wayof describing a cancer, suchas the size ofStaging is a wayof describing a cancer, suchas the size ofthe tumor and where it has spreadthe tumor and where it has spread
Staging is the most important tool doctors have toStaging is the most important tool doctors have todetermine a patients prognosisdetermine a patients prognosis
The type of treatment a person receives depends on theThe type of treatment a person receives depends on the
stage of the cancerstage of the cancer
Staging is different for nonStaging is different for non--small cell lung cancer andsmall cell lung cancer andsmall cell lung cancersmall cell lung cancer
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Stage I NonStage I Non--Small Cell Lung CancerSmall Cell Lung Cancer
Cancer is found onlyinCancer is found onlyinthe lungthe lung
Surgical removalSurgical removalrecommendedrecommended
Radiation therapyRadiation therapyand/or chemotherapyand/or chemotherapymayalsobe usedmayalsobe used
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Stage II NonStage II Non--Small Cell Lung CancerSmall Cell Lung Cancer
The cancer has spread toThe cancer has spread tolymph nodes in the lunglymph nodes in the lung
Treatment is surgerytoTreatment is surgerytoremove the tumor andremove the tumor andnearbylymph nodesnearbylymph nodes
ChemotherapyChemotherapy
recommended;recommended;rradiation therapyadiation therapysometimes given aftersometimes given afterchemotherapychemotherapy
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Stage III NonStage III Non--Small Cell Lung CancerSmall Cell Lung CancerThe cancer has spread to the lymphThe cancer has spread to the lymphnodes located in the center of the chest,nodes located in the center of the chest,outside the lungoutside the lung
Stage IIIA cancer has spread to lymphStage IIIA cancer has spread to lymph
nodes in the chest, on the same sidenodes in the chest, on the same sidewhere the cancer originatedwhere the cancer originated
Stage IIIB cancer has spread to lymphStage IIIB cancer has spread to lymphnodes on the opposite side of the chest,nodes on the opposite side of the chest,under the collarbone, or the pleuraunder the collarbone, or the pleura(lining of the chest cavity)(lining of the chest cavity)
Surgeryor radiation therapywithSurgeryor radiation therapywithchemotherapyrecommended for stagechemotherapyrecommended for stageIIIAIIIA
Chemotherapyand sometimesChemotherapyand sometimesradiation therapyrecommended forradiation therapyrecommended forstage IIIBstage IIIB
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Stage IV NonStage IV Non--Small Cell Lung CancerSmall Cell Lung Cancer
The cancer has spread toThe cancer has spread to
different lobes of the lungdifferent lobes of the lungor to other organs, suchasor to other organs, suchasthebrain,bones, and liverthebrain,bones, and liver
Stage IV nonStage IV non--small cellsmall cell
lung cancer is treated withlung cancer is treated withchemotherapychemotherapy
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Small Cell Lung CancerSmall Cell Lung CancerAll StagesAll StagesPatients with limited stage (confined to one area of the chest)Patients with limited stage (confined to one area of the chest)small cell lung cancer are treated with simultaneous radiationsmall cell lung cancer are treated with simultaneous radiationtherapyand chemotherapytherapyand chemotherapy
Patients with extensive stage (not confined to one area of thePatients with extensive stage (not confined to one area of thechest) small cell lung cancer are treated with chemotherapychest) small cell lung cancer are treated with chemotherapyonlyonly
Because small cell lung cancer can spread to thebrain,Because small cell lung cancer can spread to thebrain,preventative radiation therapyto thebrain is routinelypreventative radiation therapyto thebrain is routinelyrecommended to all patients whose tumors disappearrecommended to all patients whose tumors disappearfollowing chemotherapyand radiation therapyfollowing chemotherapyand radiation therapy
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The Role of Clinical Trials for the Treatment ofThe Role of Clinical Trials for the Treatment ofLung CancerLung Cancer
Clinical trials are research studies involving peopleClinical trials are research studies involving people
Theytest new treatments and prevention methods toTheytest new treatments and prevention methods todetermine whether theyarebetter than thebest knowndetermine whether theyarebetter than thebest knowntreatmenttreatment
The purpose ofa clinical trial is to answer a specific medicalThe purpose ofa clinical trial is to answer a specific medical
question in ahighlystructured, controlled processquestion in ahighlystructured, controlled process
Clinical trials evaluate methods of cancer prevention,Clinical trials evaluate methods of cancer prevention,screening, diagnosis, treatment, and/or qualityof lifescreening, diagnosis, treatment, and/or qualityof life
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Clinical Trials: Patient SafetyClinical Trials: Patient Safety
Informed consent: Participants should understand whyInformed consent: Participants should understand whytheyarebeing offered entryinto a clinical trial and thetheyarebeing offered entryinto a clinical trial and thepotentialbenefits and riskspotentialbenefits and risks
Informed consent is an ongoing process. Participants areInformed consent is an ongoing process. Participants areconstantlyupdated as new informationbecomes availableconstantlyupdated as new informationbecomes available
Participation is always voluntary, and patients can leaveParticipation is always voluntary, and patients can leavethe trial at anytimethe trial at anytime
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Clinical Trials: PhasesClinical Trials: PhasesPhase I trials determine safetyand dose ofa new treatment inPhase I trials determine safetyand dose ofa new treatment ina small group of peoplea small group of people
Phase II trials provide more detail about the safetyof the newPhase II trials provide more detail about the safetyof the newtreatment and determine how well it works for treating a giventreatment and determine how well it works for treating a givenform of cancerform of cancer
Phase III trials take a new treatment that has shown promisePhase III trials take a new treatment that has shown promise
when used to treat a small number of patients with cancer andwhen used to treat a small number of patients with cancer andcompare it with thebest treatment available for that disease;compare it with thebest treatment available for that disease;phase III trials involve a large number of patientsphase III trials involve a large number of patients
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Clinical Trials ResourcesClinical Trials Resources
Coalition of Cancer Cooperative GroupsCoalition of Cancer Cooperative Groups(www.CancerTrialsHelp.org)(www.CancerTrialsHelp.org)
CenterWatch (www.centerwatch.com)CenterWatch (www.centerwatch.com)
National Cancer InstituteNational Cancer Institute
(www.cancer.gov/clinical_trials)(www.cancer.gov/clinical_trials)
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CopingWith the Side Effects of CancerCopingWith the Side Effects of Cancerand its Treatmentand its Treatment
Side effects are treatable; talk with the doctor, nurse, andSide effects are treatable; talk with the doctor, nurse, andpharmacistpharmacist
Fatigue is a common, treatable side effectFatigue is a common, treatable side effect
Pain is always treatable; nonPain is always treatable; non--narcotic pain relievers arenarcotic pain relievers areavailableavailable
Medications and extra oxygen can improvebreathingMedications and extra oxygen can improvebreathing
Radiation therapyor surgerycanbe used to treatRadiation therapyor surgerycanbe used to treatmetastases that are causing pain or other symptomsmetastases that are causing pain or other symptoms
For more information, visit www.plwc.org/sideeffectsFor more information, visit www.plwc.org/sideeffects
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FollowFollow--Up CareUp Care
Quitting smoking helps recoveryand health. PatientsQuitting smoking helps recoveryand health. Patientswho have developed lung cancer who then stop livewho have developed lung cancer who then stop live
longer. It is never too late to stop smokinglonger. It is never too late to stop smoking
Your doctor will outline a program of tests and visits toYour doctor will outline a program of tests and visits tomonitoryour healthmonitoryour health
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Where to Find More Information:PLWC Guide to Lung Cancer
(www.plwc.org/lung)
OverviewOverview
Medical IllustrationsMedical IllustrationsRisk Factors andRisk Factors andPreventionPrevention
SymptomsSymptoms
DiagnosisDiagnosisStagingWith IllustrationsStagingWith Illustrations
TreatmentTreatment
Side Effects of Cancer andSide Effects of Cancer and
Cancer TreatmentCancer TreatmentLivingWith Lung CancerLivingWith Lung Cancer
Questions to Ask theQuestions to Ask theDoctorDoctor
Current ResearchCurrent ResearchPatient InformationPatient InformationResourcesResources
Clinical Trials ResourcesClinical Trials Resources
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People LivingWith Cancer (www.plwc.org)People LivingWith Cancer (www.plwc.org)
PLWC is the cornerstone of ASCOs patient resources programPLWC is the cornerstone of ASCOs patient resources program
Visitors to PLWC will find:Visitors to PLWC will find:
PLWC Guides to more than 90 types of cancerPLWC Guides to more than 90 types of cancer Coping resourcesCoping resources
Ask the ASCO Expert Series, including chats, Q&A forums,Ask the ASCO Expert Series, including chats, Q&A forums,and event transcriptsand event transcripts
Cancer information in SpanishCancer information in Spanish
The latest cancer newsThe latest cancer news
For patient information resources, please call 888For patient information resources, please call 888--651651--30383038