Lung Cancer.pdf

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Implementation of Multidisciplinary Care 5 B Figure 1–1. (continued) Figure 1–2. New cases of cancer and cancer deaths for the 4 leading cancers in the United States, 2001. Source: American Cancer Society. Cancer Facts and Figures—2001. Atlanta, Ga: American Cancer Society; 2001:5.
6 J.B. Putnam, Jr., F.V. Fossella, and R. Komaki The decrease in lung cancer incidence and mortality in men probably reflects decreases in cigarette smoking over the past 30 years. Unfortunately, smoking cessation in women has lagged behind smoking cessation in men. Cigarette smoking among young people increased during the 1990s. Etiology Cigarette smoking is unequivocally the most important risk factor in the development of lung cancer. The American Cancer Society estimates that about 170,000 cancer deaths could be avoided each year if tobacco use were eliminated (American Cancer Society, 2002). Other environmental factors that may predispose individuals to lung cancer include iatrogenic radiation exposure and exposure to industrial substances such as asbestos, arsenic, chromium, and nickel; organic chemicals; radon; air pollution; and secondary smoke. Pathology In general, lung cancer is slightly more likely to develop in the right lung than in the left lung as the right lung has approximately 55% of the lung parenchyma. In addition, lung cancer occurs more frequently in the upper lobes than in the lower lobes. The blood supply to lung tumors, which arise from the bronchial epithelium, is from the bronchial arteries. A small percentage of patients with lung cancer have a second focus or metastasis of lung cancer at diagnosis. Lung cancer can extend directly by local extension along the bronchus of origin, into the chest wall, across fissures, and into the great vessels, the pericardium, or the diaphragm. Lung cancer can also involve other thoracic structures, such as the superior vena cava, the recurrent or phrenic nerves, or the esophagus, by direct extension. Lung tumors commonly metastasize to the pulmonary (intraparenchymal) and mediastinal lymph nodes. Small cell lung cancer (SCLC) is more likely than non–small cell lung cancer (NSCLC) to metastasize to the lymph nodes and other organs. Typically, the pattern of spread is first to the hilar lymph nodes and then into the mediastinal (usually ipsilateral) lymph nodes. Tumors of the left lower lobe that metastasize to the mediastinal nodes involve the contralateral mediastinum in about 25% of patients. Lung cancer can spread hematogenously to the liver, adrenals, lung, bones, kidneys, and brain. Bone metastases are usually osteolytic. Lung cancer is the second most common cause of bone metastases after breast cancer. Metastases rarely occur distal to the elbow or distal to the knee. Spread of lung cancer through the airways to another discontinuous area
Page 1 and 2: Lung Cancer Frank V. Fossella, MD R
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Page 5 and 6: Frank V. Fossella, MD Department of
Page 7 and 8: vi Foreword possible. Since the res
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Page 11 and 12: x Contents Chapter 7 Surgical Treat
Page 13 and 14: xii Contributors Joe B. Putnam, Jr.
Page 15 and 16: 2 J.B. Putnam, Jr., F.V. Fossella,
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Page 39 and 40: 26 F.V. Fossella common sites of lu
Page 41 and 42: 28 F.V. Fossella history and physic
Page 43 and 44: 30 F.V. Fossella Computed Tomograph
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56 R.F. Munden and J.J. Erasmus Swe
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58 P. Tamboli and J.Y. Ro Chapter O
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60 P. Tamboli and J.Y. Ro Figure 4-
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62 P. Tamboli and J.Y. Ro Postopera
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64 P. Tamboli and J.Y. Ro Table 4-1
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66 P. Tamboli and J.Y. Ro Atypical
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68 P. Tamboli and J.Y. Ro Diffuse I
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70 P. Tamboli and J.Y. Ro noma. Cig
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72 P. Tamboli and J.Y. Ro Figure 4-
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74 P. Tamboli and J.Y. Ro alone. BA
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76 P. Tamboli and J.Y. Ro Other Mal
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78 P. Tamboli and J.Y. Ro Electron
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80 P. Tamboli and J.Y. Ro Niho S, Y
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82 Y. De Jesus and G.L. Walsh Chapt
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84 Y. De Jesus and G.L. Walsh Figur
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86 Y. De Jesus and G.L. Walsh guide
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88 Y. De Jesus and G.L. Walsh with
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Figure 5-2. Patient “pathway to r
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94 Y. De Jesus and G.L. Walsh Recov
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98 Y. De Jesus and G.L. Walsh KEY P
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100 Y. De Jesus and G.L. Walsh Jenn
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102 W.R. Smythe nation for these su
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104 W.R. Smythe patient reports of
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106 W.R. Smythe bar or limited lung
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108 W.R. Smythe hospitals for 149 p
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110 W.R. Smythe Figure 6-1. Postsur
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112 W.R. Smythe nant neoplasms has
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114 W.R. Smythe Future Directions F
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116 W.R. Smythe Henschke CI, McCaul
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7 SURGICAL TREATMENT OF LOCALLY ADV
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120 S.G. Swisher Treatment Options
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122 S.G. Swisher Initial Assessment
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124 S.G. Swisher Figure 7-1. Region
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126 S.G. Swisher Table 7-2. (contin
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128 S.G. Swisher upper paratracheal
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130 S.G. Swisher is performed only
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132 S.G. Swisher chance for long-te
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134 S.G. Swisher Pancoast tumors th
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136 S.G. Swisher A B Figure 7-2. Do
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138 S.G. Swisher a combination of t
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140 S.G. Swisher Dartevelle PG, Cha
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8 NONSURGICAL TREATMENT OF EARLY-ST
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144 R. Komaki morbid conditions pre
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146 R. Komaki and 26 patients had c
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148 R. Komaki Around 1998, by using
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150 R. Komaki Table 8-5. Survival a
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152 R. Komaki A total of 610 patien
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154 R. Komaki tially obstructed air
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156 R. Komaki report of Radiation T
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9 TREATMENT OF PATIENTS WITH ADVANC
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160 R. Zinner chemotherapy, in pati
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Table 9-1. Chemotherapy in Older Pa
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164 R. Zinner results of additional
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Table 9-3. Third-Generation-Agent M
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Table 9-4. Third-Generation Agents
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Table 9-5. Third-Generation Platinu
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Table 9-6. Comparisons between Diff
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174 R. Zinner may play an important
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Table 9-8. Third-Generation Cisplat
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178 R. Zinner wards higher survival
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180 R. Zinner KEY PRACTICE POINTS
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182 R. Zinner DeVore RF, Fehrenbach
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184 R. Zinner Perng RP, Chen YM, Mi
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10 TREATMENT OF LIMITED-STAGE SMALL
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188 R. Komaki Age is not a signific
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190 R. Komaki lished between 1979 a
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Table 10-1. Complete Response Rates
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194 R. Komaki twice daily to a tota
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196 R. Komaki Intergroup study 0096
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198 R. Komaki Figure 10-1. Survival
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200 R. Komaki cisplatin with concur
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202 R. Komaki KEY PRACTICE POINTS
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204 R. Komaki tients (Pts) with lim
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206 R. Komaki Wagner H, Kim K, John
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208 G.R. Blumenschein, Jr. recurs a
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210 G.R. Blumenschein, Jr. syndrome
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212 G.R. Blumenschein, Jr. toxicity
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214 G.R. Blumenschein, Jr. the year
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216 G.R. Blumenschein, Jr. is chara
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218 G.R. Blumenschein, Jr. new cyto
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12 PALLIATIVE CARE IN PATIENTS WITH
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222 J.B. Putnam, Jr. therapy. Patie
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224 J.B. Putnam, Jr. tion—includi
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226 J.B. Putnam, Jr. rates were 47%
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228 J.B. Putnam, Jr. Dyspnea The ma
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230 J.B. Putnam, Jr. Small-bore cat
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232 J.B. Putnam, Jr. A B Figure 12-
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234 J.B. Putnam, Jr. C D Figure 12-
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236 J.B. Putnam, Jr. B Figure 12-3.
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238 J.B. Putnam, Jr. KEY PRACTICE P
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240 J.B. Putnam, Jr. Rendina EA, De
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242 A.A. Vaporciyan, J.F. Kelly, an
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14 PREVENTION AND EARLY DETECTION O
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258 E.S. Kim and F.R. Khuri A secon
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260 E.S. Kim and F.R. Khuri Smoking
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262 E.S. Kim and F.R. Khuri Reversa
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264 E.S. Kim and F.R. Khuri yet to
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266 E.S. Kim and F.R. Khuri nation
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268 E.S. Kim and F.R. Khuri Methodo
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270 E.S. Kim and F.R. Khuri have be
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272 E.S. Kim and F.R. Khuri the tre
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274 E.S. Kim and F.R. Khuri changes
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276 E.S. Kim and F.R. Khuri KEY PRA
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278 E.S. Kim and F.R. Khuri Hong WK
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15 MOLECULAR EVENTS IN LUNG CANCER
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282 W.N. Hittelman, J.M. Kurie, and
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300 Index Anterior spinal column re
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302 Index Cardiac murmurs, 104 Card
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304 Index Diagnosis. See also under
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306 Index Growth. See Tumor growth
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308 Index Magnetic resonance (MR) i
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310 Index p16 gene, 285 p19 arf gen
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312 Index Pulmonary resection (cont
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314 Index Squamous metaplasia, 263-
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316 Index Vitamin A, 262 Vocal cord
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