Lung Cancer

Cancer can be one of the hardest battles that one must face, whether that battle is lost or won, it changes the lives of everyone involved. Lung cancer is one of the most diagnosed cancers and it affects the lining of the lungs and the ability to breathe. Lung cancer is the number one killer of men and women than any other cancer worldwide. This cancer is mostly found in smokers and this is why professionals are targeting this population for testing for diagnosing early and possibly saving a life (www. ncb. nlm. nih. gov). Lung cancer refers to the malignancies that originate in the airways or pulmonary parenchyma.

It is estimated that 159,480 deaths (87,260 men and 72,220 women) from this disease will occur this year. For all people with lung cancer, the one-year survival rate (percentage of people who survive at least one year after the cancer is detected excluding those who die from other diseases) is 44%. The five-year survival rate is 16% (www. cancer net). Lung cancer is mostly found in smokers or workers that worked with asbestos or environmental agents. Those that did not smoke but lived those who did, also have a higher rate of developing lung cancer.

Lung cancer is either defines as small cell lung carcinoma (SCLC) or non-small cell cancer (NSCLC), the difference between the two is the staging, treatment, and prognosis. Squamous cell carcinoma or (NSCLS) accounts for about 30% of bronchogenic carcinomas, it develops in the central lung area and also the mucoclilary epithelial cells and then adenocarcinomas (tumor arising from glands) of lung constitutes 35% to 40% of all bronchogenic carcinomas these from in the lung periphery and the alveolar types cells (Heuther/McCane, 2008. Pg. 742).

The incidence of lung cancer is more prevalent in the black community compared to the Caucasian community. In 2006, Kentucky had the highest rate of lung cancer rates in both men and women; whereas Utah had the lowest rate of lung cancer among both men and women (www. lung . org). Approximately 373,489 Americans are living with lung cancer during 2012; an estimated 226,160 new cases of lung cancer were expected to be diagnosed, representing almost 14 percent of all cancer diagnoses. The majority of those living with cancer will be diagnosed within the last five years (cancer. net). Lung cancer is not a death sentence.

The earlier that it is diagnosed the better chance for treatment and possibility for the chance to a long live, and it can also be that even if you have a chance for treatment, the rate of getting cancer in another part of the body can be very high. The lung cancer five-year survival rate (16. 3%) is lower than many other leading cancer sites, such as the colon (65. 2%), breast (90. 0%) and prostate (99. 9%). The five-year survival rate for lung cancer is 52. 6 percent for cases detected when the disease is still localized (within the lungs). However, only 15 percent of lung cancer cases are diagnosed at an early stage.

For distant tumors (spread to other organs) the five-year survival rate is only 3. 5 percent. Over half of people with lung cancer die within one year of being diagnosed (lung. org). Many people believe that only smoking can cause lung cancer but this is not true. There are several other agents that can cause cancer. The second most common cause of lung cancer is asbestos exposure. Health hazards have been recognized in workers exposed in the shipbuilding trades, asbestos mining and milling, manufacturing asbestos textiles and other asbestos products, insulation work in the construction and building trades and a variety of other trades.

There are also the environmental toxins such as: second-hand smoke, radon, metals (arsenic, chromium, and nickel), ionizing radiation, and polycyclic aromatic hydrocarbons (www. cancer. org). After looking into different genetic testing, I have learned that not a lot of genetic testing has been linked to lung cancer. Scientists have found that the retinoblastoma (RB) gene has been found in those with lung cancer and this has to do with the tumor suppressor gene, which normally inhibits expression of gene involved in all of the activities that turn cell cancerous.

According to the National Human Genome Research Institute (NHGRI) the researchers identified a large region on human chromosome 6 that conferred greater lung cancer risk in families with many affected individuals. Subsequent painstaking analysis to pinpoint the source of the elevated risk now has paid off with the identification of the precise culprit, a gene called RGS17. Researchers conducted fine-mapping of the suspect region of chromosome 6 in members of families in which five or more individuals over multiple generations were diagnosed with lung cancer.

The region contains approximately 100 genes. Precise computational analysis uncovered similar variants in the DNA sequence for members of the families with lung cancer. These variants, called single nucleotide polymorphisms (or SNPS) directed the researchers to the RGS17 gene. The conclusions of this analysis are that RGS17 plays a major role in lung cancer susceptibility, and individuals who carry the higher-risk version of this gene have an increased susceptibility to lung cancer when exposed to environmental risk factors, such as smoking.

While the research showed that RGS17 is an important gene for lung cancer susceptibility in families with a high incidence of lung cancer, the researchers did not see any correlation between this gene and lung cancer susceptibility in people without a strong family history of the disease. I also found that according to the article” Influence of genetic markers on survival in non-small cell lung cancer” overexpression of ERCC1 correlates with poor survival gemcitabine/cisplatin-treated non-small cell lung cancer patients. An ongoing customized ERCC1-based chemotherapy trial has been established on this knowledge.

Patients are randomized to the control arm of cisplatin/docetaxel is combined with cisplatin or gemcitabine according to ERCC1 levels. To date, 80 patients have been included. At the preclinical level, ERCC1 and XPD mRNA expression correlate with each other, and overexpression of XPD causes selective cisplatin resistance in human tumor cell lines. Some XPD polymorphisms have been associated with lower DNA repair capacity. In our experience, time to disease progression is significantly higher in gemcitabine/cisplatin-treated patients with the Lys751Gln genotype (9.6 months) than in those with the Lys751Lys genotype (4. 2 months; p = 0. 03).

Other polymorphisms involved in parallel DNA repair systems may well provide the same information, indicating a high degree of biological redundancy. Doctors can face a lot of obstacles when it comes to cancer. How to tell the patient, yet to be sympatric to those around, they need to be able to have an open conversation with the patient on how the patient would like to proceed after getting the diagnosis. It is not only the patient that they are treating but the loved ones as well.

Sometimes dealing with the patient may be easier because the loved one are going to have many different ideas on what they want done and how they should be done. Basically it the quality of care that is the most important aspect of the doctors job when it comes to cancer. After the research that I have done, I still think that there is so much more that needs to be done with lung cancer. How do those that have never smoked, been around smoke, or even been around the environmental dangers get the disease?

There has to be more out there and until that question is answered we all need to be vigilant about taking care of ourselves by eating right and exercising. We need to have the basic blood test that can detect cancer, like a complete blood count (CBC), if there is a suspicion the next best step would be an image of the chest that can also detect abnormalities that can be cancer. If there is an abnormality there can also be a biopsy taken and sent to pathology to determine if cancer and the stage that it is and then from there, a plan of action can be made towards the course of treatment. References Familial Lung Cancer Gene Located.

December 27, 2012. National Human Genome Research Institute. Retrieved from: http://www. genome. gov/27531412 Heuther and McCance, Understanding Pathophysiology Fourth Edition, 2008;

Mosby Elsevier, St. Louis, MO Lung Cancer Fact Sheet. 2013. Retrieved from: http://www. lung. org/lung-disease/lung-cancer/resources/facts-figures/lung-cancer-fact-sheet. html Lung Cancer. National Cancer Institute. Retrieved from: http://cancer. gov/cancertopics Rosell R, Taron M, Camps C, Lopez-Vivanco G. Influence of genetic markers on survival in non-small cell lung cancer. October, 2003. Retrieved from: http://www. ncbi. nlm. nih. gov/pubmed/14668933.

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