80-708: Humphrys is a surname. Notable people with the surname include: Bob Humphrys (1952–2008), BBC Wales sports broadcaster Fletcher Humphrys (born 1976), Australian actor Sir Francis Humphrys (1879–1971), British colonial administrator and diplomat John Humphrys (born 1943), BBC broadcaster Stephen Humphrys , English footballer William Humphrys (1794–1865), Irish engraver See also [ edit ] Humfrey , given name and surname Humphery , surname Humphrey , given name and surname Humphreys (surname) Humphry , surname Humphries , surname [REDACTED] Surname list This page lists people with
160-437: A biopsy of the suspected tissue be histologically examined for cancer cells. Given the location of lung cancer tumors, biopsies can often be obtained by minimally invasive techniques: a fiberoptic bronchoscope that can retrieve tissue (sometimes guided by endobronchial ultrasound ), fine needle aspiration , or other imaging-guided biopsy through the skin. Those who cannot undergo a typical biopsy procedure may instead have
240-709: A hairdresser and Edward George Humphrys, a self-employed French polisher . Encouraged to do his homework, he passed the eleven plus exam and became a pupil at Cardiff High School , then a grammar school. After university, he became a newspaper journalist, working on various publications until he joined the Cardiff-based Western Mail . He then joined BBC Radio Wales in 1978, and then joined BBC Wales television's team as an investigative reporter most often beside his brother on Week in Week Out , where his reports included an early investigation of
320-566: A liquid biopsy taken (that is, a sample of some body fluid) which may contain circulating tumor DNA that can be detected. Imaging is also used to assess the extent of cancer spread. Positron emission tomography (PET) scanning or combined PET-CT scanning is often used to locate metastases in the body. Since PET scanning is less sensitive in the brain, the National Comprehensive Cancer Network recommends magnetic resonance imaging (MRI) – or CT where MRI
400-537: A Proper Journalist . Humphrys and his wife Julie had three children, two daughters and a son, and lived in Cardiff. BBC Wales Today made Humphrys' death their lead story on 19 August 2008, with his former colleague and broadcast trainee Jamie Owen leading the section, with a personal tribute by colleague Vincent Kane . In 2009, local ice hockey side, the Cardiff Devils held a Nostalgia Night against
480-406: A chest radiograph or CT scan. In lung cancer screening studies as many as 30% of those screened have a lung nodule, the majority of which turn out to be benign. Besides lung cancer many other diseases can also give this appearance, including hamartomas , and infectious granulomas caused by tuberculosis , histoplasmosis , or coccidioidomycosis . At diagnosis, lung cancer is classified based on
560-433: A high-volume surgery clinic improve chances of survival. Those who are unable or unwilling to undergo surgery can instead receive radiation therapy. Stereotactic body radiation therapy is best practice, typically administered several times over 1–2 weeks. Chemotherapy has little effect in those with stage I NSCLC, and may worsen disease outcomes in those with the earliest disease. In those with stage II disease, chemotherapy
640-439: A mass inside the lung. The X-ray may reveal an obvious mass, the widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (lung collapse), consolidation ( pneumonia ), or pleural effusion ; however, some lung tumors are not visible by X-ray. Next, many undergo computed tomography (CT) scanning , which can reveal the sizes and locations of tumors. A definitive diagnosis of lung cancer requires
720-607: A new cough, or an increase in the frequency or strength of a pre-existing cough. Around one in four cough up blood , ranging from small streaks in the sputum to large amounts. Around half of those diagnosed with lung cancer experience shortness of breath, while 25–50% experience a dull, persistent chest pain that remains in the same location over time. In addition to respiratory symptoms, some experience systemic symptoms including loss of appetite , weight loss , general weakness, fever , and night sweats . Some less common symptoms suggest tumors in particular locations. Tumors in
800-516: A societal level, smoking cessation can be promoted by tobacco control policies that make tobacco products more difficult to obtain or use. Many such policies are mandated or recommended by the WHO Framework Convention on Tobacco Control , ratified by 182 countries, representing over 90% of the world's population. The WHO groups these policies into six intervention categories, each of which has been shown to be effective in reducing
880-495: A symptom tend to have worse outcomes. Tumor mutations in KRAS are associated with reduced survival. The uncertainty of lung cancer prognosis often causes stress, and makes future planning difficult, for those with lung cancer and their families. Those whose cancer goes into remission often experience fear of their cancer returning or progressing, associated with poor quality of life, negative mood, and functional impairment. This fear
SECTION 10
#1732801310048960-427: A tumor, and eventually spreading within and then beyond the lung. Rampant tumor growth and spread causes the symptoms of lung cancer. If unstopped, the spreading tumor will eventually cause the death of affected individuals. Tobacco smoking is by far the major contributor to lung cancer, causing 80% to 90% of cases. Lung cancer risk increases with quantity of cigarettes consumed. Tobacco smoking's carcinogenic effect
1040-520: A variety of other toxic chemicals – typically encountered in certain occupations – is associated with an increased risk of lung cancer. Occupational exposures to carcinogens cause 9–15% of lung cancer. A prominent example is asbestos , which causes lung cancer either directly or indirectly by inflaming the lung. Exposure to all commercially available forms of asbestos increases cancer risk, and cancer risk increases with time of exposure. Asbestos and cigarette smoking increase risk synergistically – that is,
1120-1202: Is hypercalcemia (high blood calcium) caused by over-production of parathyroid hormone-related protein or parathyroid hormone . Hypercalcemia can manifest as nausea, vomiting, abdominal pain, constipation, increased thirst , frequent urination , and altered mental status. Those with lung cancer also commonly experience hypokalemia (low potassium) due to inappropriate secretion of adrenocorticotropic hormone , as well as hyponatremia (low sodium) due to overproduction of antidiuretic hormone or atrial natriuretic peptide . About one of three people with lung cancer develop nail clubbing , while up to one in ten experience hypertrophic pulmonary osteoarthropathy (nail clubbing, joint soreness, and skin thickening). A variety of autoimmune disorders can arise as paraneoplastic syndromes in those with lung cancer, including Lambert–Eaton myasthenic syndrome (which causes muscle weakness), sensory neuropathies , muscle inflammation , brain swelling , and autoimmune deterioration of cerebellum , limbic system , or brainstem . Up to one in twelve people with lung cancer have paraneoplastic blood clotting, including migratory venous thrombophlebitis , clots in
1200-648: Is also a risk of radiation-induced cancer . The United States Preventive Services Task Force recommends yearly screening using low-dose CT in people between 55 and 80 who have a smoking history of at least 30 pack-years . The European Commission recommends that cancer screening programs across the European Union be extended to include low-dose CT lung scans for current or previous smokers. Similarly, The Canadian Task Force for Preventative Health recommends that people who are current or former smokers (smoking history of more than 30 pack years) and who are between
1280-567: Is associated with the development of the rare lung cancer lymphoepithelioma-like carcinoma in people from Asia, but not in people from Western nations . A role for several other infectious agents – namely human papillomaviruses , BK virus , JC virus , human cytomegalovirus , SV40 , measles virus , and Torque teno virus – in lung cancer development has been studied but remains inconclusive as of 2020. Particular gene combinations may make some people more susceptible to lung cancer. Close family members of those with lung cancer have around twice
1360-507: Is different from Wikidata All set index articles Bob Humphrys George Robert Humphrys (16 April 1952 – 18 August 2008) was a Welsh broadcaster, chiefly known as a sports presenter on BBC Wales . Humphrys was born in Splott , a poor working-class district of central Cardiff and was the younger brother of journalist and television presenter John Humphrys . Humphrys was one of five children born to Winifred Mary (Matthews),
1440-413: Is due to various chemicals in tobacco smoke that cause DNA mutations, increasing the chance of cells becoming cancerous. The International Agency for Research on Cancer identifies at least 50 chemicals in tobacco smoke as carcinogenic , and the most potent is tobacco-specific nitrosamines . Exposure to these chemicals causes several kinds of DNA damage: DNA adducts , oxidative stress , and breaks in
1520-576: Is exacerbated by frequent or prolonged surveillance imaging, and other reminders of cancer risks. Lung cancer is caused by genetic damage to the DNA of lung cells. These changes are sometimes random, but are typically induced by breathing in toxic substances such as cigarette smoke. Cancer-causing genetic changes affect the cell's normal functions , including cell proliferation , programmed cell death ( apoptosis ), and DNA repair . Eventually, cells gain enough genetic changes to grow uncontrollably, forming
1600-497: Is impractical are treated with combination chemotherapy and radiotherapy along with the immunotherapy durvalumab . Combined chemotherapy and radiation enhances survival compared to chemotherapy followed by radiation, though the combination therapy comes with harsher side effects. Those with stage IV disease are treated with combinations of pain medication, radiotherapy, immunotherapy, and chemotherapy. Many cases of advanced disease can be treated with targeted therapies depending on
1680-485: Is necessary due to the length of time it can take for lung cancer to develop following an exposure to carcinogens. The smoking of non-tobacco products is not known to be associated with lung cancer development. Marijuana smoking does not seem to independently cause lung cancer – despite the relatively high levels of tar and known carcinogens in marijuana smoke. The relationship between smoking cocaine and developing lung cancer has not been studied as of 2020. Exposure to
SECTION 20
#17328013100481760-510: Is not targetable by current molecular therapies instead can be treated with combination chemotherapy plus immune checkpoint inhibitors, which prevent cancer cells from inactivating immune T cells . The chemotherapeutic agent of choice depends on the NSCLC subtype: cisplatin plus gemcitabine for squamous cell carcinoma, cisplatin plus pemetrexed for non-squamous cell carcinoma. Immune checkpoint inhibitors are most effective against tumors that express
1840-407: Is present in many lung cancers, but absent from squamous cell carcinomas. Lung cancer staging is an assessment of the degree of spread of the cancer from its original source. It is one of the factors affecting both the prognosis and the treatment of lung cancer. SCLC is typically staged with a relatively simple system: limited stage or extensive stage. Around a third of people are diagnosed at
1920-402: Is stage IV. Each stage is further subdivided based on the combination of T, N, and M scores. Some countries recommend that people who are at a high risk of developing lung cancer be screened at different intervals using low-dose CT lung scans. Screening programs may result in early detection of lung tumors in people who are not yet experiencing symptoms of lung cancer, ideally, early enough that
2000-405: Is the most diagnosed and deadliest cancer worldwide, with 2.2 million cases in 2020 resulting in 1.8 million deaths. Lung cancer is rare in those younger than 40; the average age at diagnosis is 70 years, and the average age at death 72. Incidence and outcomes vary widely across the world, depending on patterns of tobacco use. Prior to the advent of cigarette smoking in the 20th century, lung cancer
2080-799: Is treated with radiation therapy and chemotherapy alongside drug treatments that target specific cancer subtypes. Even with treatment, only around 20% of people survive five years on from their diagnosis. Survival rates are higher in those diagnosed at an earlier stage, diagnosed at a younger age, and in women compared to men. Most lung cancer cases are caused by tobacco smoking . The remainder are caused by exposure to hazardous substances like asbestos and radon gas, or by genetic mutations that arise by chance. Consequently, lung cancer prevention efforts encourage people to avoid hazardous chemicals and quit smoking. Quitting smoking both reduces one's chance of developing lung cancer and improves treatment outcomes in those already diagnosed with lung cancer. Lung cancer
2160-442: Is typically treated with a combination of chemotherapy and radiotherapy. For chemotherapy, the National Comprehensive Cancer Network and American College of Chest Physicians guidelines recommend four to six cycles of a platinum-based chemotherapeutic – cisplatin or carboplatin – combined with either etoposide or irinotecan . This is typically combined with thoracic radiation therapy – 45 Gray (Gy) twice-daily – alongside
2240-420: Is unavailable – to scan the brain for metastases in those with NSCLC and large tumors, or tumors that have spread to the nearby lymph nodes. When imaging suggests the tumor has spread, the suspected metastasis is often biopsied to confirm that it is cancerous. Lung cancer most commonly metastasizes to the brain, bones, liver, and adrenal glands . Lung cancer can often appear as a solitary pulmonary nodule on
2320-564: Is usually initiated six to twelve weeks after surgery, with up to four cycles of cisplatin – or carboplatin in those with kidney problems, neuropathy , or hearing impairment – combined with vinorelbine , pemetrexed , gemcitabine, or docetaxel . Treatment for those with stage III NSCLC depends on the nature of their disease. Those with more limited spread may undergo surgery to have the tumor and affected lymph nodes removed, followed by chemotherapy and potentially radiotherapy. Those with particularly large tumors (T4) and those for whom surgery
2400-515: The AIDS epidemic developing in the UK. From the early 1990s Humphrys began reporting on sport, a passion of his. Humphrys and his then colleague, former Welsh Rugby union legend J.J. Williams , presented the first BBC pre-match club house show from Cardiff Rugby Club before a Welsh Rugby international – Humphrys added Taffs Well RFC for atmosphere, who got a bit too drunk through the programme. In 2004 he
2480-690: The Hull Stingrays honouring Bob Humphrys' work with BBC Sport and the coverage of the Devils in the early 1990s. BBC Wales announced a £5,500 student bursary, the Bob Humphrys Bursary, in his honour. Lung cancer Lung cancer , also known as lung carcinoma , is a malignant tumor that begins in the lung . Lung cancer is caused by genetic damage to the DNA of cells in the airways, often caused by cigarette smoking or inhaling damaging chemicals. Damaged airway cells gain
Humphrys - Misplaced Pages Continue
2560-584: The cell division cycle , cellular stress responses , and chromatin remodeling . Some rare genetic disorders that increase the risk of various cancers also increase the risk of lung cancer, namely retinoblastoma and Li–Fraumeni syndrome . As with all cancers, lung cancer is triggered by mutations that allow tumor cells to endlessly multiply, stimulate blood vessel growth , avoid apoptosis (programmed cell death), generate pro-growth signalling molecules, ignore anti-growth signalling molecules, and eventually spread into surrounding tissue or metastasize throughout
2640-508: The spinal cord . Metastasis into the bone marrow can deplete blood cells and cause leukoerythroblastosis (immature cells in the blood). Liver metastases can cause liver enlargement , pain in the right upper quadrant of the abdomen , fever, and weight loss. Lung tumors often cause the release of body-altering hormones , which cause unusual symptoms, called paraneoplastic syndromes . Inappropriate hormone release can cause dramatic shifts in concentrations of blood minerals . Most common
2720-502: The surname Humphrys . If an internal link intending to refer to a specific person led you to this page, you may wish to change that link by adding the person's given name (s) to the link. Retrieved from " https://en.wikipedia.org/w/index.php?title=Humphrys&oldid=1189168839 " Categories : Surnames English-language surnames Patronymic surnames Surnames from given names Hidden categories: Articles with short description Short description
2800-450: The thorax can cause breathing problems by obstructing the trachea or disrupting the nerve to the diaphragm ; difficulty swallowing by compressing the esophagus ; hoarseness by disrupting the nerves of the larynx ; and Horner's syndrome by disrupting the sympathetic nervous system . Horner's syndrome is also common in tumors at the top of the lung , known as Pancoast tumors , which also cause shoulder pain that radiates down
2880-472: The DNA strands. Being around tobacco smoke – called passive smoking – can also cause lung cancer. Living with a tobacco smoker increases one's risk of developing lung cancer by 24%. An estimated 17% of lung cancer cases in those who do not smoke are caused by high levels of environmental tobacco smoke. Vaping may be a risk factor for lung cancer, but less than that of cigarettes, and further research as of 2021
2960-627: The US, China, South Korea, Taiwan, Israel, Latvia, Iceland, Sweden, Austria, and Switzerland. SCLC is particularly aggressive. 10–15% of people survive five years after a SCLC diagnosis. As with other types of lung cancer, the extent of disease at diagnosis also influences prognosis. The average person diagnosed with limited-stage SCLC survives 12–20 months from diagnosis; with extensive-stage SCLC around 12 months. While SCLC often responds initially to treatment, most people eventually relapse with chemotherapy-resistant cancer, surviving an average 3–4 months from
3040-468: The ability to multiply unchecked, causing the growth of a tumor. Without treatment, tumors spread throughout the lung, damaging lung function. Eventually lung tumors metastasize , spreading to other parts of the body. Early lung cancer often has no symptoms and can only be detected by medical imaging . As the cancer progresses, most people experience nonspecific respiratory problems: coughing , shortness of breath , or chest pain . Other symptoms depend on
3120-426: The affected individual loses the ability to swallow. Coughing is also common, and can be managed with opioids or cough suppressants . Some experience terminal delirium – confused behavior, unexplained movements, or a reversal of the sleep-wake cycle – which can be managed by antipsychotic drugs, low-dose sedatives, and investigating other causes of discomfort such as low blood sugar , constipation , and sepsis . In
3200-593: The ages of 55–74 years be screened for lung cancer. Treatment for lung cancer depends on the cancer's specific cell type, how far it has spread , and the person's health. Common treatments for early stage cancer includes surgical removal of the tumor, chemotherapy , and radiation therapy . For later-stage cancer, chemotherapy and radiation therapy are combined with newer targeted molecular therapies and immune checkpoint inhibitors . All lung cancer treatment regimens are combined with lifestyle changes and palliative care to improve quality of life. Limited-stage SCLC
3280-515: The average person's lifespan by around 2 months. For stage I and stage II NSCLC the first line of treatment is often surgical removal of the affected lobe of the lung. For those not well enough to tolerate full lobe removal, a smaller chunk of lung tissue can be removed by wedge resection or segmentectomy surgery. Those with centrally located tumors and otherwise-healthy respiratory systems may have more extreme surgery to remove an entire lung ( pneumonectomy ). Experienced thoracic surgeons , and
Humphrys - Misplaced Pages Continue
3360-399: The blocking tissue by bronchoscopy, sometimes aided by thermal or laser ablation . Other causes of lung cancer-associated shortness of breath can be treated directly, such as antibiotics for a lung infection, diuretics for pulmonary edema , benzodiazepines for anxiety, and steroids for airway obstruction. Up to 92% of those with lung cancer report pain, either from tissue damage at
3440-753: The body. Different tumors can acquire these abilities through different mutations, though generally cancer-contributing mutations activate oncogenes and inactivate tumor suppressors . Some mutations – called "driver mutations" – are particularly common in adenocarcinomas, and contribute disproportionately to tumor development. These typically occur in the receptor tyrosine kinases EGFR, BRAF, MET, KRAS , and PIK3CA . Similarly, some adenocarcinomas are driven by chromosomal rearrangements that result in overexpression of tyrosine kinases ALK, ROS1, NTRK, and RET. A given tumor will typically have just one driver mutation. In contrast, SCLCs rarely have these driver mutations, and instead often have mutations that have inactivated
3520-739: The center of the lungs, in the major airways. Their cells appear small with ill-defined boundaries, not much cytoplasm , many mitochondria , and have distinctive nuclei with granular-looking chromatin and no visible nucleoli . NSCLCs comprise a group of three cancer types: adenocarcinoma , squamous-cell carcinoma , and large-cell carcinoma . Nearly 40% of lung cancers are adenocarcinomas. Their cells grow in three-dimensional clumps, resemble glandular cells, and may produce mucin . About 30% of lung cancers are squamous-cell carcinomas. They typically occur close to large airways. The tumors consist of sheets of cells, with layers of keratin . A hollow cavity and associated cell death are commonly found at
3600-438: The center of the tumor. Less than 10% of lung cancers are large-cell carcinomas, so named because the cells are large, with excess cytoplasm, large nuclei, and conspicuous nucleoli . Around 10% of lung cancers are rarer types. These include mixes of the above subtypes like adenosquamous carcinoma , and rare subtypes such as carcinoid tumors , and sarcomatoid carcinomas . Several lung cancer types are subclassified based on
3680-405: The extent of local spread: with the cancer metastasized to no lymph nodes (N0), pulmonary or hilar nodes (along the bronchi) on the same side as the tumor (N1), mediastinal or subcarinal lymph nodes (in the middle of the lungs, N2), or lymph nodes on the opposite side of the lung from the tumor (N3). Metastases are staged as no metastases (M0), nearby metastases (M1a; the space around the lung or
3760-549: The first two chemotherapy cycles. First-line therapy causes remission in up to 80% of those who receive it; however most people relapse with chemotherapy-resistant disease. Those who relapse are given second-line chemotherapies. Topotecan and lurbinectedin are approved by the US FDA for this purpose. Irinotecan, paclitaxel , docetaxel , vinorelbine , etoposide, and gemcitabine are also sometimes used, and are similarly efficacious. Prophylactic cranial irradiation can reduce
3840-691: The genetic makeup of the cancerous cells. Up to 30% of tumors have mutations in the EGFR gene that result in an overactive EGFR protein; these can be treated with EGFR inhibitors osimertinib , erlotinib , gefitinib , afatinib , or dacomitinib – with osimertinib known to be superior to erlotinib and gefitinib, and all superior to chemotherapy alone. Up to 7% of those with NSCLC harbor mutations that result in hyperactive ALK protein, which can be treated with ALK inhibitors crizotinib , or its successors alectinib , brigatinib , and ceritinib . Those treated with ALK inhibitors who relapse can then be treated with
3920-487: The growth characteristics of the cancer cells. Adenocarcinomas are classified as lepidic (growing along the surface of intact alveolar walls), acinar and papillary , or micropapillary and solid pattern. Lepidic adenocarcinomas tend to be least aggressive, while micropapillary and solid pattern adenocarcinomas are most aggressive. In addition to examining cell morphology, biopsies are often stained by immunohistochemistry to confirm lung cancer classification. SCLCs bear
4000-465: The heart , arrhythmia (irregular heartbeat), and heart failure . About one in three people diagnosed with lung cancer have symptoms caused by metastases in sites other than the lungs. Lung cancer can metastasize anywhere in the body, with different symptoms depending on the location. Brain metastases can cause headache , nausea , vomiting , seizures , and neurological deficits . Bone metastases can cause pain, bone fractures , and compression of
4080-409: The heart, and disseminated intravascular coagulation (clots throughout the body). Paraneoplastic syndromes involving the skin and kidneys are rare, each occurring in up to 1% of those with lung cancer. A person suspected of having lung cancer will have imaging tests done to evaluate the presence, extent, and location of tumors. First, many primary care providers perform a chest X-ray to look for
SECTION 50
#17328013100484160-423: The heart, or the opposite lung), a single distant metastasis (M1b), or multiple metastases (M1c). These T, N, and M scores are combined to designate a stage grouping for the cancer. Cancer limited to smaller tumors is designated stage I. Disease with larger tumors or spread to the nearest lymph nodes is stage II. Cancer with the largest tumors or extensive lymph node spread is stage III. Cancer that has metastasized
4240-473: The last few days of life, many develop terminal secretions – pooled fluid in the airways that can cause a rattling sound while breathing. This is thought not to cause respiratory problems, but can distress family members and caregivers. Terminal secretions can be reduced by anticholinergic medications . Even those who are non-communicative or have reduced consciousness may be able to experience cancer-related pain, so pain medications are typically continued until
4320-510: The limited stage, meaning cancer is confined to one side of the chest, within the scope of a single radiotherapy field. The other two thirds are diagnosed at the "extensive stage", with cancer spread to both sides of the chest, or to other parts of the body. NSCLC – and sometimes SCLC – is typically staged with the American Joint Committee on Cancer 's Tumor, Node, Metastasis (TNM) staging system . The size and extent of
4400-403: The little-finger side of the arm as well as destruction of the topmost ribs . Swollen lymph nodes above the collarbone can indicate a tumor that has spread within the chest. Tumors obstructing bloodflow to the heart can cause superior vena cava syndrome (swelling of the upper body and shortness of breath), while tumors infiltrating the area around the heart can cause fluid buildup around
4480-494: The location and size of the tumor. Those suspected of having lung cancer typically undergo a series of imaging tests to determine the location and extent of any tumors. Definitive diagnosis of lung cancer requires a biopsy of the suspected tumor be examined by a pathologist under a microscope . In addition to recognizing cancerous cells, a pathologist can classify the tumor according to the type of cells it originates from. Around 15% of cases are small-cell lung cancer (SCLC), and
4560-1057: The lower levels of radon that seep into residential spaces can increase occupants' risk of lung cancer. Like asbestos, cigarette smoking and radon exposure increase risk synergistically. Radon exposure is responsible for between 3% and 14% of lung cancer cases. Several other chemicals encountered in various occupations are also associated with increased lung cancer risk including arsenic used in wood preservation , pesticide application, and some ore smelting ; ionizing radiation encountered during uranium mining ; vinyl chloride in papermaking ; beryllium in jewelers , ceramics workers, missile technicians, and nuclear reactor workers; chromium in stainless steel production, welding , and hide tanning ; nickel in electroplaters , glass workers, metal workers, welders, and those who make batteries, ceramics, and jewelry; and diesel exhaust encountered by miners. Exposure to air pollution , especially particulate matter released by motor vehicle exhaust and fossil fuel -burning power plants, increases
4640-550: The lung increase one's risk of lung cancer. This association is strongest for chronic obstructive pulmonary disorder – the risk is highest in those with the most inflammation, and reduced in those whose inflammation is treated with inhaled corticosteroids . Other inflammatory lung and immune system diseases such as alpha-1 antitrypsin deficiency , interstitial fibrosis , scleroderma , Chlamydia pneumoniae infection, tuberculosis , and HIV infection are associated with increased risk of developing lung cancer. Epstein–Barr virus
4720-410: The markers of neuroendocrine cells , such as chromogranin , synaptophysin , and CD56 . Adenocarcinomas tend to express Napsin-A and TTF-1 ; squamous cell carcinomas lack Napsin-A and TTF-1 , but express p63 and its cancer-specific isoform p40. CK7 and CK20 are also commonly used to differentiate lung cancers. CK20 is found in several cancers, but typically absent from lung cancer. CK7
4800-516: The most-advanced stage, IVB, have a two-year survival of 10% and a five-year survival of 0%. Five-year survival is higher in women (22%) than men (16%). Women tend to be diagnosed with less-advanced disease, and have better outcomes than men diagnosed at the same stage. Average five-year survival also varies across the world, with particularly high five-year survival in Japan (33%), and five-year survival above 20% in 12 other countries: Mauritius, Canada,
4880-431: The nicotine replacement varenicline as first-line therapies to aid in smoking cessation. Clonidine and nortriptyline are recommended second-line therapies. The majority of those diagnosed with lung cancer attempt to quit smoking; around half succeed. Even after lung cancer diagnosis, smoking cessation improves treatment outcomes, reducing cancer treatment toxicity and failure rates, and lengthening survival time. At
SECTION 60
#17328013100484960-530: The protein PD-L1 , but are sometimes effective in those that do not. Treatment with pembrolizumab , atezolizumab , or combination nivolumab plus ipilimumab are all superior to chemotherapy alone against tumors expressing PD-L1. Those who relapse on the above are treated with second-line chemotherapeutics docetaxel and ramucirumab . Integrating palliative care (medical care focused on improving symptoms and lessening discomfort) into lung cancer treatment from
5040-459: The remaining 85% (the non-small-cell lung cancers or NSCLC) are adenocarcinomas , squamous-cell carcinomas , and large-cell carcinomas . After diagnosis, further imaging and biopsies are done to determine the cancer's stage based on how far it has spread. Treatment for early stage lung cancer includes surgery to remove the tumor, sometimes followed by radiation therapy and chemotherapy to kill any remaining cancer cells. Later stage cancer
5120-412: The risk of brain metastases and improve survival in those with limited-stage disease. Extensive-stage SCLC is treated first with etoposide along with either cisplatin or carboplatin. Radiotherapy is used only to shrink tumors that are causing particularly severe symptoms. Combining standard chemotherapy with an immune checkpoint inhibitor can improve survival for a minority of those affected, extending
5200-400: The risk of developing lung cancer as an average person, even after controlling for occupational exposure and smoking habits. Genome-wide association studies have identified many gene variants associated with lung cancer risk, each of which contributes a small risk increase. Many of these genes participate in pathways known to be involved in carcinogenesis, namely DNA repair , inflammation ,
5280-420: The risk of lung cancer. Indoor air pollution from burning wood , charcoal , or crop residue for cooking and heating has also been linked to an increased risk of developing lung cancer. The International Agency for Research on Cancer has classified emission from household burning of coal and biomass as "carcinogenic" and "probably carcinogenic" respectively. Several other diseases that cause inflammation of
5360-459: The risk of someone who smokes and has asbestos exposure dying from lung cancer is much higher than would be expected from adding the two risks together. Similarly, exposure to radon , a naturally occurring breakdown product of the Earth's radioactive elements , is associated with increased lung cancer risk. Radon levels vary with geography. Underground miners have the greatest exposure; however even
5440-413: The same lobe of the lung, or invade the chest wall , diaphragm (or the nerve that controls it ), or area around the heart. Tumors that are larger than 7 cm, have nodules spread in different lobes of a lung, or invade the mediastinum (center of the chest cavity), heart, largest blood vessels that supply the heart, trachea , esophagus , or spine are designated T4. Lymph node staging depends on
5520-681: The third-generation ALK inhibitor lorlatinib . Up to 5% with NSCLC have overactive MET , which can be inhibited with MET inhibitors capmatinib or tepotinib . Targeted therapies are also available for some cancers with rare mutations. Cancers with hyperactive BRAF (around 2% of NSCLC) can be treated by dabrafenib combined with the MEK inhibitor trametinib ; those with activated ROS1 (around 1% of NSCLC) can be inhibited by crizotinib, lorlatinib, or entrectinib ; overactive NTRK (<1% of NSCLC) by entrectinib or larotrectinib ; active RET (around 1% of NSCLC) by selpercatinib . People whose NSCLC
5600-442: The time of death. Around 19% of people diagnosed with lung cancer survive five years from diagnosis , though prognosis varies based on the stage of the disease at diagnosis and the type of lung cancer. Prognosis is better for people with lung cancer diagnosed at an earlier stage; those diagnosed at the earliest TNM stage, IA1 (small tumor, no spread), have a two-year survival of 97% and five-year survival of 92%. Those diagnosed at
5680-419: The time of diagnosis improves the survival time and quality of life of those with lung cancer. Particularly common symptoms of lung cancer are shortness of breath and pain. Supplemental oxygen, improved airflow, re-orienting an affected person in bed, and low-dose morphine can all improve shortness of breath. In around 20 to 30% of those with lung cancer – particularly those with late-stage disease – growth of
5760-443: The time of relapse. Those with limited stage SCLC that go into complete remission after chemotherapy and radiotherapy have a 50% chance of brain metastases developing within the next two years – a chance reduced by prophylactic cranial irradiation. Several other personal and disease factors are associated with improved outcomes. Those diagnosed at a younger age tend to have better outcomes. Those who smoke or experience weight loss as
5840-531: The tumor (T), spread to regional lymph nodes (N), and distant metastases (M) are scored individually, and combined to form stage groups. Relatively small tumors are designated T1, which are subdivided by size: tumors ≤ 1 centimeter (cm) across are T1a; 1–2 cm T1b; 2–3 cm T1c. Tumors up to 5 cm across, or those that have spread to the visceral pleura (tissue covering the lung) or main bronchi , are designated T2. T2a designates 3–4 cm tumors; T2b 4–5 cm tumors. T3 tumors are up to 7 cm across, have multiple nodules in
5920-502: The tumor can narrow or block the airway , causing coughing and difficulty breathing. Obstructing tumors can be surgically removed where possible, though typically those with airway obstruction are not well enough for surgery. In such cases the American College of Chest Physicians recommends opening the airway by inserting a stent , attempting to shrink the tumor with localized radiation ( brachytherapy ), or physically removing
6000-1312: The tumor site(s) or nerve damage. The World Health Organization (WHO) has developed a three-tiered system for managing cancer pain. For those with mild pain (tier one), the WHO recommends acetominophen or a nonsteroidal anti-inflammatory drug . Around a third of people experience moderate (tier two) or severe (tier three) pain, for which the WHO recommends opioid painkillers. Opioids are typically effective at easing nociceptive pain (pain caused by damage to various body tissues). Opioids are occasionally effective at easing neuropathic pain (pain caused by nerve damage). Neuropathic agents such as anticonvulsants , tricyclic antidepressants , and serotonin–norepinephrine reuptake inhibitors , are often used to ease neuropathic pain, either alone or in combination with opioids. In many cases, targeted radiotherapy can be used to shrink tumors, reducing pain and other symptoms caused by tumor growth. Individuals who have advanced disease and are approaching end-of-life can benefit from dedicated end-of-life care to manage symptoms and ease suffering. As in earlier disease, pain and difficulty breathing are common, and can be managed with opioid pain medications, transitioning from oral medication to injected medication if
6080-529: The tumor suppressors p53 and RB . A cluster of tumor suppressor genes on the short arm of chromosome 3 are often lost early in the development of all lung cancers. Those who smoke can reduce their lung cancer risk by quitting smoking – the risk reduction is greater the longer a person goes without smoking. Self-help programs tend to have little influence on success of smoking cessation, whereas combined counseling and pharmacotherapy improve cessation rates. The US FDA has approved antidepressant therapies and
6160-478: The tumors can be successfully treated and result in decreased mortality. There is evidence that regular low-dose CT scans in people at high risk of developing lung cancer reduces total lung cancer deaths by as much as 20%. Despite evidence of benefit in these populations, potential harms of screening include the potential for a person to have a 'false positive' screening result that may lead to unnecessary testing, invasive procedures, and distress. Although rare, there
6240-417: The type of cells the tumor is derived from; tumors derived from different cells progress and respond to treatment differently. There are two main types of lung cancer, categorized by the size and appearance of the malignant cells seen by a histopathologist under a microscope : small cell lung cancer (SCLC; 15% of cases) and non-small-cell lung cancer (NSCLC; 85% of cases). SCLC tumors are often found near
6320-453: Was a rare disease. In the 1950s and 1960s, increasing evidence linked lung cancer and tobacco use, culminating in declarations by most large national health bodies discouraging tobacco use. Early lung cancer often has no symptoms. When symptoms do arise they are often nonspecific respiratory problems – coughing , shortness of breath , or chest pain – that can differ from person to person. Those who experience coughing tend to report either
6400-706: Was given a lifetime achievement award by BBC Wales at the Welsh Sports Personality of the Year awards. After suffering from pains in his shoulders in late 2007, he undertook an X-ray examination under instruction from his doctor in May 2008, which revealed he was suffering from lung cancer , despite never having smoked. Humphrys confirmed his retirement in June 2008, before revealing his diagnosis in an interview. Before he died, he completed his autobiography Not
#47952