Lung Cancer Disease Summary

Overview

Lung cancer develops when cells inside the lungs (lining of the bronchi) begin to grow out of control, invade nearby tissues, and metastasize as stated in the Introduction section.

Lung cancer is the leading cause of cancer mortality in the world. Incidence and prevalence of this cancer worldwide and regionally can be found in the Epidemiology section.

The pathophysiology of lung cancer is not completely understood but there are hypotheses that carcinogen exposure contributes to the mechanism of development of this cancer and they are discussed in the Pathophysiology section.

The Risk Factors section discusses the patient factors that contribute to the development of lung cancer. The radiologic factors that are used in assessment of lung cancer are enumerated in this section.

The Classification section enumerates and differentiates the risk categories, lung classification based on histologic diagnosis and the World Health Organization (WHO) 2021 classification of thoracic tumors.

History and Physical Examination

Primary tumor-related symptoms include cough, dyspnea, hemoptysis, and wheezing.  The Clinical Presentation section enumerates other symptoms of lung cancer. Paraneoplastic syndromes are also discussed in this section.

Pertinent information that should be elicited in History is in this section.

The Physical Examination section states the 2 important factors that predict the survival of patients following treatment which are weight loss and performance status.

The Screening section enumerates the recommendations for patients with lung nodules on initial treatment screening and for follow-up or annual screening using low-dose CT scan.

Diagnosis

Tests and imaging procedures to assess patients suspected of having lung cancer are enumerated and discussed in the Laboratory Tests and Ancillaries and Imaging sections.

The Diagnosis or Diagnostic Criteria section states that diagnosis of a patient will depend on the size of the tumor, location of the tumor, presence of mediastinal or distant disease, presence of pulmonary pathology and/or other comorbidities, and the experience and expertise of the healthcare personnel. 

The Differential Diagnosis section enumerates the diseases that may mimic lung cancer, and these should be ruled out.

Management

The Evaluation section mentions the non-small cell lung cancer Tumor, Nodes, and Metastasis (TNM) system 8^th edition staging and patient assessment. This section also discusses the staging of small-cell lung cancer that includes the limited disease and extensive disease.

Treatment strategies for small-cell lung cancer are discussed in the Principles of Therapy section.

The Pharmacological Therapy section includes the discussion of therapeutic options for non-small cell lung cancer perioperative systemic chemotherapy, chemoradiotherapy, systemic therapy, subsequent therapy, continuation maintenance therapy, switch maintenance therapy, and postoperative therapy. It also has discussions on small-cell lung cancer systemic therapy and palliative care for lung cancer.

Surgery is the treatment of choice for the management of stage I and II non-small cell lung cancer and considered only for patients with clinical stage I-IIA small cell lung cancer. Indications for surgery and discussion about the options and techniques are discussed in the Surgery section.

Radiation therapy is an adjunct to management of patients with non-small cell lung cancer and a vital part of treatment of small cell lung cancer. The different types of radiation therapy are analyzed in the Radiation Therapy section.

Disease recurrence should be monitored using different examinations. Tests and assessments to be done in surveillance of patients with lung cancer are in the Monitoring section.