Adenocarcinoma of the lung natural history, complications, and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

Common complications of adenocarcinoma of the lung include breathing difficulties, pneumonia, pleural effusion, metastasis, and Horner's syndrome.[1] The prognosis of adenocarcinoma of the lung varies with the staging of tumor; Stage IA have the most favorable prognosis. The presence of metastasis is associated with a particularly poor prognosis.

Natural History

  • The majority of lung cancers present with advanced disease because the symptoms tend to occur later in the course of the disease.[2]
  • The patient experiences non-specific symptoms such as cough, hemoptysis, dyspnea, chest pain, dysphonia, dysphagia, lack of appetite, weight loss, and fatigue from 3 weeks to 3 months before seeking medical attention.
  • While of duration of symptoms, the tumor cell may double 20 times.[2]
  • In more advanced disease, the tumor may spread to other organs such as the spinal cord, brain, and bone.
  • These patients may develop symptoms such as leg weakness, paresthesias, bladder dysfunction, seizures, hemiplegia, cranial nerve palsies, confusion , personality changes, skeletal pain, and pleuritic pain.[2]
  • Once the cancer spreads to the other organs, it is most likely fatal.

Complications

  • Lung cancer patients can experience trouble breathing especially when tumors grow and block the airways. Also, it is possible for fluid to build up in the lungs of the patients which makes it difficult for the lungs to fully expand when inhaling.
  • If the cancer grows in the airway, it may obstruct airflow, causing breathing difficulties. This can lead to accumulation of secretions behind the blockage, predisposing the patient to pneumonia.
  • Lung cancer can cause fluid to build up in the lungs which can cause breathing difficulties.
  • There are treatments available to help drain the excess fluid
  • In many cases, lung cancer will spread out to other parts of the body. Some of the more common places lung cancer metastasizes to are the bones, liver, brain, and adrenal glands.

Prognosis

  • The prognosis of adenocarcinoma of the lung varies with the staging of tumor; Stage IA have the most favorable prognosis.
  • The presence of metastasis is associated with a particularly poor prognosis.

Survival rate by stage[4]

Stage 5-year survival rate
IA 49%
IB 45%
IIA 30%
IIB 31%
IIIA 14%
IIIB 5%
IV 1%

References

  1. 1.0 1.1 Lung cancer complications. Mayo Clinic 2015. http://www.mayoclinic.org/diseases-conditions/lung-cancer/basics/complications/con-20025531 Accessed on December 20, 2015
  2. 2.0 2.1 2.2 Leary, A (2012). Lung cancer a multidisciplinary approach. Chichester, West Sussex, UK Ames, Iowa: Wiley-Blackwell. ISBN 9781405180757. 
  3. Jones, DR; Detterbeck FC (Jul 1998). "Pancoast tumors of the lung". Current Opinion in Pulmonary Medicine. 4 (4): 191–197. PMID 10813231.  Cite uses deprecated parameter |coauthors= (help)
  4. Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/prognosis-and-survival/survival-statistics/?region=ab

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