Lung cancer Natural History, Complications and Prognosis: Difference between revisions

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VisualWikitext

Latest revision as of 19:40, 3 July 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Michael Maddaleni, Saarah T. Alkhairy M.D, Dildar Hussain, MBBS [2]

Overview

The majority of lung cancers present with advanced disease because the symptoms tend to occur later in the course of the disease. Patients experience non-specific symptoms such as cough, hemoptysis, dyspnea, chest pain, difficulty speaking, difficulty swallowing, lack of appetite, weight loss, and fatigue from 3 weeks to 3 months before seeking medical attention. There are a variety of complications associated with lung cancer, such as pleural effusion, leg weakness, paresthesias, bladder dysfunction, seizures, hemiplegia, cranial nerve palsies, confusion, personality changes, skeletal pain, pleuritic pain, atelectasis, and bronchopleural fistula. The prognosis of lung cancer is poor if diagnosed at the advanced stages.

Natural History, Complications, and 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.^[1]
Patients experience non-specific symptoms such as cough, hemoptysis, dyspnea, chest pain, difficulty speaking, difficulty swallowing, lack of appetite, weight loss, and fatigue from 3 weeks to 3 months before seeking medical attention.
Depending on the duration of the presence of symptoms, the tumor cells may double 20 times.^[1]
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.^[1]
Once the cancer spreads to the other organs, it is most likely fatal.

Complications

General Complications

The complications associated with lung cancer are:^[2]^[3]

Breathing difficulties

Lung cancer patients can experience trouble in 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 can negatively affect breathing.

Pneumonia

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.

Hemoptysis

Occasionally, lung cancer can cause bleeding in the airways which can result in hemoptysis.

Pain

It is possible that lung cancer will cause pain as well, especially if it spreads to the pleura or other areas of the body, like the bones.

Pleural effusion

Lung cancer can cause fluid to build up in the lungs which can cause breathing difficulties.

Metastasis

In many cases, lung cancer will spread to other parts of the body. Some of the more common places lung cancer metastasizes to are the bones, liver, brain, and adrenal glands.

Horner's syndrome

Tumors in the apex of the lung, known as Pancoast tumors, may invade locally into the sympathetic nervous system leading to Horner's syndrome.

Superior vena cava syndrome
- SVCS is a group of symptoms caused by obstruction of the superior vena cava. More than 60% of cases of superior vena cava obstruction are caused by malignancies, especially with a tumor outside the vessel compressing the vessel wall.

Surgical Complications

Bronchopleural fistula

It is when air leaks from a pneumonectomy bronchial stump.
Approximately 2% of the patients that undergo a pneumonectomy experience this.
It will most commonly occur approximately 7 to 10 days after surgery.

Hemothorax

Atelectasis
Sputum retention

Prognosis

The prognosis of lung cancer is poor and it depends on the following factors:

Whether or not the tumor can be removed by surgery
Stage of the cancer
Patient’s general health
Whether the cancer has just been diagnosed or has recurred

Non-small Cell Lung Cancer Survival Rate by Stage^[4]


Stage	5-year survival rate

IA	49%
IB	45%
IIA	30%
IIB	31%
IIIA	14%
IIIB	5%
IV	1%

Small Cell Lung Cancer Survival Rate

To view the prognosis among patients with small cell lung carcinoma, please click Here.

References

↑ ^1.0 ^1.1 ^1.2 Leary, A (2012). Lung cancer a multidisciplinary approach. Chichester, West Sussex, UK Ames, Iowa: Wiley-Blackwell. ISBN 9781405180757.
↑ Jones, DR (Jul 1998). "Pancoast tumors of the lung". Current Opinion in Pulmonary Medicine. 4 (4): 191–197. PMID 10813231. Unknown parameter |coauthors= ignored (help)
↑ Eren S, Karaman A, Okur A (2006). "The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT". Eur J Radiol. 59 (1): 93–103. doi:10.1016/j.ejrad.2006.01.003. PMID 16476534.
↑ Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/prognosis-and-survival/survival-statistics/?region=ab

Template:WH Template:WS

[leary-1] 1.0 ^1.1 ^1.2 Leary, A (2012). Lung cancer a multidisciplinary approach. Chichester, West Sussex, UK Ames, Iowa: Wiley-Blackwell. ISBN 9781405180757.

[Jones-2] Jones, DR (Jul 1998). "Pancoast tumors of the lung". Current Opinion in Pulmonary Medicine. 4 (4): 191–197. PMID 10813231. Unknown parameter |coauthors= ignored (help)

[pmid16476534-3] Eren S, Karaman A, Okur A (2006). "The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT". Eur J Radiol. 59 (1): 93–103. doi:10.1016/j.ejrad.2006.01.003. PMID 16476534.

[4] Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/prognosis-and-survival/survival-statistics/?region=ab

[1]

[2]

[3]

[4]

@@ Line 4: / Line 4: @@
 ==Overview==
-The majority of lung cancers present with advanced disease because the [[symptoms]] tend to occur later in the course of the disease. The patient experiences non-specific symptoms such as [[cough]], [[hemoptysis]], [[dyspnea]], [[chest pain]], [[dysphonia]], [[dysphagia]], [[fatigue]], [[lack of appetite]], [[weight loss]], and [[fatigue]] from 3 weeks to 3 months before seeking medical attention. There are a variety of complications associated with lung cancer such as [[pleural effusion]], leg weakness [[paresthesias]], bladder dysfunction, [[seizures]], [[hemiplegia]], [[cranial nerve palsies]], [[confusion]], [[personality changes]], skeletal pain, and/or [[pleuritic pain]], [[atelectasis]], and/or [[bronchopleural fistula]]. The [[prognosis]] of lung cancer is poor if diagnosed during the advanced stages.
+The majority of lung cancers present with advanced [[disease]] because the [[symptoms]] tend to occur later in the course of the [[disease]]. [[Patient|Patients]] experience non-specific [[Symptom|symptoms]] such as [[cough]], [[hemoptysis]], [[dyspnea]], [[chest pain]], [[dysphonia|difficulty speaking]], [[dysphagia|difficulty swallowing]], [[lack of appetite]], [[weight loss]], and [[fatigue]] from 3 weeks to 3 months before seeking medical attention. There are a variety of [[complications]] associated with lung cancer, such as [[pleural effusion]], [[leg weakness]], [[paresthesias]], [[Urinary bladder|bladder]] dysfunction, [[seizures]], [[hemiplegia]], [[cranial nerve palsies]], [[confusion]], [[personality changes]], [[Skeleton|skeletal]] [[pain]], [[pleuritic pain]], [[atelectasis]], and [[bronchopleural fistula]]. The [[prognosis]] of lung cancer is poor if [[Diagnosis|diagnosed]] at the advanced stages.
-==Natural History==
+==Natural History, Complications, and Prognosis==
-*The majority of lung cancers present with advanced disease because the [[symptoms]] tend to occur later in the course of the disease.<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref>
-*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.<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref>
-*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.<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref>
-*Once the cancer spreads to the other organs, it is most likely fatal.
-==Complications==
+=== Natural History ===
+*The majority of lung cancers present with advanced [[disease]] because the [[symptoms]] tend to occur later in the course of the [[disease]].<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref>
+*[[Patient|Patients]] experience non-specific [[Symptom|symptoms]] such as [[cough]], [[hemoptysis]], [[dyspnea]], [[chest pain]], [[dysphonia|difficulty speaking]], [[dysphagia|difficulty swallowing]], [[lack of appetite]], [[weight loss]], and [[fatigue]] from 3 weeks to 3 months before seeking medical attention.
+*Depending on the duration of the presence of [[symptoms]], the [[Tumor cell|tumor cells]] may double 20 times.<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref>
+*In more advanced [[disease]], the [[tumor]] may spread to other [[Organ (anatomy)|organs]] such as the [[spinal cord]], [[brain]], and [[bone]].
+*These [[Patient|patients]] may develop [[symptoms]] such as [[leg weakness]], [[paresthesias]], [[Urinary bladder|bladder]] dysfunction, [[seizures]], [[hemiplegia]], [[cranial nerve palsies]], [[confusion]], [[personality changes]], [[Skeleton|skeletal]] [[pain]], and [[pleuritic pain]].<ref name="leary">{{cite book | last = Leary | first = A | title = Lung cancer a multidisciplinary approach | publisher = Wiley-Blackwell | location = Chichester, West Sussex, UK Ames, Iowa | year = 2012 | isbn = 9781405180757 }}</ref>
+*Once the [[cancer]] spreads to the other [[Organ (anatomy)|organs]], it is most likely [[fatal]].
+===Complications===
 '''General Complications'''
-The complications associated with Lung cancer are:<ref name="Jones">{{cite journal | last =Jones | first =DR | coauthors =Detterbeck FC | title =Pancoast tumors of the lung | journal =Current Opinion in Pulmonary Medicine | volume =4 | issue =4 | pages =191–197 | date =Jul 1998 | pmid =10813231 }}</ref><ref name="pmid16476534">{{cite journal |vauthors=Eren S, Karaman A, Okur A |title=The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT |journal=Eur J Radiol |volume=59 |issue=1 |pages=93–103 |year=2006 |pmid=16476534 |doi=10.1016/j.ejrad.2006.01.003 |url=}}</ref>
+The [[Complication (medicine)|complications]] associated with lung cancer are:<ref name="Jones">{{cite journal | last =Jones | first =DR | coauthors =Detterbeck FC | title =Pancoast tumors of the lung | journal =Current Opinion in Pulmonary Medicine | volume =4 | issue =4 | pages =191–197 | date =Jul 1998 | pmid =10813231 }}</ref><ref name="pmid16476534">{{cite journal |vauthors=Eren S, Karaman A, Okur A |title=The superior vena cava syndrome caused by malignant disease. Imaging with multi-detector row CT |journal=Eur J Radiol |volume=59 |issue=1 |pages=93–103 |year=2006 |pmid=16476534 |doi=10.1016/j.ejrad.2006.01.003 |url=}}</ref>
 * [[Breathing difficulties]]
-:* 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]].
+:* Lung cancer [[Patient|patients]] can experience trouble in [[breathing]] especially when [[tumors]] grow and block the [[Airway|airways]]. Also, it is possible for [[fluid]] to build up in the [[Lung|lungs]] of the [[Patient|patients]] which can negatively affect [[breathing]].
 * [[Pneumonia]]
-:* If the cancer grows in the [[airway]], it may obstruct airflow, causing [[dyspnea|breathing difficulties]]. This can lead to accumulation of secretions behind the blockage, predisposing the patient to [[pneumonia]].
-* [[Hemoptysis]] (coughing up blood)
+:* If the [[cancer]] grows in the [[airway]], it may obstruct airflow, causing [[dyspnea|breathing difficulties]]. This can lead to accumulation of [[Secretion|secretions]] behind the blockage, predisposing the [[patient]] to [[pneumonia]].
-:* Occasionally lung cancer can cause bleeding in the airways which results in the patient coughing up [[blood]].
+* [[Hemoptysis]]
+:* Occasionally, lung cancer can cause [[bleeding]] in the [[Airway|airways]] which can result in [[hemoptysis]].
 * [[Pain]]
-:* It is possible that lung cancer will cause pain as well, especially if it spreads to the lining of the lung, or other areas of the body, like the [[bones]].
-:* There are treatments to help combat the pain.
+:* It is possible that lung cancer will cause [[pain]] as well, especially if it spreads to the [[pleura]] or other areas of the [[Human body|body]], like the [[bones]].
 * [[Pleural effusion]]
-:* 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
+:* Lung cancer can cause [[fluid]] to build up in the [[Lung|lungs]] which can cause [[breathing]] difficulties.
 * [[Metastasis]]
-:* 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]].
+:* In many cases, lung cancer will spread to other parts of the [[Human body|body]]. Some of the more common places lung cancer [[Metastasis|metastasizes]] to are the [[bones]], [[liver]], [[brain]], and [[adrenal glands]].
 * [[Horner's syndrome]]
-:* Tumors in the top (apex) of the lung, known as [[Pancoast tumor]]s, may invade the local part of the [[sympathetic nervous system]], leading to changed sweating patterns and eye muscle problems (a combination known as [[Horner's syndrome]]).
+:*[[Tumor|Tumors]] in the apex of the [[lung]], known as [[Pancoast tumor]]s, may [[Invasive (medical)|invade]] locally into the [[sympathetic nervous system]] leading to [[Horner's syndrome]].
 *[[Superior vena cava syndrome]]
-**SVCS is a group of symptoms caused by obstruction of the superior vena cava. More than 60% of cases of superior vena cava obstruction are caused by malignant causes, typically a tumor outside the vessel compressing the vessel wall.
+**[[Superior vena cava syndrome|SVCS]] is a group of [[Symptom|symptoms]] caused by [[obstruction]] of the [[superior vena cava]]. More than 60% of cases of [[superior vena cava]] [[obstruction]] are caused by [[Malignant|malignancies]], especially with a [[tumor]] outside the [[Blood vessel|vessel]] compressing the [[Blood vessel|vessel wall]].
 '''Surgical Complications'''
 * [[Bronchopleural fistula]]
-:* It is when air leaks from a [[pneumonectomy]] bronchial stump
-:* Approximately 2% of patients that undergo a [[pneumonectomy]] experience this
+:* It is when air leaks from a [[pneumonectomy]] [[bronchial]] stump.
-:* It will most commonly occur approximately 7 to 10 days after surgery
+:* Approximately 2% of the [[patients]] that undergo a [[pneumonectomy]] experience this.
+:* It will most commonly occur approximately 7 to 10 days after [[surgery]].
 * [[Hemothorax]]
-:* In most cases it occurs from [[bronchial vessels]] or lung parenchyma
-:* It may have the [[symptoms]] of [[hypovolemia]]
-:* Usually, it can be treated by [[transfusion]]
 * [[Atelectasis]]
 * [[Sputum]] retention
-==Prognosis==
+===Prognosis===
-The prognosis of lung cancer is poor and it depends on the following:
+The [[prognosis]] of lung cancer is poor and it depends on the following factors:
-* Whether or not the tumor can be removed by surgery
-* The stage of the cancer: the size of the tumor, whether the cancer has spread outside the lung
-* The patient’s general health
-* Whether the cancer has just been diagnosed or has recurred
-'''Non–small cell lung cancer survival rate by stage'''<ref>Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/prognosis-and-survival/survival-statistics/?region=ab </ref>
+* Whether or not the [[tumor]] can be removed by [[surgery]]
+*[[Cancer staging|Stage]] of the [[cancer]]
+*[[Patient|Patient’s]] general health
+* Whether the [[cancer]] has just been [[Diagnosis|diagnosed]] or has recurred
+'''Non-small Cell Lung Cancer Survival Rate by Stage'''<ref>Lung cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/lung/prognosis-and-survival/survival-statistics/?region=ab </ref>
 {| style="border: 0px; font-size: 90%; margin: 3px; width: 300px" align="center"
 | valign="top" |
 |+
-! style="background: #4479BA; width: 20px;" | {{fontcolor|#FFF|Stage}}
+! style="background: #4479BA; width: 20px;" |{{fontcolor|#FFF|Stage}}
-! style="background: #4479BA; width: 20px;" | {{fontcolor|#FFF|5-year survival rate}}
+! style="background: #4479BA; width: 20px;" |{{fontcolor|#FFF|5-year survival rate}}
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |IA
+! style="padding: 5px 5px; background: #DCDCDC;" |IA
-| style="padding: 5px 5px; background: #F5F5F5;" |49%
+! style="padding: 5px 5px; background: #F5F5F5;" |49%
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |IB
+! style="padding: 5px 5px; background: #DCDCDC;" |IB
-| style="padding: 5px 5px; background: #F5F5F5;" |45%
+! style="padding: 5px 5px; background: #F5F5F5;" |45%
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |IIA
+! style="padding: 5px 5px; background: #DCDCDC;" |IIA
-| style="padding: 5px 5px; background: #F5F5F5;" |30%
+! style="padding: 5px 5px; background: #F5F5F5;" |30%
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |IIB
+! style="padding: 5px 5px; background: #DCDCDC;" |IIB
-| style="padding: 5px 5px; background: #F5F5F5;" |31%
+! style="padding: 5px 5px; background: #F5F5F5;" |31%
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |IIIA
+! style="padding: 5px 5px; background: #DCDCDC;" |IIIA
-| style="padding: 5px 5px; background: #F5F5F5;" |14%
+! style="padding: 5px 5px; background: #F5F5F5;" |14%
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |IIIB
+! style="padding: 5px 5px; background: #DCDCDC;" |IIIB
-| style="padding: 5px 5px; background: #F5F5F5;" |5%
+! style="padding: 5px 5px; background: #F5F5F5;" |5%
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" |IV
+! style="padding: 5px 5px; background: #DCDCDC;" |IV
-| style="padding: 5px 5px; background: #F5F5F5;" |1%
+! style="padding: 5px 5px; background: #F5F5F5;" |1%
 |}
-'''Small cell lung cancer survival rate'''
+'''Small Cell Lung Cancer Survival Rate'''
-* To view the prognosis among patients with small cell lung carcinoma, please click [[Small cell carcinoma of the lung natural history, complications and prognosis|'''Here''']]
+* To view the [[prognosis]] among [[Patient|patients]] with small cell lung carcinoma, please click [[Small cell carcinoma of the lung natural history, complications and prognosis|'''Here''']].
 ==References==