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Austin Alexander
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Dr. Van Elswyk
17 November 2014
Lung Cancer
Lung cancer is a major public health issue because it is the leading cause of cancer deaths
in the U.S. in men and women. At least four out of five cases of lung cancer are associated with
cigarette smoke. Cases of lung cancer are uncommon among people who do not smoke. An
estimated 224,000 people are diagnosed with lung cancer in the U.S. per year and it causes
approximately 160,000 deaths (WebMD, n.d.).
The purpose of the lungs and respiratory system is to provide an avenue and surface area
for gas exchange. The respiratory system supplies oxygen to, and removes carbon dioxide wastes
from the blood steam, which in turn supplies the oxygen to the cells that facilitate life. The
structure is a tree-like network of gas conducting tubes that terminates in the gas exchanging
alveoli. The tree structure tubes decease in size from the largest bronchi to the smaller
bronchioles and end in the even smaller terminal bronchioles. The terminal bronchioles branch
into what is known as the respiratory bronchioles, which contain the gas exchanging alveoli. The
functional part is called the respiratory unit, and is composed of a cluster of respiratory
bronchioles, alveolar ducts, and alveoli, which together form a single terminal bronchiole
(Crowley, 2012).
Lung cancer is known to be a smoking related neoplasm that is common in both men and
women. It arises from the mucosa of the bronchi and the bronchioles, which is why it can also be

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referred to as bronchogenic carcinoma. The lungs and respiratory system are rich with lymphatic
and vascular networks that facilitate metastasis - the spread of cancer cells to other distant
locations within the body. There are two major types of lung cancer: small cell carcinoma and
non-small cell carcinoma. Non-small cell carcinoma can be further divided into 3 sub types:
Squamous cell, adenocarcinoma, and large cell carcinoma (WebMD, n.d.).
Squamous cell carcinoma is very common and is responsible for an estimated 30% of
cases. It usually starts in central bronchi and occurs more commonly in men and tobacco
smokers. Because of the presence of cancer cells in the mucus, it is the type easiest to detect
early. It is also the most curable if found early because of its relatively slow spreading and its
usual confinement to the lung tissues (WebMD, n.d.).
Adenocarcinoma is the most common type, accounting for 40% of cases. It mainly occurs
in current and former tobacco smokers, but it is also the most common type found among
nonsmokers. Adenocarcinoma is more common in women than men and is more common than
other lung cancers among young people. It is known to spread to the lymph nodes and distant
organs (WebMD n.d.).
Large cell carcinoma manifests itself as large, irregular epithelial cells. Accounting for
10-15% of cases, it is the least common of the non-small cell lung cancers. It originates at the
outer edges of the lungs and has a high tendency to spread to the lymph nodes and to other
distant sites (WebMD n.d.).
The fourth kind of lung cancer is called small cell carcinoma. It is identified as small,
irregular dark cells with little cytoplasm and often resembles lymphocytes. It is the most
aggressive type of all the lung cancers and has a very poor prognosis. It originates in the central

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bronchi and spreads to other areas quickly, usually within 90 days. Areas it tends to spread to are
the liver, brain, and bones. Metastasis occurs before diagnosis in 75% of patients (WebMD, n.d.).
Association with secondhand smoke is stronger for small cell lung cancer than for the other
histological types (Kim, 2014, p. 1919).
The main cause of all four types of lung cancer is tobacco smoke. In fact, 85% of all
cases are associated with cigarette smoking. Hookah, pipe tobacco, marijuana, and other tobacco
use also significantly increase the risk of lung cancers, but cigarettes in specific are related to
most cases. Cigarette smoke is a mixture of more than 5000 chemical compounds, among which
more than 60 are recognized to have a specific carcinogenic potential (Tonini, DOnofrio,
DellAquilla, & Pezzuto, 2013, p. 649). A person that smokes one pack of cigarettes per day is
20 times more likely to develop some kind of lung cancer than a nonsmoker. Additionally,
second hand tobacco smoke kills about 3,000 people per year and there is a 30% increased risk if
living at home with a smoker (WebMD, n.d.).
There are also certain occupational hazards associated with lung cancers. Daily asbestos
exposure in the workplace causes a 90-fold increase in the likelihood of developing cancer.
Uranium dust and radon gas exposure also increases risk (WebMD, n.d.).
Some previous medical conditions are also known to increase the risk of lung cancer.
Lung tissue, scared by disease or infection, such as tuberculosis or pneumonia, are more likely to
develop tumors. A prior history of lung cancer also increases the risk for recurring cancers.
Studies have shown as well that diets high in cholesterol can increase the risk of lung cancer
(WebMD, n.d.).

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Environmental factors such as air pollution from vehicles, industry and manufacturing,
and power plants are known to increase the risk for lung cancers (WebMD, n.d.).
Some of the potential signs and symptoms that one may have lung cancer would be
chronic coughing, wheezing, hoarseness, shortness of breath, and bloody mucous. Others might
include persistent chest pain, swelling of the neck and face, and pain in the shoulders, hands or
arms. Fatigue, weakness, weight and appetite loss, fever, headache, and difficulty swallowing
may also be indicative, as well as recurring respiratory infections such as bronchitis and
pneumonia. The early stages usually have no symptoms. This is why it is difficult to diagnose
early and has such a poor prognosis (WebMD, n.d.).
There are several ways to diagnose lung cancer. One way is by identifying tumor cells in
the patients sputum. Physical exams, chest x-rays, blood tests, as well as CT and PET scans can
all be used to find the presence of and diagnose lung cancers, along with tissue sampling and
biopsy. After diagnosis, a medical provider would perform tests to determine areas of metastasis.
MRI, CT and PET scans, bone scans, and endoscopic ultrasound are all ways of determining
areas where the cancers may have spread to. Treatment includes surgical resection,
chemotherapy, radiation treatment, and laser therapy, depending of the type and stage of the
cancer. The most useful way to treat it, however, is to prevent it in the first place. This is largely
made possible by abstaining or cessation of smoking (WebMD, n.d.).
Prognosis is usually poor, depending on how early the cancer is detected. This is because
of the early metastasis before diagnosis or symptoms even occur. Other factors include the
cancer type and the patients overall health (WebMD, n.d.). Additionally, nonsmokers have a
significantly better prognosis than smokers (Tatsuro, 2014).

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Lung cancer is a very serious and deadly disease and claims the lives of hundreds of
thousands of people in the U.S. every year, many of which could have largely been prevented.
These are unnecessary deaths that could be avoided simply from avoiding tobacco smoke. Yet,
thousands of people continue to smoke every day in America. There are several anti-smoking
campaigns in the media and programs to assist in quitting. Changes in behavioral factors, in
particular the decline in cigarette smoking, have been identified as the major reason for the
observed decline in the number of U.S. men being diagnosed with lung cancer(Feuer, Levy, &
McCathy, 2012, p. S7). But, until smoking in completely eradicated in society, lung cancer will
continue to be a major public health issue.

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References
Crowley, C. (2012). Essentials of human disease. Burlington, MA: Jones & Bartlett.
Feuer, E.J., Levy, D.T., & McCarthy W.J. (2012). The impact of the reduction in tobacco
smoking on U.S. lung cancer mortality, 1975-2000: An introduction to the problem. Risk
Analysis: An International Journal, 32(S1). doi: 10.1111/j.1539-6924.2011.01745.x
Kim, C.H., Lee, Y.C., Hung, R.J., McNallan, S.R., Cote, M.L., Lim, W.Y., Zhang, Z.F. (2014).
Exposure to secondhand tobacco smoke and lung cancer by histological type: A pooled
analysis of the International Lung Cancer Consortium (ILCCO). International Journal of
Cancer, 135(8), 1918-1930. doi: 10.1002/ijc.28835
Tatasuro, O., Yuzo, S., Takatoshi, F., Hirokazu, K., Shinichiro, S., Mikihiro, K., Yosuke, M.,
Yoshihiko, M. (2014). The prognostic impact of the amount of tobacco smoking in nonsmall cell lung cancer Differences between adenocarcinoma and squamous cell
carcinoma. Lung Cancer, 85(2), 125-130. doi: 10.1016/j.lungcan.2014.06.006
Tonini, G., DOnofrio, L., DellAquila, E., & Pezzuto, A. (2013). New molecular insights in
tobacco-induced lung cancer. Future Oncology, 9(5), 649-655. Retrieved from
http://eds.a.ebscohost.com.ezproxy.lib.usf.edu
WebMD. (n.d.). Lung cancer guide. Retrieved from www.webmd.com.