Tobacco Use and Lung Cancer
Lung cancer is the leading cancer killer among both men and women. There are two different types of lung cancer: nonsmall cell lung cancer and small cell lung cancer. There are also many different things that can cause lung cancer, but the number one cause for lung cancer is tobacco use.
What is lung cancer? This is a question that a lot of people are still asking. Lung cancer is definitely something to want to be educated about so that it can be recognizable. There are healthy cells that grow and divide throughout the body to keep it functioning properly, but sometimes this growth gets out of control when the cells continue to produce even though cells aren’t needed. These abnormal cells in the lungs originate when the lungs are exposed to carcinogens for instance those found in cigarette smoke. At first, only a small number of abnormal cells might appear, but as these cells are increasingly exposed to carcinogens they will definitely progress and eventually these cells become cancerous. Once these cancerous cells have reached the lungs, they have easy access to a large number of blood and lymph vessels. (MFMER 1998-2001)
Cancer that begins in the lungs is divided into two major types, small cell lung cancer and nonsmall cell lung cancer. Nonsmall cell lung cancer is more common than small cell lung cancer and it generally grows and spreads more slowly. There are three main types of nonsmall cell lung cancer that are named for the type of cells in which the cancer develops. These three types are: squamous cell carcinoma, adenocarcinoma and large cell carcinoma. Squamous cell carcinoma is a cancer that forms in cells that are lining the airways. It’s the most common type of lung cancer in men. Adenocarcinoma is the most common type of lung cancer in women and people who have never smoked, it is a cancer that usually begins in the mucus-producing cells of the lung. The last type of nonsmall cell lung cancer is large cell carcinoma; this type of cancer originates in the peripheral part of the lungs. The other major type of lung cancer is small cell lung cancer which sometimes is called oat cell cancer, it is less common than nonsmall cell lung cancer. This particular type of lung cancer grows more quickly and is more likely to spread to other organs in the body.(MFMER 1998-2001)
The number one leading cause of lung cancer is tobacco use. At one time smoking was just considered a socially acceptable behavior, but is now the leading cause of disability and death in the U.S. It is considered to be the most important cause of chronic bronchitis in both sexes, lung and laryngeal cancer in men and probable cause of lung cancer in women. There are many reasons smoking causes lung cancer but one is that the smoke from one single cigarette is composed of over four thousand different constituents and of those, approximately sixty of them are known carcinogens or tumor promoters. Smoking may be the number one leading cause of death, but it is also preventable.
Although smoking is the leading cause of lung cancer, there are many other contributors to lung cancer such as cigarettes, cigars and pipes, environmental tobacco smoke, radon, asbestos, pollution, lung diseases and medical history. Cigarettes cause lung cancer from the harmful substances that damage cell in the lungs. Whether the person will develop lung cancer is affected by the age at which they began smoking, how long they have been smoking, the number of cigarettes that are smoked per day, and how deeply the person inhales. Cigars and pipes give the person a higher risk of lung cancer than nonsmokers, the affects are the same as the ones for smoking cigarettes. There are people who smoke cigars and pipes and do not inhale and these people are at a risk for lung, mouth and other types of cancer. Environmental tobacco smoke also known as secondhand smoke is called involuntary or passive smoking is also a risk of lung cancer. Radon is an invisible, tasteless, and odorless radioactive gas that occurs naturally in soil and rocks. Radon can cause damage to the lungs eventually causing lung cancer, it is mostly found in mines and in some parts of the country it is found in houses. Asbestos is another risk factor for lung cancer, it is the name of a group of minerals that occur naturally as fibers and are used in certain industries. These fibers can float in the air and stick to clothes by breaking down into particles and when the particles are inhaled, they can lodge in the lungs damaging the cells. The exposure of asbestos has been observed in industries such as shipbuilding, asbestos mining and manufacturing, insulation work, and brake repair. Pollution such as by-products of the combustion of diesel and other fossil fuels have a link with lung cancer if exposed to these air pollutants. Lung diseases such as tuberculosis increase a person’s chance of developing of lung cancer because lung cancer tends to develop in areas of the lung that are scarred from tuberculosis. The final risk factor in developing lung cancer is medical history. This means that if a person has had lung cancer once before it is more likely that they develop a second lung cancer versus a person who has never had lung cancer before. (WebMD Corporation 1996-2002)
Smoking cigarettes accounts for nearly ninety percent of all lung cancers. It is also linked to one-third of all cancers of the mouth, pharynx, larynx, lung and esophagus. In the United States, tobacco use is responsible for nearly one in five deaths killing more than four hundred thousand Americans each year and is a risk factor for approximately twenty-five diseases. Tobacco use as a risk factor is expected to make a greater claim on health than any single disease. Smoking and tobacco use caused about ten million people in the United States to die and two million of those deaths alone were the result of lung cancer.
Tobacco use is more common in women and is clearly a women’s issue. It wasn’t until the mid 1920’s that cigarette advertising began targeting women and at that time, very few women smoked. As the advertising increasingly targeted women, cigarette use increased rapidly. Based on a report from the U.S. Surgeon General, lung cancer among white women has increased by six hundred percent between 1950 and 2000. In the year 2000, lung cancer accounted for an estimated twenty-five percent and twenty-seven thousand more women died of lung cancer than breast cancer. (BMJ 2001) This fact may be a surprise to a large number of people because most would have thought that breast cancer was the leading cause of deaths among women. This just goes to show how deadly cigarettes really are and how uneducated people are about the use of tobacco and lung cancer, it is a very serious issue but it is also preventable.
Even though women are targeted by advertisers, they are not the only ones that are greatly affected by tobacco use. There are also certain racial and ethnic groups that are greatly affected as well. For example, African American men have the highest lung cancer incidence and mortality rates. Lung cancer is the leading cause of cancer deaths in most racial/ethnic groups of women except American Indian, Filipino, and Hispanic women. In men, lung cancer is the leading cause in all racial/ethnic groups except American Indians. White women are said to have higher smoking rates than Hispanic or African American women, and African American men have higher rates than Hispanic or White men. Among all, White adolescents have the highest smoking rates and African American adolescents have the lowest smoking rates. It seems as though compared to all racial and ethnic groups; White men and women start at an early age and continue on to be the highest rated smokers. (RamEx Ars Medica, Inc. 2000)
How is lung cancer detected? Lung cancer does not cause symptoms in it’s early stages, but when the cancer is advanced the symptoms include: a chronic cough that does not go away and gets worse over time, fatigue, coughing up blood, weight loss and loss of appetite, constant chest pain, fever without a known reason, swelling of the neck and face, repeated problems with pneumonia or bronchitis, wheezing, shortness of breath and hoarseness. A person who has any of these symptoms should see a doctor to find out the cause because these symptoms are also symptomatic of many other lung problems or other less serious conditions. The doctor many ask questions about the medical history of the patient when thy go for an exam. The doctor will also give the patient a physical exam and if the patient has a cough that produces mucus, it may be examined for cancer cells. If the patient is diagnosed with cancer, the doctor will do testing that may include a CT scan, an MRI or a bone scan to find out whether the cancer has spread. (American Lung Association 2002)
The doctor must examine tissue from the lung to confirm the presence of lung cancer. To show whether a person has cancer, there is a biopsy, the removal of a small sample of tissue for examination under a microscope by a pathologist. There are a number of procedures that may be used to obtain this tissue for instance a bronchoscopy. This is where the doctor inserts a bronchoscope into the mouth or nose and down through the trachea to look into the breathing passages. The doctor is able to collect cells or small samples of tissue through this tube. Another procedure is the needle aspiration; this is where a needle is inserted through the chest into the tumor to remove a sample of tissue. A third type of procedure used is thoracentesis, by using a needle the doctor removes a sample of the fluid that is surrounding the lungs to check for cancer cells. The last procedure discussed is thoracotomy, this is a surgery that is used to open the chest. This procedure is a major operation performed in a hospital. (United States 1998)
If the patient is diagnosed with cancer, the doctor will want to learn the extent of the disease. This is done to find out whether the cancer has spread and to what parts of the body. Lung cancer often spreads to the brain or bones, therefore knowing the extent of the disease helps the doctor plan treatment for it. To determine whether the cancer has spread or not these are some of the tests used: Cat (CT) scan, a computer hooked up to an X-ray machine that creates a series of detailed pictures of areas inside the body. A MRI is also used; this is a powerful magnet hooked up to a computer to make detailed pictures inside the body. Radionuclide scanning is used to show whether the cancer has spread to other organs. This is done by having the patient swallow or receive an injection of a mildly radioactive substance. A scanner records and measures the level of radioactivity to reveal abnormal areas in certain organs. Another test used is the bone scan, which is one type of radionuclide scanning. As small amount of radioactive substance is injected into the blood stream of the patient and it collects in areas of abnormal bone growth. The last test discussed is a mediastinoscopy, which is used to show whether the cancer has spread to the chest of lymph nodes. The doctor examines the center of the chest and nearby lymph nodes with a lighted viewing instrument called a scope. In this procedure, the scope is inserted through a small incision in the neck. (United States 1997-1998)
Once the patient is diagnosed with cancer, it doesn’t always necessarily mean there is no cure or treatment for it and that the doctor is going to tell the patient how much longer they are expected to live. There are many types of treatments that can be used, but the treatment does depend on a number of factors including the type of cancer (nonsmall cell or small cell lung cancer), the stage of the disease, and the general health of the patient. Surgery is one of these treatments used to remove the cancer. Depending on the location of the cancer in the lung allows the doctor to know what type of surgery to perform. An operation to remove only a small portion of the lung is called a segmental or wedge resection, the removal of an entire lobe of the lung is known as a lobectomy, and when the entire lung is removed it is called pneumonectomy. There are some tumors that are inoperable due to the size, location or medical reasons of the patient. Chemotherapy is another type of treatment that is the use of an anticancer drug to kill cancer cells throughout the body. Cancer cells still may be present in a nearby tissue or elsewhere in the body even after cancer has been removed from the lung. Chemotherapy can be used to control the cancer or even just to relieve symptoms. Most anticancer drugs are given in the form of a pill or even by injection into a vein, but another way to get chemotherapy is by means of a catheter, which is a thin tube that is placed into large vein and remains there as long as needed. A third type of treatment is radiation therapy also called radiotherapy, involves the use of high-energy rays to kill cancer cells. Radiation may be used after surgery to destroy any cancer cells that remain in the treated areas or even before surgery to try to shrink down the tumor. Radiation treatment of lung cancer most often comes from a machine, but it can also come from an implant that is placed directly into or near the tumor. Photodynamic therapy is the use of a special chemical that is injected into the bloodstream and absorbed by cells. The chemical remains in the cancer cells for a longer period of time as it rapidly leaves normal cells. Photodynamic therapy is used for lung cancers that are localized, but is being studied for possible use in controlling symptoms in advanced cases when tumors are compressing against other organs of the body. The final treatment mentioned is clinical trials to evaluate new ways to treat cancer. This is an option for many lung cancer patients, with some doctors all patients receive the new treatment but with others they test it out with one group of patients and give the usual to another group. (United States 1997-1998)
As stated in this paper before, the number one leading cancer killer among both men and women is lung cancer and approximately ninety percent of lung cancer is caused by tobacco use. People just do not realize how serious of an issue this really is, which is due to the fact that they are not near educated enough about lung cancer and the use of tobacco. Although millions of people have died as a result of this, it is still a very preventable cause. Granted there are some cases that might not be as obvious to the person such as radon, or asbestos, which in that case they should be more aware of their environment and surroundings. As for the number one cause of cancer, there is a number one prevention and that is to never start smoking or to quit smoking and live a longer more enjoyable lifestyle.