als including arsenic, chromium and nickel can also increase risk.
Some studies have suggested that diet can play a role in lung cancer risk. Though it is not known how it works, diets high in fruits and vegetables seem to decrease risk.
Radiation exposure damages the DNA material within the cells and can also cause lung cancer.
Radon (a radioactive gas) exposure from our normal surrounding environment, if higher than normal, can predispose to lung cancer. This evidence is mainly based upon population studies which show that people living in areas with a high radon content are prone to increased incidences of a variety of cancers.
Progression of Lung Cancer (Large Cell Carcinoma of the Lung)
Spread of the tumour can occur by the lymphatic vessels to lymph nodes located within the lung, mediastinum and thorax. If spread by the blood stream, it can lead to deposits of tumour in the liver, opposite lung, bone and brain.
Symptoms of Lung Cancer (Large Cell Carcinoma of the Lung)
Patients with large cell carcinoma of the lung may notice:
- Coughing (8-75%)
- Weight loss (0-68%)
- Shortness of breath (3-60%)
- Chest pain (20-49%): often ill-defined and aching
- Haemoptysis (coughing up blood): sputum may be streaked with blood
- Non-specific symptoms: fever, weakness, lethargy.Rarely, patients may present with difficulty swallowing or wheezing.
How is Lung Cancer (Large Cell Carcinoma of the Lung) Diagnosed?
- Full blood picture: this may reveal anaemia (low haemoglobin).
- Liver function tests: abnormal liver function tests may suggest that the tumour has spread to the liver.
- Urea and electrolytes: low levels of sodium in the blood may indicate inappropriate secretion of ADH (SIADH), a complication of some types of lung cancer.Imaging tests:
- Chest x-ray: lung cancer may be seen on chest x-ray as a solitary pulmonary nodule or mass. As many as 80% of solitary pulmonary nodules (
- CT: this is more accurate than chest x-ray, and may be particularly useful in identification of lymph node involvement. See the example image below.
- PET scanning can help to distinguish between benign and malignant solitary pulmonary nodules seen on chest x-ray. PET scanning may also be used in the assessment of nodal spread and metastatic disease.
- Imaging of other organs: if it is suspected that the cancer has spread to other organs, scans of the liver, brain or bone may be required.While imaging tests are helpful in raising the suspicion of lung cancer, diagnosis requires that cancer cells are seen under a microscope. There are a number of ways of obtaining samples of suspected cancer cells:
- Sputum cytology: cells from the sputum (spit) are examined for signs of malignancy (cancer).
- Bronchoscopy with washings, brushings and biopsy: a bronchoscopy is a camera tube placed through the throat into the airways of the lungs. Samples of the cells from the airways can be taken with washing, brushing, or biopsy.
- Fine needle aspiration biopsy through the skin may be used to investigate suspected lung tumours located on the outside of the lungs.
Prognosis of Lung Cancer (Large Cell Carcinoma of the Lung)
The prognosis (probable outcome) depends on the stage of the tumour. Cancer staging is a tool which allows prediction of patient outcomes, and helps decide on the best treatment options. It takes into account various features of a tumour in an individual patient, which can then be compared to other patients with similar tumour features.
Staging of large cell carcinoma of the lung is based on the TNM (Tumour, Node, Metastasis) system. ‘Tumour’ refers to tumour size, which is measured in centimetres. ‘Node’ refers to the presence of cancerous cells in regional lymph nodes. ‘Metastasis’ refers to the spread of cancer beyond regional lymph nodes to other organs of the body.
- Tumour size (T):
- Tx: Primary tumour not able to be assessed
- T0: No evidence of primary tumour, ie. cancer cells seen on sputum sampling or bronchial washing only
- Tis: Carcinoma in situ
- T1: Tumour 3 cm or less, surrounded by pleura, without evidence of invasion more prox