Smoking Or Second Hand Smoke Is Cause of Deadly Small Cell Lung Cancer

Small cell lung cancer has the characteristic of the most aggressive type of the three classifications which is small cell, large cell and carcinoid lung cancer.  Within the category of small cell lung cancer there are two types.
These two types include many different types of cells. The cancer cells of each type grow and spread in different ways. The types of small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look when viewed under a microscope.  They are small cell carcinoma (oat cell) or combined small cell cancer.

                                                             Small cell lung cancer scan

                                                  Small cell lung cancer under the microscope




Diagnosing small cell lung cancer involves several procedures.

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

General Information About Small Cell Lung Cancer

Key Points for This Section

Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung. There are two types of small cell lung cancer. Smoking tobacco is the major risk factor for developing small cell lung cancer. Possible signs of small cell lung cancer include coughing, chest pain, and shortness of breath. Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer. Certain factors affect prognosis (chance of recovery) and treatment options. For most patients with small cell lung cancer, current treatments do not cure the cancer.

Small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.
The lungs are a pair of cone-shaped breathing organs that are found within the chest. The lungs bring oxygen into the body when breathing in and take out carbon dioxide when breathing out. Each lung has sections called lobes. The left lung has two lobes. The right lung, which is slightly larger, has three. A thin membrane called the pleura surrounds the lungs. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Small tubes called bronchioles and tiny air sacs called alveoli make up the inside of the lungs.

Enlarge

Anatomy of the respiratory system, showing the trachea and both lungs and their lobes and airways. Lymph nodes and the diaphragm are also shown. Oxygen is inhaled into the lungs and passes through the thin membranes of the alveoli and into the bloodstream (see inset).

Risk factors for small cell lung cancer include:

• Smoking cigarettes, cigars, or pipes now or in the past.
• Being exposed to secondhand smoke.
• Being exposed to asbestos or radon.

Possible signs of small cell lung cancer include coughing, chest pain, and shortness of breath.
These and other symptoms may be caused by small cell lung cancer. Other conditions may cause the same symptoms. A doctor should be consulted if any of the following problems occur:

• A cough that doesn’t go away.
• Shortness of breath.
• Chest pain that doesn’t go away.
• Wheezing.
• Coughing up blood.
• Hoarseness.
• Swelling of the face and neck.
• Loss of appetite.
• Weight loss for no known reason.
• Unusual tiredness.

Tests and procedures that examine the lungs are used to detect (find), diagnose, and stage small cell lung cancer.
The following tests and procedures may be used:

• Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.

  Enlarge

  X-ray of the chest. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film.

• Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
• CT scan (CAT scan) of the brain, chest, and abdomen: A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.

  Enlarge

  PET (positron emission tomography) scan. The patient lies on a table that slides through the PET machine. The head rest and white strap help the patient lie still. A small amount of radioactive glucose (sugar) is injected into the patient's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.

• Sputum cytology: A microscope is used to check for cancer cells in the sputum (mucus coughed up from the lungs).
• Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer. 

Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.

Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

 Unfortunately, the prognosis for small cell lung cancer is not positive.

Approximately 65-70% of patients with small cell lung cancer have disseminated or extensive disease at presentation. Extensive-stage small cell lung cancers are incurable, and patients with extensive disease have a median survival duration of 6 weeks. Patients presenting with localized disease (ie, limited stage) have a median survival duration of about 12 weeks. These survival figures are for untreated patients.
The median survival of patients with small cell lung cancer who are treated with multiple-agent chemotherapy and multimodality therapy are as follows:

• For limited disease, 20 months, with a 2-year survival rate of 45%^[21] and a 5-year survival rate of 20%
• For extensive disease, 12 months (In 1973, the 2-year survival rate was 1.5%; in 2000, the 2-year survival rate was 4.6%.)

Indicators of poor prognosis include relapsed disease, weight loss, and performance status. Patients who ambulate less than 50% of their waking hours and those with weight loss of more than 10% in 6 months have a worse prognosis.  For more information:

http://emedicine.medscape.com/article/280104-overview  or

http://www.cancer.gov/cancertopics

Better Treatment Option Recently FDA Approved For Basal Cell Carcinoma

Basal cell carcinoma is the most common form of skin cancer and usually found on the upper body.  As this cancer advances it can become disfiguring and fatal.

After a few years of testing and clinical trials the FDA has approved a new drug called Erivedge.

Testing found that the drug, Erivedge, shrank tumors in 30 percent of patients whose disease had metastasized and spread in the body. Also, 43 percent of patients in which the disease had spread to surrounding tissue had a complete or partial response.
Erivedge, a pill taken once a day, works by blocking the signals in the cellular pathway that leads to cancer growth.
Scottsdale Healthcare and TGen began working on Phase 1 of the drug's clinical trial in 2007, through a partnership the entities have maintained for seven years.
It is amazing how those in cancer research are committed to improving the lives of cancer patients!

Read more: http://www.azcentral.com/news/articles/2012/01/30/20120130skin-cancer-drug-tested-valley-approved.html#ixzz1l9NNowLY

Living With Chronic Myelogenous Leukemia

Having worked with cancer patients I know the stages of grief that patients go through when hearing the diagnosis.  There is unbelief, sadness, anger and sometimes rebellion in compliance with treatment.  I am talking specifically now about CML patients.  There is a great amount of hope for these patients now. Right now CML patients are required to take their Gleevac every day for a  long life span.  This may one day change because researchers are having many breakthroughs with molecular studies. 
A great website for support and education is "The National CML Society".  This site is full of information and direct help for your needs.  Below is a video of testimonials of CML patients.

The hope for CML is great for there are great doctors who are adamant about continued clinical trials and research to continue to find a cure.  You can help yourself and others by volunteering to participate in clinical trials and lab testing.  Listen to the following video of one the most prominent hematology oncologists in America today.

                                                          Dr. Jorge Cortes

Be active in your treatment!  Research and join online support groups.  There is always hope!

United Kingdom Reveals DNA Testing For Individualized Treatment Of Cancer

This testing is a wonderful development because it focuses on the DNA of cancer patients which allows treatment to be personalized instead of treating everyone the same way depending on their diagnosis.


Health Secretary Andrew Lansley unveiled plans to give more cancer patients access to tests that screen their DNA.
The aim is to make the most of recent advances that enable cancer treatments to be tailored to individuals.
Increasingly, targeted drugs are being developed that work in small sub-groups of patients with specific genetic profiles. Future genetic tests will also show if a patient is more likely to respond to one treatment or another.

Mr Lansley said: "The new developments can help patients to get the best treatments to improve their chances of survival and their quality of life. We want to make sure that all patients can benefit from these tests - as soon as the tests are recommended by Nice (National Institute for health and Clinical Excellence). We have therefore been working to establish a new system to ensure speedy introduction of high quality tests. This is the way forward for the future."

For more information:  http://www.google.com/hostednews/ukpress/article/ALeqM5i-DSigwZkCOwNI32CB6h-inucDfg?docId=N0127971327500789606A

Waldenstrom Macroglobulinemia, A Rare and Complicated Disease

WM is a rare disorder with an incidence of approximately three per million people per year with 1400 new cases diagnosed in the United States each year . The median age at diagnosis is 64 years; less than 1 percent of patients are under 40 years of age, and approximately 60 percent are males. WM is much more common in Caucasians than in other ethnic groups . Specifically, it is uncommon in Blacks and those of Mexican descent who make up approximately 5 percent of cases.
The majority of patients with the histopathologic finding of lymphoplasmacytic lymphoma (LPL) have a circulating monoclonal IgM consistent with the diagnosis of WM. In the past, LPL and WM have been arbitrarily differentiated from each other based on the level of the monoclonal IgM protein. Currently, the preferred terminology in cases of LPL with circulating monoclonal IgM is WM, rather than lymphoplasmacytic lymphoma, regardless of the size of the monoclonal IgM protein.

Waldenström macroglobulinemia, one of the malignant monoclonal gammopathies, is a chronic, indolent, lymphoproliferative disorder.It is characterized by the presence of a high level of a macroglobulin (immunoglobulin M [IgM]), elevated serum viscosity, and the presence of a lymphoplasmacytic infiltrate in the bone marrow. (See Pathophysiology, Etiology, and Workup.)
A clonal disease of B lymphocytes, Waldenström macroglobulinemia is considered to be a lymphoplasmacytic lymphoma, as defined by the Revised European American Lymphoma Classification (REAL) and World Health Organization (WHO) classification.
The clinical manifestations of Waldenström macroglobulinemia result from the presence of the IgM paraprotein and malignant lymphoplasmacytic cell infiltration of the bone marrow and other tissue sites. The clinical presentation is similar to that of multiple myeloma except that organomegaly is common in Waldenström macroglobulinemia and is uncommon in multiple myeloma and  lytic bony disease and renal disease are uncommon in Waldenström macroglobulinemia but are common in multiple myeloma. (See Pathophysiology, Presentation, and Workup.)

Complications

Complications of Waldenström macroglobulinemia include the following:

• Hyperviscosity syndrome
• Visual disturbances secondary to hyperviscosity syndrome
• Diarrhea and malabsorption secondary to gastrointestinal (GI) involvement
• Renal disease (less common)
• Amyloidosis of the heart, kidney, liver, lungs, and joints
• Bleeding manifestations secondary to platelet dysfunction and coagulation factor and fibrinogen abnormalities due to interaction with  plasma IgM
• Raynaud phenomenon secondary to cryoglobulinemia
• Increased predisposition to infection due to B-cell dysfunction (disease related) or T-cell dysfunction (therapy related, particularly after nucleoside analogues)
• Cardiac failure
• Increased incidence of lymphomas, myelodysplasia, and leukemias
•  
   
  Initially this disease may look like Multiple Myeloma, but one can see that extensive testing is required for diagnosis. Of course, a bone marrow biopsy is important so the pathologist can look for abnormalities in the bone marrow tissue.
   

  Blood counts

  The complete blood count (CBC) is a test that measures the levels of red cells, white cells, and platelets in the blood. If the lymphoma cells occupy too much of the bone marrow, these levels will be low.
  

  Quantitative immunoglobulins

  This test measures the blood levels of the different antibodies. There are several different types of antibodies in the blood: IgA, IgE, IgG, and IgM. The levels of these immunoglobulins are measured to see if any are abnormally high or low. In WM the level of IgM is high but the IgG level is often low.
  

  Electrophoresis

  The immunoglobulin produced in WM (IgM) is abnormal because it is monoclonal -- meaning that it is just many copies of the exact same antibody. Serum protein electrophoresis (SPEP) is a test that measures the total amount of immunoglobulins in the blood and finds any abnormal (monoclonal) immunoglobulin. Then, another test, such as immunofixation or immunoelectrophoresis, is used to determine the type of antibody that is abnormal (IgM or some other type). Finding a monoclonal IgM immunoglobulin in the blood is necessary to make a diagnosis of WM. The abnormal protein in WM is known by several different names, including monoclonal immunoglobulin M, IgM protein, IgM spike, IgM paraprotein, and M-spike. Other types of monoclonal immunoglobulins, like IgA or IgG, are seen in different disorders (like multiple myeloma and some lymphomas).
  Sometimes pieces of the IgM protein are excreted by the kidneys into the urine. The procedure used for finding a monoclonal immunoglobulin in the urine is called urine protein electrophoresis (UPEP).
  

  Viscosity

  Viscosity measures how thick the blood is. If the IgM level is too high, it will cause the blood to become thick (viscous) so that it can't flow freely. Think about pouring honey compared to pouring water. If the blood becomes too thick, the brain doesn't get enough blood and oxygen. This can be treated with plasmapheresis (see below).
  

  Cryocrit

  This tests the blood for a cryoglobulin (a protein that causes the blood to clump together in cool temperatures).
  

  Beta-2-microglobulin

  This is another protein produced by the malignant lymphoplasmacytoid cells. This protein itself doesn't cause any problems, but it is a useful indicator of a patient’s prognosis (outlook). High levels mean a poor outlook.
  
  WM is a rare disorder with an incidence of approximately three per million people per year with 1400 new cases diagnosed in the United States each year. The median age at diagnosis is 64 years; less than 1 percent of patients are under 40 years of age, and approximately 60 percent are males . WM is much more common in Caucasians than in other ethnic groups . Specifically, it is uncommon in Blacks and those of Mexican descent who make up approximately 5 percent of cases .
  The majority of patients with the histopathologic finding of lymphoplasmacytic lymphoma (LPL) have a circulating monoclonal IgM consistent with the diagnosis of WM. In the past, LPL and WM have been arbitrarily differentiated from each other based on the level of the monoclonal IgM protein. Currently, the preferred terminology in cases of LPL with circulating monoclonal IgM is WM, rather than lymphoplasmacytic lymphoma, regardless of the size of the monoclonal IgM protein.
  
  
  
• For more information:  www.medscape.com, www.uptodate.com, www.cancer.org