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Non-Small Cell Lung Carcinoma


Presentation

  • We present the results of our observational case series to better delineate the presentation and clinical course of this uncommon entity which shows that ISCM may present atypically and should be considered in any patient with a previous history of bronchogenic[ncbi.nlm.nih.gov]
  • Clinical examination, OCT imaging, photographs, and corneal scrapes were completed at presentation. Afatinib was discontinued.[ncbi.nlm.nih.gov]
  • In this report, we present a case illustrating the uncommon situation of a patient presenting with bilateral superior sulcus tumors, and we review the latest combined therapeutic approach developed to aggressively treat the more common unilateral presentation[ncbi.nlm.nih.gov]
  • We present a 65-year-old man with multiple paraneoplastic syndrome forms consisting of pancytopenia leukocytoclastic vasculitis and hypertrophic pulmonary osteoarthropathy, associated with non-small cell lung carcinoma.[ncbi.nlm.nih.gov]
  • We report the rare case of a 77-year-old man with localized non-small cell lung carcinoma who underwent extirpative surgery and 2 years later presented with gross hematuria and was noted to have a large infiltrating renal mass on computed tomography.[ncbi.nlm.nih.gov]
Weight Loss
  • The most common symptoms of lung cancer are: A cough that does not go away or gets worse Coughing up blood or rust-colored sputum (spit or phlegm) Chest pain that is often worse with deep breathing, coughing, or laughing Hoarseness Weight loss and loss[cancer.org]
  • Some of the symptoms of less advanced cancer include chronic cough, coughing up blood, chest pain, hoarseness, shortness of breath, wheezing, chest pain, weight loss, and loss of appetite.[en.wikipedia.org]
  • Cox proportional-hazards models, stratified according to the measurability of disease, disease stage, presence or absence of prior radiation therapy, and amount of prior weight loss, were used to estimate the hazard ratios and to test for significance[doi.org]
  • Systemic findings may include unexplained weight loss and low-grade fever. (See Presentation .) Because of the importance of stage on the therapeutic decision-making process, all patients with NSCLC must be staged adequately.[emedicine.medscape.com]
Fatigue
  • Some of the more common paraneoplastic syndromes that can be caused by non-small cell lung cancer include: High blood calcium levels (hypercalcemia), which can cause frequent urination, thirst, constipation, nausea, vomiting, belly pain, weakness, fatigue[cancer.org]
  • Some more of the symptoms that indicate further progression of the cancer include shortness of breath, superior vena cava syndrome, trouble swallowing, large amounts of mucus, weakness, fatigue, and hoarseness.[en.wikipedia.org]
  • Among the 215 patients receiving bevacizumab monotherapy, the most common grade 3 or 4 toxic effects were hypertension (in 12 patients [5.6%]), proteinuria (in 9 patients [4.2%]), fatigue (in 11 patients [5.1%]), and dyspnea (in 12 patients [5.6%]).[doi.org]
  • Figures and Tables - Analysis 1.19 Comparison 1 chemotherapy plus cetuximab versus chemotherapy alone, Outcome 19 Fatigue.[doi.org]
  • Common adverse events that were mainly grade 1 or 2, which occurred in 25% to 33% of patients, were constipation, fatigue, and peripheral edema.[cancer.gov]
Rigor
  • Before clinical implementation, individual methylation markers need to be rigorously validated, ideally by using different methodologies 13.[doi.org]
Cough
  • The most common symptoms of lung cancer are: A cough that does not go away or gets worse Coughing up blood or rust-colored sputum (spit or phlegm) Chest pain that is often worse with deep breathing, coughing, or laughing Hoarseness Weight loss and loss[cancer.org]
  • Some of the symptoms of less advanced cancer include chronic cough, coughing up blood, chest pain, hoarseness, shortness of breath, wheezing, chest pain, weight loss, and loss of appetite.[en.wikipedia.org]
  • A cough that doesn’t go away or gets worse over time. Trouble breathing. Wheezing. Blood in sputum ( mucus coughed up from the lungs). Hoarseness. Loss of appetite. Weight loss for no known reason. Feeling very tired. Trouble swallowing.[cancer.gov]
  • Symptoms depend on the location of cancer. [1] The most common signs and symptoms of lung cancer include the following: Cough Chest pain Shortness of breath Coughing up blood Wheezing Hoarseness Recurring infections such as bronchitis and pneumonia Weight[emedicine.medscape.com]
Chronic Cough
  • Some of the symptoms of less advanced cancer include chronic cough, coughing up blood, chest pain, hoarseness, shortness of breath, wheezing, chest pain, weight loss, and loss of appetite.[en.wikipedia.org]
Macroscopic Hematuria
  • Urinary protein over creatinine ratio was 0.31 g/g with 22% albumin and macroscopic hematuria.[ncbi.nlm.nih.gov]
Hyperactivity
  • A number of different EGFR mutations have been discovered, however certain aberrations will result in hyperactive forms of the protein. People with these mutations are more likely to have adenocarcinoma histology and be non-smokers or light smokers.[en.wikipedia.org]

Workup

  • A complete staging workup for NSCLC should be carried out to evaluate the extent of disease. (See Workup .) Treatment primarily involves surgery, chemotherapy, or radiation therapy.[emedicine.medscape.com]
  • Preprocedural clinical and imaging workup is required to assess indications, stage the tumour, exclude contraindications (such as uncorrected coagulopathy) and plan the treatment, with particular reference to the needle trajectory.[doi.org]
Lymphocytic Infiltrate
  • Skin biopsy revealed dermal fibrosis and dilated lymph vessels in the dermis, but lymphocytic infiltration around the lymph vessels, in contrast to the blood vessels, was minimal.[ncbi.nlm.nih.gov]

Treatment

  • This determines treatment options.[en.wikipedia.org]
  • Careful monitoring for signs of ocular adverse events is recommended during treatment with afatinib for non-small-cell lung carcinoma.[ncbi.nlm.nih.gov]
  • Background Although resection of the metastases is the treatment of choice for unilateral solitary adrenal metastasis of non-small cell lung carcinoma (NSCLC), the surgical treatment for bilateral adrenal metastases is quite rare, likely due to the coexistence[ncbi.nlm.nih.gov]
  • Stage III NSCLC without effusion and inoperable NSCLC can be treated effectively with concurrent local and systemic treatment without significant toxicity.[ncbi.nlm.nih.gov]
  • Second-generation anaplastic lymphoma kinase (ALK) inhibitor (alectinib) is initiated as first line of treatment. After 8 months of treatment with alectinib, F-NaF PET/CT demonstrated resolution of bone lesions.[ncbi.nlm.nih.gov]

Prognosis

  • But they are grouped together as NSCLC because the approach to treatment and prognosis (outlook) are often similar. Adenocarcinoma: About 40% of lung cancers are adenocarcinomas.[cancer.org]
  • The survival distributions of the prognosis groups are presented in Fig. 3B.[doi.org]
  • Most lung carcinomas are diagnosed at an advanced stage, conferring a poor prognosis. The need to diagnose lung cancer at an early and potentially curable stage is thus obvious. (See Prognosis.)[emedicine.medscape.com]
  • DLEC1 and MLH1 promoter methylation are associated with poor prognosis in non-small cell lung carcinoma. Br J Cancer 99, 375–82 (2008). 59. Wang, Y. C. et al.[doi.org]

Etiology

  • These differences are significant and suggest possible multiple etiologies including inherited genetic susceptibility and environmental, hormonal, and other unknown factors.[doi.org]
  • A study by Bagnardi et al determined that alcohol is not an independent factor in the etiology of lung cancer. [16] Smoking Smoking prevalence in the United States has gradually declined over last 4 decades.[emedicine.medscape.com]
  • Alterations in other components of DSB signaling, including RAD50, MRE11, XRCC4, and XRCC6, in NSCLC samples are under investigation to more clearly determine the etiology of this disease.[doi.org]

Epidemiology

  • Comparison of aspects of smoking among the four histological types of lung cancer S A Kenfield 1, 2, E K Wei 2, M J Stampfer 1, 2, B A Rosner 2, 3, G A Colditz 4 1 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA[doi.org]
  • *SEER Surveillance, Epidemiology, and End Results[cancer.org]
  • Koo LC, Ho JH-C: Worldwide epidemiological patterns of lung cancer in non smokers. Int J Epidemiol 19:: s14, 1990 -s23, (suppl) Crossref, Medline, Google Scholar 6.[doi.org]
  • Surveillance, Epidemiology, and End Results Program. Available at . Accessed: April 12, 2019. Jonnalagadda S, Smith C, Mhango G, Wisnivesky JP.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Both exposure (environmental or occupational) to particular agents and an individual’s susceptibility to these agents are thought to contribute to one’s risk of developing lung cancer.[emedicine.medscape.com]

Prevention

  • Moyer VA; US Preventive Services Task Force. Screening for lung cancer: US Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;160(5):330-338. PMID: 24378917 www.ncbi.nlm.nih.gov/pubmed/24378917.[medlineplus.gov]
  • Smoking prevention and cessation should continue to be the focus of public health efforts to reduce lung cancer incidence and mortality.[doi.org]
  • This lecture will provide examples of how these insights are leading back to new approaches to treatment and prevention. Table 1.[doi.org]
  • Preventing Lung Cancer Mortality by Computed Tomography Screening: The Effect of Risk-Based Versus U.S. Preventive Services Task Force Eligibility Criteria, 2005–2015. Ann Intern Med. 2 January 2018. [Full Text].[emedicine.medscape.com]

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