Lung cancer: a treatment difficult

inevitable consequence of the increase in smoking among women, lung cancer has become the leading cause of cancer death in women in the US and is poised to follow suit in France.

Decreasing the intensity of symptoms, chemotherapy improves the quality of life of patients with lung cancer. But despite the progress made in the terms of administration of combination therapies, the treatment of these tumors remains very difficult.

Overall lung, the survival rate for this cancer five years barely exceeds 10%. If surgery alone can bring healing in the rare cases known as small-cell, when the tumor is spotted at a very limited stage for more advanced tumors, hopes based on the combination of different treatments.

Surgery can easily remove the entire tumor when it is small. However, studies have shown that rather than just removing the tumor, it is necessary to remove the entire lobe to reduce the risk of recurrence. With radiotherapy, chemotherapy improves survival after surgery and to reduce the size of cancer that cannot be removed.

Many trials are conducted to clarify the interest of so-called third generation of agents such as gemcitabine, taxanes, topoisomerase I inhibitors (topotecan and irinotecan) or vinorelbine, with encouraging results. The combination of three agents could be better than the usual dual therapy.

Reduce adverse reactions

Radiation therapy should progress to more intense radiation, to increase efficiency, but also specifically directed to the tumor through modern imaging techniques, to limit the effects of this treatment. One of the major challenges is indeed to achieve limiting toxicity of radiation.

However, tests must be conducted to see if these more targeted radiotherapy does not increase the risk of recurrence.

The tolerance of the treatment could also be improved by the use of cytoprotective drugs that protect cells against the toxicity of chemotherapy and radiotherapy. Thus, amifostine seems to reduce cisplatin toxicity to the kidney. Tests are underway to determine if they can also prevent esophagitis, very common after treatments.

Treatments map

Many studies are underway to try to define the optimal treatment modality for each type of tumor. Thus, in tumors of the upper lung (Pancoast tumor), high survival rate at three years were collected with two chemotherapy cycles and radiation therapy before surgery and two cycles of chemotherapy after surgery. The progress thus come more individualized treatment, taking into account the characteristics of each patient.

Overall, unfortunately current treatments do not increase, at best, a few months survival in the advanced stages of cancer. Some researchers put their hopes in drugs that block the formation of new vessels, to prevent tumor vascularization, or in monoclonal antibodies directed against a protein in malignant cells. But clinical trials are still at the very beginning. As to gene therapy, several trials began, to introduce into the tumor cells a tumor suppressor gene (p53 gene) or a gene capable of enhancing the immune system against the tumor. But many years will certainly be needed before such treatment come in practice.

Faced with therapeutic difficulties, early detection of tumors in smokers could increase the proportion of curable cancers. New tools would achieve this goal of new imaging techniques, such as spiral CT or looking for monoclonal antibodies specific for tumor cells in sputum. Preliminary tests have shown encouraging results. However, the cost of these techniques limits its applications. The future remains, more than ever, the fight against smoking.

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Statistics

The breast cancer incidence starts to decline: between 2004 and 2005, the number of new cases fell by 2.1% and 3.3% between 2005 and 2006 (Academy of Medicine, February 2008). Two breast cancers 3 appearing after menopause. 

Breast cancer occurs more and more young: 7% of affected women under 40, while the figure was 5.6% in 2002 (French Society of Senology and breast pathology, October 2010). A woman dies of breast cancer approximately every 53 minutes. Breast cancer detected early is easier to treat and less risk of sequelae. It reduces mortality by 25%.

Half of the cancers are detected even when they are less than 2 cm. Every year worldwide, about one million of breast cancers are diagnosed and 400,000 women die. The increased number of cases affects mainly postmenopausal women, but also, increasingly, younger women, that is to say aged 40 to 45 years. Breast cancer represents 52 000 new cases in 2010.

Between 2005 and 2011, 53,000 new cases a year were reported with 11,500 annual deaths. Breast cancer remains the first among cancers in terms of frequency (33.5% of all new cancer cases) and 75% of breast cancers declare after 50 years.

symptoms

The first breast cancer symptom is the presence of a ball in the breast corresponding to the tumor. It can also be accompanied by hard glands in the armpit (axillary nodes) corresponding to a spread of cancer as well as skin changes in the breast and nipple (dimpled appearance of skin and nipple between instead of going out). 

The breast can progressively deform and ulcerate, which sometimes results in nipple discharge, only one side. If the cancer is diagnosed late, the tumor can spread and trigger other symptoms such as nausea, vomiting, loss of weight, jaundice, bone pain or headaches, shortness of breath or cough.

Healing

In 2008, breast cancer has led to 11,300 deaths, while 17,000 women died of breast cancer 10 years ago. The vast majority of women recover from breast cancer. The survival rate at 10 years is now 75%.

Prevention

Recommendations of the Academy of Medicine to prevent breast cancer:

Conceive a baby before age 25 (average age of 28/29 years since 2001, when he was 24 years in 1970), reducing the risk factors such as tobacco, alcohol, obesity and sedentary lifestyle, avoid prolonged hormonal treatment of menopause, which increase the risk of breast cancer of 1.3 to 2 and identify women at high individual risk are recommendations of the Academy of medicine (2008).

Learn more about the medical academy report

mammography

Mammography is a painless and quick examination, lasting about 15 minutes. It can detect an anomaly and an accurate diagnosis. It is carried out routinely in women over 50 years as part of a monitoring to detect incipient tumour small, invisible and impalpable to quickly set up a processing to optimize the chances of recovery. 

The radiologist delivers in the day the first interpretations and the results are sent to the doctor. If an anomaly is detected, other radiological examinations can be immediately applied by the radiologist, such as ultrasound for example.

Tell the radiologist if you wear breast prostheses, if you take hormonal drugs or if you have undergone surgery.

Ultrasound

Ultrasound is not a cancer screening examination within the first line. It may be advisable after a mammogram to analyze a detected lesion or when a mass was discovered during palpation and has not been located on mammography.

Biopsy

It involves taking a fragment of suspicious tissue for examination under a microscope. The biopsy can be performed under local anesthesia, using for example a fine needle aspiration cytology in a or in the operating room under general anesthesia during surgery on the tumor. If this option is chosen, it can be performed during a biopsy, or consist of a lumpectomy. Diagnosis is achieved via microscopic examination of the tumor removed piece.

staging

This assessment determines the extent of the cancer and check for metastasis. The results depend on the events and results of the sampling of the tumor. It will usually include at least one chest X-ray, abdominal ultrasound, a blood and bone scintigraphy.

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Stomach (general)

Antigen (general)

The basal cell carcinoma, variety of skin tumor of the deep layer skin whose malignancy is reduced.

The squamous cell carcinoma, a variety of skin tumor or malignant mucosa and is growing at the expense of epidermal keratinocytes.

The squamous intra-epidermal variety of relatively rare skin tumor that may indicate early lesions, precancerous, and basal cell carcinoma or squamous cell.

Sarcomas conjunctiva origin. This malignant tumor grows at the expense of connective tissue (supportive tissue in the body) and has the characteristic of being composed of cell proliferation (multiplication) very active and giving birth to the elements that are not fully developed, like the embryonic tissue. Sarcomas account for about 2% of all cancers. They occur mainly in young patients, and in children. 

Their main feature is their ability to invade surrounding tissues, but also to spread away from the primary tumor in the form of metastases. 

They are evolving rapidly and we are 2 types, as they develop on the common connective tissue or in the specialized tissue. Sarcomas of the common connective tissue grow at the expense of supporting tissue: they are fibrosarcoma and malignant histiocytofibroma.

 We meet this variety of tumor most often in the limbs, in the skin and peritoneum. They tend to compress the adjacent tissues and disseminate as metastases through blood, the lungs and others.

Tumors of the lymphatic system (lymphoid) tumors and leukemia bone marrow.

Metastases. Malignant tumors that spread quickly tend to generalize. They are many, and still imperfectly known. Metastasis corresponds to the migration through blood circulation or through lymphatic system, of pathological substances such as viruses, bacteria, parasites, and cancer cells that are derived from an initial injury. The main feature of malignant tumors is to metastasize. 

Specifically, metastases are caused by the detachment of cells from the original tumor (primary). Then, these cells are migrating in the blood vessels or lymph vessels. Then they bind in an organ (liver, brain, bone, lungs, etc ...) Some cancers have early metastasis, that is to say before the primary tumor is detected. Other primitive cancer cells, never give metastases.

 The metastasis site will depend on the type of cancer. Thus, breast cancer metastases mainly in the liver, bone, lung, brain and skin. A digestive cancer gives metastases primarily in the liver.

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Definition

Cancer is the term for all malignant tumors growing rapidly, and tend to generalize (metastasis).

Called cancerous transformation of healthy cells composing a tissue, neoplastic (cancerous) cells of the same type.

All body tissues are susceptible to carcinogenesis; No organ is immune.

Overview

Carcinogenicity (also called carcinogenic or carcinogenic) regarding anything that can cause the development of cancer, or lesional process that can cause cancer.

Historical

Oncology or carcinology term used by Ducuing, is the scientific study of cancers and their treatments.

The term cancerophobia (from cancer and Greek phobos: fear, cancerophobia in English) is the agonizing fear, not always justified, of certain individuals to be affected by cancer.

The cancroid term (from cancer and Greek eidos: shape, in English concroid) is the term used in 1806 by Alibert to designate a tumor, meeting at the level of the skin, called a few years later keloid, and corresponding to a variety skin cancers (skin) with a slower evolution than other cancers.

This type of skin lesion is primarily the face, specifically lips.

Classification

Cancers are classified according to their histological type (histology is the study of tissue) in:

Carcinomas (also called epithelial cancers, or carcinomas). It is a malignant tumor that develops at the expense of epithelial tissues. Epithelial tissues are tissues covering and protecting the surface of some body organs located outside, such as skin and mucous membranes of the body orifices among others. The epithelial tissues are also glands. There are several types of epithelial tissues: the epidermis is. The term carcinoma is better than that of carcinoma. But usage has kept the name of carcinoma to describe certain diseases, particularly skin, such as basal cell or squamous cell carcinoma of. A distinction even within carcinoma:

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