Mesothelioma

Living With a Diagnosis of Lung Cancer
What is Lung Cancer?

Only cancers that begin in the lungs are called "lung cancer." Sometimes cancer from other parts of the body may spread to the lungs, but when that happens, it is not called lung cancer. For example, breast cancer that spreads to the lungs is still breast cancer, and will be treated as breast cancer, not lung cancer. Lung cancer that spreads to the liver is treated as lung cancer, not liver cancer.

A cancer forms when cells start to multiply out of control. All of the normal cells in your body have very specific jobs and functions. For example, intestine cells absorb vitamins, minerals and other nutrients from our food; red blood cells carry oxygen throughout the body; and white blood cells fight infections. Normal cells stop growing and dividing when they get old. Normal cells also die if they are injured.

Cancer cells are different. They do not function normally and they often divide uncontrollably. Cancer cells do not die when they grow old. They may spread to nearby organs. They also can spread through the blood stream, invade nearby lymph nodes and metastasize.

Why does cancer happen?
How does cancer spread?
Types of lung cancer
Stages of lung cancer

Why does cancer happen?
Every cell contains genes. Genes are the “brains” that tell the cell what to do. When the cell’s genes are mutated, cancer may result. Some of these changes are inherited – they are passed down from parent to child; others may be due to things you are exposed to, such as cigarette smoke, radon and asbestos. These mutations to the genes can cause cells to multiply uncontrollably, resulting in a mass of tissue called a tumor.

How does cancer spread?
Lung cancer can spread to other organs in one of three ways:
1. The cancer tumor grows and invades another organ near the lungs.
2. Cancer cells travel through the blood stream.
3. Cancer cells travel through the lymphatic system.
The lymphatic system includes tissues and organs that produce, store and carry white blood cells that fight infection and disease. It includes the bone marrow, spleen, thymus, and lymph nodes.

There are hundreds of lymph nodes scattered throughout the body and they are important because cancer sometimes can spread through the lymphatic system. Cancer cells traveling through the body in lymph fluid can be trapped in the lymph nodes.

If you have surgery for your cancer, the surgeon also will likely remove some lymph nodes at the time of the operation. If the lymph nodes contain cancer, it raises the question of whether the cancer also may have escaped out of the lymph nodes and spread elsewhere in your body.

The most important lymph nodes involved with lung cancer are called hilar lymph nodes, which are located near the tumor (also called N1 nodes). Mediastinal lymph nodes are nodes between the lung and the heart. If they are on the same side as the tumor, they are called N2 nodes. If they are on the opposite side of the chest, they are called N3 nodes.

The most common sites where lung cancer spreads are:
• Elsewhere in the lungs
• The liver
• The adrenal glands
• The bones
• The brain

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Types of lung cancer
There are four common types of lung cancer:
1. squamous cell carcinoma
2. adenocarcinoma
3. large cell carcinoma
4. small cell carcinoma
The first three types behave very much alike and are grouped into a single category called non-small cell lung cancer (NSCLC) to make it clear that they are different from the fourth type, small cell lung cancer (SCLC). The majority of lung cancers (about eight out of ten) are NSCLC. Small cell lung cancers tend to grow and spread more rapidly and cause symptoms sooner than non-small cell cancers. For these reasons, surgery usually is not a good option for small cell lung cancers, and treatment is more likely to be with chemotherapy and, sometimes, radiation therapy.

There are many other types of cancers that occur in the chest, most of which are rare. One of these, mesothelioma, is commonly associated with exposure to asbestos.

Bronchioloalveolar Carcinoma (BAC) is a rare form of adenocarcinoma. The number of cases of BAC is rising worldwide. BAC spreads throughout the lung, unlike more typical cancer cells, which tend to “stick together” and form solid, individual tumors. The cause of BAC is not known. Although people who smoke can get BAC, it often occurs in people who have never smoked.

Stages of lung cancer
When you are diagnosed with lung cancer, your doctor will determine not only the type of cancer you have, but also the stage of the disease, which is based on the tumor’s location and size, and whether it has spread to any lymph nodes in the area or to other organs of the body. The type and stage of cancer you have will help your medical team determine which treatment plan is right for you. NSCLC is staged as I, II, III or IV, while SCLC is classified as limited or extensive stage.
Non-Small Cell Lung Cancer (NSCLC)
Stage I
A tumor that has not spread to any lymph nodes or other organs and is still relatively small is classified as Stage I. This tumor is typically resectable.

Stage II
A tumor that has spread to lymph nodes on the same side of the chest, or a tumor that has begun to invade structures within the chest (but has not spread to any lymph nodes) is called Stage II cancer. Generally, these tumors can be removed surgically.

Stage III
Cancer that does not appear to have spread to other organs beyond lymph nodes in the chest is classified as Stage III. Often, Stage III cancers are unresectable. There are two types of Stage III lung cancer: Stage IIIA refers to a tumor that has spread to lymph nodes near the heart. Stage IIIB is a cancer that has spread to lymph nodes on the opposite side of the chest or involves major structures such as the heart, trachea, esophagus, etc. The most serious form of Stage IIIB is with pleural effusion.

Stage IV
Cancer that has metastasized, or spread, to other parts of the body is called Stage IV. Although Stage IV and Stage IIIB cancers with pleural effusion are quite difficult to cure, there are treatments available that may help you live longer.

Small Cell Lung Cancer (SCLC)
Limited Stage SCLC is a cancer that is on only one side of the chest. This cancer can be treated with radiation and chemotherapy.

Extensive Stage SCLC is cancer that has spread to other areas of the chest or other parts of the body. Although it is rarely cured, this type of cancer often responds well to chemotherapy and patients experience a great improvement in symptoms.

What Is Mesothelioma?
Mesothelioma the medical name for cancer of the pleura (the lining of the lung and chest cavity) or cancer of the peritoneum (the lining of the abdomen). It is usually caused by prolonged or persistent exposure to asbestos. Symptoms of mesothelioma may not appear until between twenty and fifty years after exposure, which explains why so many new cases of this form of cancer are coming to light now, even though the dangers of asbestos were realized long ago and measures taken to reduce the risk of the disease. As with many forms of cancer, the mesothelioma tumor can spread rapidly, often infecting the opposite pleura, and continuing on to other internal organs. Symptoms include a shortness of breath, chest pains, coughing, and loss of weight. Testing can be carried out initially by X-Ray, with a Thoric CT and open lung biopsy being used to confirm the findings of the early tests. If it is diagnosed early enough, the tumor can be surgically removed, and with follow-up chemotherapy and radiation treatment, full recovery is often possible. However, in more advanced cases, cure is usually not possible. In such cases, chemotherapy and radiation treatment can be used alongside other pain relief treatments, to ease the symptoms. Where cure is not possible, the average survival time is between four and eighteen months, depending on the stage of the tumor and the general health of the patient.
"Mesothelioma" is the term used to describe a cancerous tumor that involves the mesothelial cells of an organ. Mesothelial cells are cells that form a protective lining over the lungs, heart and abdominal organs. The most common type of mesothelioma is pleural mesothelioma. The pleura is a thin membrane found between the lungs and the chest cavity. It provides a lubricated surface so that the lungs do not rub and chafe against the chest walls. What causes it? Virtually all cases of mesothelioma are related to inhaling of asbestos fibers. There are about 3,000 cases per year (mostly men over the age of 40) and there will be about 300,000 cases before 2030. Mesothelioma usually spreads rapidly through the mesothelial cells to the heart and abdominal organs. The life span is typically 24 months after diagnosis, but it depends on what stage the cancer is detected, the health of the patient and other factors. Although asbestos exposure causes mesothelioma, it has a latency period after exposure that could last 15 to 50 years. This means that someone who worked in a factory with asbestos 40 years ago could be developing mesothelioma now. Anyone who knows they were exposed to loose asbestos fibers should be tested regularly for mesothelioma. Diagnosis The onset of mesothelioma is usually very slow. The first symptom is a constant pain in the chest. This pain is later accompanies by difficulty breathing due to an accumulation of fluid in the chest.Other symptoms include coughing, fever and weight loss. Mesothelioma can be diagnosed by your doctor with a chest CT-scan. Prognosis (the outcome) Mesothelioma advances in 4 stages: Stage I - the tumor is limited to the area of the lining of the lung and usually limited to only one side of the chest. Stage II - the tumor extends to other organs within the chest cavity, such as the heart or lymph nodes in the chest. Stage III - the tumor expands to the other side of the chest or it spreads into the abdominal organs. The lymph nodes outside the chest are affected. Stage IV -the cancer spreads to different parts of the body far outside the chest area (liver, brain, bone, etc...). Mesothelioma is an extremely deadly disease. The average survival time is about one year from date of diagnosis. About 20% of patients who find their cancer early and treat it aggressively will reach the five-year mark. for more information and articles about mesothelioma go to