Lung Cancer: Principles and Practice

Lung Cancer: Principles and Practice

Publisher: Lippincott; Third edition | ISBN: 0781746205 | edition 2004 | CHM | 1000 pages | 57 mb

Lung cancer remains the leading cause of cancer-related death in men, and in women it has surpassed even breast cancer. The primary cause of lung cancer in up to 90 percent of patients is smoking, and it is estimated that bronchiogenic carcinoma will develop in 10 to 15 percent of all smokers. Environmental factors -- for example, passive smoke, occupational exposure to asbestos or chromium, and air pollution -- as well as genetic predisposition in a multistep carcinogenic process may both play a part. Nevertheless, cessation of cigarette smoking is the most effective, most easily achievable, and least expensive intervention in reducing the risk of lung cancer.

Despite marked progress in the treatment of lung cancer, most patients still die of their disease within several months to a few years. Some patients and physicians have a nihilistic perception of the treatment of lung cancer, and adequate treatment is often delayed or not even considered. However, even locally advanced disease can be cured in many patients with the appropriate multimodal therapy. Patients with a suspected or confirmed diagnosis of lung cancer are best evaluated by a team of lung-cancer specialists consisting of thoracic surgeons, medical oncologists, radiation therapists, pneumologists, radiologists, and pathologists.

Lung Cancer: Principles and Practice reflects this multidisciplinary approach to a common disease. Lung cancer should be suspected in any patient who presents with persistent cough or hemoptysis or with deep venous thrombosis, without other clinical explanations or constitutional symptoms. A simple chest radiograph may reveal a pulmonary mass, and subsequent computed tomography of the chest and upper abdomen will allow rapid assessment of any extension of the tumor into the mediastinum and of any metastases to the liver and adrenals. Tissue diagnosis should then be performed by the most appropriate means (e.g., transthoracic fine-needle biopsy, transbronchial biopsy, or mediastinoscopy). The advantages and appropriateness of each technique are discussed in detail in this book.

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