Overview of the initial evaluation, treatment and prognosis of lung cancer
- David E Midthun, MD
David E Midthun, MD
- Section Editor — Lung Cancer
- Professor of Medicine, Mayo Clinic College of Medicine
- Section Editors
- Rogerio C Lilenbaum, MD, FACP
Rogerio C Lilenbaum, MD, FACP
- Section Editor — Lung Cancer
- Yale Cancer Center
- Steven E Schild, MD
Steven E Schild, MD
- Section Editor — Radiation Therapy
- Professor of Radiation Oncology
- Mayo Clinic College of Medicine
Worldwide, lung cancer occurred in approximately 1.8 million patients in 2012 and caused an estimated 1.6 million deaths . In the United States, there will be approximately 225,000 new cases of lung cancer and over 160,000 deaths annually .
Both the absolute and relative frequencies of lung cancer have risen dramatically. Around 1953, lung cancer became the most common cause of cancer deaths in men. In 1985 it became the leading cause of cancer deaths in women, and now causes approximately twice as many deaths as breast cancer. Lung cancer deaths are declining in men, and the death rate in women has plateaued secondary to decreases in smoking. Now however, almost one-half of all lung cancer deaths occur in women. (See "Women and lung cancer".)
The term lung cancer, or bronchogenic carcinoma, refers to malignancies that originate in the airways or pulmonary parenchyma. Approximately 95 percent of all lung cancers are classified as either small cell lung cancer (SCLC) or non-small cell lung cancer (NSCLC). This distinction is required for proper staging, treatment, and prognosis. Other cell types comprise about 5 percent of malignancies arising in the lung.
This discussion will present an overview of the initial diagnosis, treatment, and prognosis of patients with both NSCLC and SCLC. An overview of the risk factors, pathology, and clinical manifestations of lung cancer is presented separately, as is an overview of the management of patients with advanced NSCLC, and a discussion of issues concerning lung cancer survivors. (See "Overview of the risk factors, pathology, and clinical manifestations of lung cancer" and "Overview of the treatment of advanced non-small cell lung cancer" and "Overview of approach to lung cancer survivors".)
The main issues to assess in a patient with a suspected lung cancer are to confirm that the lesion is malignant, determine whether the cell type non-small cell lung cancer (NSCLC) or small cell lung cancer (SCLC), assess the stage of disease, and the functional status of the patient. These parameters are essential for appropriate patient management. The initial evaluation of a patient with suspected lung cancer is discussed in detail separately. (See "Overview of the initial evaluation, diagnosis, and staging of patients with suspected lung cancer".)
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