Cancers or lung, heart and vasculature Flashcards
What is cardiovascular cancer?
Primary cancer of blood vessels and heart very rare
What is the most common cardiovascular cancer?
Angiosarcoma
What is angiosarcoma?
- Malignancy of vascular endothelial cells
- Of skin, heart, liver etc
- Annual incidence 1.5 cases per million
What are cardiac tumours?
- E.g. myxoma, tumour of connective tissue
- Annual incidence <1case per million
What are cardiac cancers so rare?
- Low exposure of cells to carcinogens
- Turnover rate: cardiac myocytes divide very rarely - increase size of myocytes is how it grows (not like in lungs)
- Strong selective advantage against anything which could compromise function, shape of cells is specialised and any change in shape would impact change in cardiovascular system
How many deaths and diagnoses are in lung cancer?
- Around 48,000 diagnoses/year
- Around 35,000 deaths/year
How common is lung cancer with other cancers?
- 3rd most common cancer in UK
- Leading cause of cancer death - in men and women
When did lung cancer become less rare?
smoking only popular WW1 Onwards (1930s onwards)
What were the other suggested causes of lung cancer?
- Air pollution
- Asphlated roads
- Road traffic
- Gas exposure. In WW1
- Influenza pandemic 1918
- Working with petroleum
Who found that smoking causes lung cancer?
- Doll + Hill - 1950s, classic prospective case control study of >40,000 British doctor’s smoking habit and development of lung cancer
- Strong influence of tobacco companies
What demographic tends to get lung cancer?
- age, peak 75-90
- Sex M>F
- Lower socioeconomic status
- Smoking history
What affects lung cancer risk with smoking history?
- Duration
- Intensity
- When stopped - if stopped 30 years then risk lower than 10 years
What is the worldwide tobacco use like?
- Cigarettes cause around 1.5million deaths from lung cancer per year (1 lung cancer death per 3 or 4 million smoked
- Developing world e.g china
What percentage of patients with lung cancer never smoked?
- 10-15% patients with lung cancer never smoked
2. Passive smoking (around 15% of these)
What are the other etiological causes of lung cancer?
- Asbestos: exposure (plumbers, ship-builders, carriage workers, carpenters, etc) - risk up to 2x
- Radon: e.g. silver miner in Germany later 19th centres; 1950s uranium mining in Colorado
- Indoor cooking fumes: wood smoke, frying fats
- Chronic lung disease (COPD, fibrosis) independent effect of smoking
- Immunodeficenciey
- Familial/genetic - several loci identified
What are four pathophysiologies of lung cancer?
- Squamous cell carcinoma
- Adenocarcinoma
- Large cell lung cancer
- Small cell lung cancer
- 1-3 often grouped together (non-small cell lung cancer (NSCLC)
What is squamous cell carcinoma?
- around 30% of cases
- previously the most common
- originating form bronchial epithelium; centrally located
What is adenocarcinoma?
- around 40% of cases
- Most common from 1980s onwards: low tar cigarettes, inhaled more deeply/retained longer
- Originating from mucus-producing glandular tissue; more peripherally located
What is large cell lung cancer?
- around 15% of cases
- heterogenous group
- undifferentiated
What is small cell lung cancer?
- around 15% of cases
- originate from pulmonary neuroendocrine cells
- highly malignant