My Health

Sugars in our Diet

2008-05-11T21:18:00.000-07:00

In view of the increasing prevalence of overweight and obesity in Europe, the role of certain carbohydrates, like sugar, is often controversially discussed. Here are some facts about the role of carbohydrates, sugars and sugar in our diet.

Carbohydrates, sugars and sugar

The two main types of carbohydrates are sugars and starch. Sugars and starch provide the same energy per gram (4kcal). Carbohydrates provide less energy than fat (9kcal per gram) or alcohol (7kcal per gram). Fibre is a type of carbohydrate. Unlike other carbohydrates, it is not absorbed in the small intestine to provide energy, although some metabolism occurs in the large bowel. At least half the energy in our diets should come from carbohydrates, mostly as starchy carbohydrates.

Starch is found in cereals (rice, maize, wheat, etc) and their derived products (bread, pasta, etc), potatoes and legumes. Sugars include sucrose (or table sugar, that we will call ‘sugar’), glucose, fructose, lactose and maltose and are naturally found in foods such as fruits, vegetables and milk products. Manufacturers also add many of these sugars to foods during processing to perform important functions. Sugars provide sweet taste, texture, structure and consistency to foods. The texture has an important influence on palatability and thus on the acceptance of foods. Other functions of sugars include preserving jams and jellies, aiding in the fermentation of yeast and playing a role in the browning and flavouring of baked goods.

Sucrose (table sugar, a disaccharide consisting of the building blocks glucose and fructose) is a sweet tasting carbohydrate. It is produced by plants from carbon dioxide (CO2) and water with the help of light energy via the photosynthesis process. Large quantities are formed in sugar beet and sugar cane. Sucrose extracted from sugar cane or sugar beet is a natural product, which does not differ in its properties from the sugar present in fruits and vegetables.

Energy for brain and muscles

Carbohydrates are important for the functioning of our body. The brain is almost exclusively dependent on a constant supply of glucose from the blood stream. An adult brain uses about 140 g of glucose per day, and this can represent up to half of the total dietary carbohydrate consumed.
There are a few studies in adults, which have shown that the consumption of a carbohydrate meal or a sugar-sweetened drink is associated with improved mental efficiency, including improved memory, reaction times, attention span and arithmetic ability. Eating carbohydrate rich meals or having a snack or a sugar-sweetened beverage has been found to induce beneficial cognitive effects, and to contribute to reducing feelings of fatigue.1,2 Adults under the conditions of a driving performance test in an automobile simulator over a long-term distance of 120 km had significantly lower error rates while consuming sugar-sweetened beverages before and during the test compared to persons who had only consumed water.3 As studies differ in relation to the type of sugar, amount and total food composition, results are not totally consistent.

As the body’s glycogen stores (short-term energy storage made from glucose) in liver and muscle are limited, the glycogen depletion of muscle is the main cause of fatigue during anaerobic, intensive and long-duration physical activity (60-90 minutes). Sports drinks, containing sugars and electrolytes, as well as water, can prevent dehydration, delay fatigue and protect body’s glycogen stores from depletion, as the sugars ingested and released into the blood stream are preferentially used up by the muscles. In the case of high intensity activity, the glycogen can be mobilised at a later stage if physical demands continue.

With respect to replenishment of depleted glycogen stores, which is particularly important for elite athletes, carbohydrates that are quickly digested and absorbed by our body are stored much faster as glycogen than carbohydrates that have a low glycaemic index (GI). The GI effectively reflects the extent to which foods raise blood sugar levels after eating.

Sugar and body weight

A substantial number of epidemiological studies (looking at factors affecting the health of populations) in adults, adolescents and children repeatedly found a clear inverse relationship between sucrose intake and body weight or BMI as well as sucrose intake and total fat intake.4,5 In other words, individuals who consume a higher percentage of their energy needs (calories) as sugar are generally less overweight than individuals consuming a lower percentage of calories as sugar. Often there is an inverse relationship between the level of sugar intake and the level of fat intake (high sugar consumers tend to eat less fat). However, some individuals may exceed their energy needs by over consuming calories from both fat and sugar, which may result over time in weight gain. In addition, carbohydrates, including sugars, are recognised by the body’s appetite regulatory system and help promote satiety.6

The Health Behaviour in School-Aged Children Study (HBSC-Study) of WHO Europe, conducted during the years 2001-2002 with about 140 000 adolescents in the age range 10-16 years from 34 (mostly European) countries, compared overweight and obesity prevalence and their relationships with physical activity and dietary patterns.5 A significant negative correlation between the consumption of sweets and chocolate, and the BMI of adolescents from 31 out of 34 countries was reported. A higher intake of sweets was associated with a lower odds ratio for overweight and there was also no association between the consumption of soft drinks and overweight.5 These findings could be partially due to confounding factors; overweight and obese children may have already reduced their intake of sweets and chocolate because of weight concerns; they tend to underreport their consumption and may actually consume more of those foods. In a more recent UK study, based on data from 3-day dietary records for over 1000 children aged 5 and 7 years, sugar-sweetened beverages accounted for 3% of total energy intake, and no association was noted between their consumption and adiposity at the age of 9.7 Other studies, mainly from the US, have shown that a higher intake of sweetened soft drinks and fruit juice is linked to higher BMI or weight gain.8 The equivocal evidence on this topic makes it difficult to draw firm conclusions about a direct link between the consumption of sugar-sweetened soft drinks and an increase in body weight.

Weight gain occurs when energy intake from food and beverages is greater than the energy burnt through metabolism or activity. It is thus difficult to establish links between obesity and the consumption of a single food, nutrient or ingredient. Eating too many calories, no matter what the source is, can lead to overweight if they are not expended through activity. This is true for all types of foods and drinks: if they contribute to an excessive energy intake relative to energy needs, then they contribute to weight gain.

Vitamin and mineral supply

There is a popular belief that adding sugar would displace other foods from the diet and would lead to reduced intakes of vitamin and minerals. However, research has shown that added sugar intake can be compatible with a healthy diet, and there is no evidence to support a displacement of micronutrients caused by sugar.9 The nutritional quality of the diet of children even with the highest sugar intake was adequate with respect to vitamin and mineral intakes.

Dental health

People frequently point to sucrose as the only cause of cavities (dental caries). However, all food carbohydrates are capable of being involved in tooth decay. Research has shown that not only sugar, sweets or honey but also fruits, as well as non sweet-tasting carbohydrate-rich foods, like wholegrain bread, potatoes, and crisps, are potentially caries-promoting. Cavities occur when bacteria in dental plaque ferment starches and sugars to produce acids that destroy the teeth. Good oral hygiene and the use of fluoride containing tooth paste are now considered the main factors responsible for preventing dental caries and promoting good oral health. Caries prevalence has declined substantially in children and adolescents since the 1970’s despite unchanged sugar consumption and increasing between-meal snacking. Nowadays, the majority of 12 year olds have caries-free dentition.10 Caries can be prevented if the teeth are cleaned twice a day with fluoride toothpaste, and if drinking or eating occasions are limited to 6 times per day avoiding continuous sipping and nibbling.11

Diabetes

Type 2 diabetes has a strong genetic base and the onset of symptoms is linked to age, obesity and lack of physical activity. There are no causal links between sugar intake
and diabetes. Nowadays, moderate amounts of sugars, as a part of a balanced diet, are approved in the diets of well-controlled diabetics.12

References

1. Westenhoefer J. (2006) Carbohydrates and cognitive performance. Aktuelle Ernaehrungsmedizin 31 Supplement 1: S 96-S 102
2. Sunram-Lea SI, Foster JK, Durlach P, Perez C (2001): Glucose facilitation of cognitive performance in healthy young adults: examination of the influence of fast-duration, time of day and pre-consumption plasma glucose levels. Psychopharmacology 157: 46-54
3. Keul J and Jakob E (1990) Zur Wirkung von Saccharose auf Fahrverhalten, Kreislauf und Stoffwechsel. Oesterreichisches Journal fuer Sportmedizin 20: 102-110
4. Bolton-Smith C and Woodward M (1994): Dietary composition and fat to sugar ratios in relation to obesity. International Journal of Obesity 18: 820-828
5. Janssen I et al. (2005) Comparison of overweight and obesity prevalence in school-aged youth from 34 countries and their relationships with physical activity and dietary patterns. Obesity Reviews 6: 123-132
6. Anderson GH and Woodend D. (2003) Consumption of sugars and the regulation of short-term satiety and food intake. American Journal of Clinical Nutrition; 78:(suppl):843S-849S
7. Johnson L et al. (2007) Is sugar-sweetened beverage consumption associated with increased fatness in children? Nutrition 23 (7-8): 557-563
8. Malik VS et al (2006) Intake of sugar-sweetened beverages and weight gain: a systematic review. American Journal of Clinical Nutrition, Vol. 84, No. 2, 274-288
9. Rennie KL and Livingstone MBE (2007): Associations between dietary added sugar intake and micronutrient intake: a systematic review. British Journal of Nutrition 97: 832-841
10. WHO Global Oral health data base http://www.whocollab.od.mah.se/index.html http://www.whocollab.od.mah.se/euro.html
11. Touger-Decker R and van Loveren C (2003) Sugars and dental health. American Journal of Clinical Nutrition. 78 (Suppl): 881 S-892 S
12. Franz MJ., et al. (2002) Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. Diabetes Care, 25(1): p. 148-198.

2008-05-11T20:58:00.000-07:00

What is Lung Cancer ?
This animation brought to you by Blausen Medical Communications. Contact Andrew Walbank.Lung cancers are tumours arising from cells lining the airways of the respiratory system. One type of lung cancer is known as Large Cell Carcinoma. The cells of this tumour appear large and abnormal under the microscope.

Who gets it?
Lung cancer is common. One in every 28 Australians will develop lung cancer during their lifetime. Lung cancer is also deadly: it is the commonest cause of cancer death in Australia, accounting for around 23% of male and 15% of female cancer deaths.Lung cancer is more than twice as common in men as in women. Geographically, the tumour is found worldwide, but it is especially common in countries with a high tobacco consumption.Large cell lung cancer is a rare type of lung cancer, accounting for just 9% of all cases of lung cancer.
Predisposing Factors
Cigarette smoking is the main predisposing factor. In recent years, it has been recognised that passive smoking (e.g. from a first degree relative in a house of smokers) can also put people at risk. Generally, the risk increases with the number of cigarettes smoked.Exposure to asbestos increases the risk of developing this tumour. The combination of asbestos exposure plus cigarette smoking is particularly harmful. Other occupational exposures such as exposure to metals including arsenic, chromium and nickel can also increase risk.Some studies have suggested that diet can play a role in lung cancer risk. Though it is not known how it works, diets high in fruits and vegetables seem to decrease risk.Radiation exposure damages the DNA material within the cells and can also cause lung cancer.Radon (a radioactive gas) exposure from our normal surrounding environment, if higher than normal, can predispose to lung cancer. This evidence is mainly based upon population studies which show that people living in areas with a high radon content are prone to increased incidences of a variety of cancers.
Progression
Spread of the tumour can occur by the lymphatic vessels to lymph nodes located within the lung, mediastinum and thorax. If spread by the blood stream, it can lead to deposits of tumour in the liver, opposite lung, bone and brain.
Probable Outcomes
The prognosis (probable outcome) depends on the stage of the tumour. Cancer staging is a tool which allows prediction of patient outcomes, and helps decide on the best treatment options. It takes into account various features of a tumour in an individual patient, which can then be compared to other patients with similar tumour features. Staging of large cell carcinoma of the lung is based on the TNM (Tumour, Node, Metastasis) system. 'Tumour' refers to tumour size, which is measured in centimetres. 'Node' refers to the presence of cancerous cells in regional lymph nodes. 'Metastasis' refers to the spread of cancer beyond regional lymph nodes to other organs of the body.
Tumour size (T):
Tx: Primary tumour not able to be assessed
T0: No evidence of primary tumour, ie. cancer cells seen on sputum sampling or bronchial washing only
Tis: Carcinoma in situ
T1: Tumour 3 cm or less, surrounded by pleura, without evidence of invasion more proximal than the lobar bronchus.
T2: Tumour with any of the following features:
>3cm in greatest dimension
Involves main bronchus, 2cm or more distal to the carina
Invades visceral pleura
Associated with atelectasis or obstructive pneumonitis, extending to the hilar region but not involving the entire lung.
T3: Tumour of any size,
directly invading the chest wall, diaphragm, mediastinal pleura or parietal pericardium; or tumour in the main bronchus; or
in the main bronchus, less than 2cm distal to the carina, but without involvement of the carina; or
with associated atelectasis or obstructive pneumonitis of the entire lung
T4: Tumour of any size, invading the mediastinum, heart, great vessels, trachea, oesophagus, vertebral body, carina; or with separate tumour nodules in one lobe, or with malignant pleural effusion
Regional lymph nodes (N):
NX: Regional lymph nodes not able to be assessed
N0: No regional lymph node metastasis
N1: Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension
N2: Metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes
N3: Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph nodes
Distant Metastasis (M)
MX: Distant metastasis not able to be assessed
M0: No distant metastasis
M1: Distant metastasis, including separate tumour nodule(s) in a different lobe (ipsi- or contralateral).Using this classification, non-small cell lung cancers are grouped into stages as follows:
Stage 0: TIS N0 M0
Stage Ia: T1 N0 M0
Stage Ib: T2 N0 M0
Stage IIa: T1 N1 M0
Stage IIb: T2 N1 M0, T3 N0 M0
Stage IIIa: T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0
Stage IIIb: any T N3 MO, T4 any N M0
Stage IV: any T any N M1 Using this system, outcomes are best for patients with early stages of disease, with small tumours, no spread to lymph nodes, and no distant spread (metastasis) to other organs. Outcomes are also better for younger patients. Overall, despite treatment, 5-year survival for all types of lung cancer in Australia is not good: 11% for males and 14% for females. Survival for large cell carcinoma is poorer than that for squamous cell carcinoma and adenocarcinoma, though better than for small cell carcinoma. One estimate places 5-year survival for large cell carcinoma at 11%.

How will it affect me?
Patients with large cell carcinoma of the lung may notice:
Coughing (8-75%)
Weight loss (0-68%)
Shortness of breath (3-60%)
Chest pain (20-49%): often ill-defined and aching
Haemoptysis (coughing up blood): sputum may be streaked with blood
Non-specific symptoms: fever, weakness, lethargy. Rarely, patients may present with difficulty swallowing or wheezing.

How is it diagnosed?
Blood tests:
Full blood picture: this may reveal anaemia (low haemoglobin).
Liver function tests: abnormal liver function tests may suggest that the tumour has spread to the liver.
Urea and electrolytes: low levels of sodium in the blood may indicate inappropriate secretion of ADH (SIADH), a complication of some types of lung cancer.Imaging tests:
Chest x-ray: lung cancer may be seen on chest x-ray as a solitary pulmonary nodule or mass. As many as 80% of solitary pulmonary nodules (<4cm title="Large Cell Carcinoma of the Lung" href="http://www.virtualcancercentre.com/investigations.asp?sid=2">CT scanning: this is more accurate than chest x-ray, and may be particularly useful in identification of involvement..

PET scanning can help to distinguish between benign and malignant solitary pulmonary nodules seen on chest x-ray. PET scanning may also be used in the assessment of nodal spread and metastatic disease.
Imaging of other organs: if it is suspected that the cancer has spread to other organs, scans of the liver, brain or bone may be required.While imaging tests are helpful in raising the suspicion of lung cancer, diagnosis requires that cancer cells are seen under a microscope. There are a number of ways of obtaining samples of suspected cancer cells:
Sputum cytology: cells from the sputum (spit) are examined for signs of malignancy (cancer).
Bronchoscopy with washings, brushings and biopsy: a bronchoscopy is a camera tube placed through the throat into the airways of the lungs. Samples of the cells from the airways can be taken with washing, brushing, or biopsy.
Fine needle aspiration biopsy through the skin may be used to investigate suspected lung tumours located on the outside of the lungs.

How is it treated?
Surgical treatment:
Surgery offers the best chance of cure, but is usually only possible with small tumours that have not yet spread (stage I or II). In some cases, lobectomy may be more appropriate than limited resection.
If surgical treatment is to be given, the lymph nodes draining the tumour should be sampled and removed if the cancer has spread. Radiotherapy:
Patients with tumours which are not suitable for surgical resection can benefit from radiotherapy to the chest.
Patients with early disease (Stage I or II cancer) who have had the tumour completely surgically removed do not usually need radiotherapy. Chemotherapy:
Chemotherapy can increase survival for patients with advanced cancer who are otherwise medically fit. Chemotherapy may also have improve quality of life for these patients.
If chemotherapy is to be used, combination regimes (using more than one drug together) are better than single-drug regimes. Chemotherapy using platinum-based drugs produces the best results. New classes of treatment agents, such as biological therapies, are finding a place alongside chemotherapy. Watch this site for breaking news regarding this treatment.Palliative care Lung symptoms commonly reported by patients with incurable lung cancer include shortness of breath from pleural effusion, coughing, or haemoptysis (coughing up blood). Pain may be from the lung tumour itself, or from spread (metastasis) to other organs, including bone. Treatment is available for all of these symptoms. In some cases, radiotherapy may be used to manage cancer pain. Spinal cord compression is a complication of cancer spread to the spine which requires urgent treatment.
Regimens used in the treatment of this disease:
Carboplatin + Docetaxel
Carboplatin + Paclitaxel
Carboplatin + Vinorelbine
Cisplatin + Docetaxel
Cisplatin + Paclitaxel
Cisplatin + Vinorelbine
Docetaxel
Gemcitabine
Gemcitabine + Carboplatin
Gemcitabine + Cisplatin
Methotrexate (high dose)
MIC (Mitomycin + Ifosfamide + Cisplatin)
Mitomycin
Paclitaxel
Symptoms of this disease:
Breathlessness in cancer
Drugs used in the treatment of this disease:
Zoledronic acid(Zometa)

2008-05-11T20:47:00.000-07:00

What is Lung Cancer ?
This animation brought to you by Blausen Medical Communications. Contact Andrew Walbank.Lung cancers are tumours arising from cells lining the airways of the respiratory system. Adenocarcinoma of the lung is one of the main types of lung cancers. Adenocarcinoma of the lung arises from the secretory (glandular) cells located in the epithelium lining the bronchi.

Who gets it?
Lung cancer is common. One in every 28 Australians will develop lung cancer during their lifetime. Lung cancer is also deadly: it is the commonest cause of cancer death in Australia, accounting for around 23% of male and 15% of female cancer deaths. Lung cancer is more than twice as common in men as in women. Geographically, the tumour is found worldwide, but it is especially common in countries with a high tobacco consumption. Adenocarcinoma of the lung is the commonest type of lung cancer, accounting for 32% of all cases of lung cancer.
Predisposing Factors
Cigarette smoking is the main predisposing factor. In recent years, it has been recognised that passive smoking (e.g. from a first degree relative in a house of smokers) can also put people at risk. Generally, the risk increases with the number of cigarettes smoked. The link between cigarette smoking and adenocarcinoma is weaker than the link between smoking and other types of lung cancer, but is still the most significant risk factor identified. Exposure to asbestos increases the risk of developing this tumour. The combination of asbestos exposure plus cigarette smoking is particularly harmful. Other occupational exposures such as exposure to metals including arsenic, chromium and nickel can also increase risk. Some studies have suggested that diet can play a role in lung cancer risk. Though it is not known how it works, diets high in fruits and vegetables seem to decrease risk. Radiation exposure damages the DNA material within the cells and can also cause lung cancer. Radon (a radioactive gas) exposure from our normal surrounding environment, if higher than normal, can predispose to lung cancer. This evidence is mainly based upon population studies which show that people living in areas with a high radon content are prone to increased incidences of a variety of cancers.
Progression
Adenocarcinomas tend to be slow-growing. Spread of the tumour can occur by the lymphatic vessels to lymph nodes located within the lung, mediastinum and thorax. If spread by the blood stream, it can lead to deposits of tumour in the liver, opposite lung, bone and brain. Example of Lung Cancer. The image to the right is that of a cancerous lung post mortem, showing local growth of the tumour.
Probable Outcomes
The prognosis (probable outcome) depends on the stage of the tumour. Cancer staging is a tool which allows prediction of patient outcomes, and helps decide on the best treatment options. It takes into account various features of a tumour in an individual patient, which can then be compared to other patients with similar tumour features. Staging of adenocarcinoma of the lung is based on the TNM (Tumour, Node, Metastasis) system. 'Tumour' refers to tumour size, which is measured in centimetres. 'Node' refers to the presence of cancerous cells in regional lymph nodes. 'Metastasis' refers to the spread of cancer beyond regional lymph nodes to other organs of the body.
Tumour size (T):
Tx: Primary tumour not able to be assessed
T0: No evidence of primary tumour, ie. cancer cells seen on sputum sampling or bronchial washing only
Tis: Carcinoma in situ
T1: Tumour 3 cm or less, surrounded by pleura, without evidence of invasion more proximal than the lobar bronchus.
T2: Tumour with any of the following features:
>3cm in greatest dimension
Involves main bronchus, 2cm or more distal to the carina
Invades visceral pleura
Associated with atelectasis or obstructive pneumonitis, extending to the hilar region but not involving the entire lung.
T3: Tumour of any size,
directly invading the chest wall, diaphragm, mediastinal pleura or parietal pericardium; or tumour in the main bronchus; or
in the main bronchus, less than 2cm distal to the carina, but without involvement of the carina; or
with associated atelectasis or obstructive pneumonitis of the entire lung
T4: Tumour of any size, invading the mediastinum, heart, great vessels, trachea, oesophagus, vertebral body, carina; or with separate tumour nodules in one lobe, or with malignant pleural effusion
Regional lymph nodes (N):
NX: Regional lymph nodes not able to be assessed
N0: No regional lymph node metastasis
N1: Metastasis in ipsilateral peribronchial and/or ipsilateral hilar lymph nodes and intrapulmonary nodes, including involvement by direct extension
N2: Metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes
N3: Metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, or supraclavicular lymph nodes
Distant Metastasis (M)
MX: Distant metastasis not able to be assessed
M0: No distant metastasis
M1: Distant metastasis, including separate tumour nodule(s) in a different lobe (ipsi- or contralateral).Using this classification, non-small cell lung cancers are grouped into stages as follows:
Stage 0: TIS N0 M0
Stage Ia: T1 N0 M0
Stage Ib: T2 N0 M0
Stage IIa: T1 N1 M0
Stage IIb: T2 N1 M0, T3 N0 M0
Stage IIIa: T1 N2 M0, T2 N2 M0, T3 N1 M0, T3 N2 M0
Stage IIIb: any T N3 MO, T4 any N M0
Stage IV: any T any N M1Using this system, outcomes are best for patients with early stages of disease, with small tumours, no spread to lymph nodes, and no distant spread (metastasis) to other organs. Outcomes are also better for younger patients. Overall, despite treatment, 5-year survival for all types of lung cancer in Australia is not good: 11% for males and 14% for females. Adenocarcinoma has the best prognosis of any type of lung cancer.

How will it affect me?
Patients with adenocarcinoma of the lung may notice:
Coughing (8-75%)
Weight loss (0-68%)
Shortness of breath (3-60%)
Chest pain (20-49%): if the tumour involves the chest wall, pain may be localised to this area
Haemoptysis (coughing up blood): sputum may be streaked with blood
Non-specific symptoms: fever, weakness, lethargy.Rarely, patients may present with difficulty swallowing or wheezing.

How is it diagnosed?
Blood tests:
Full blood picture: this may reveal anaemia (low haemoglobin).
Liver function tests: abnormal liver function tests may suggest that the tumour has spread to the liver.
Urea and electrolytes: low levels of sodium in the blood may indicate inappropriate secretion of ADH (SIADH), a complication of some types of lung cancer. Imaging tests:
Chest x-ray: lung cancer may be seen on chest x-ray as a solitary pulmonary nodule or mass. As many as 80% of solitary pulmonary nodules (<4cm diameter) in the over-50 age group are cancer. Chest x-ray may also be used to evaluate the size of the tumour and possible involvement of lymph nodes in the chest. See the example image below.
CT scanning: this is more accurate than chest x-ray, and may be particularly useful in identification of lymph node involvement. See the example image below.
PET scanning can help to distinguish between benign and malignant solitary pulmonary nodules seen on chest x-ray. PET scanning may also be used in the assessment of nodal spread and metastatic disease.
Imaging of other organs: if it is suspected that the cancer has spread to other organs, scans of the liver, brain or bone may be required. While imaging tests are helpful in raising the suspicion of lung cancer, diagnosis requires that cancer cells are seen under a microscope. There are a number of ways of obtaining samples of suspected cancer cells:
Fine needle aspiration biopsy through the skin may be used to investigate suspected lung tumours located on the outside of the lungs.
Sputum cytology: cells from the sputum (spit) are examined for signs of malignancy (cancer). Sputum cytology may not be very useful in adenocarcinoma of the lung, because the tumours are usually in the periphery of the lung, meaning tumour cells are less likely to be coughed up.
Bronchoscopy with washings, brushings and biopsy: a bronchoscopy is a camera tube placed through the throat into the airways of the lungs. Samples of the cells from the airways can be taken with washing, brushing, or biopsy.

How is it treated?
Surgical treatment:
Surgery offers the best chance of cure, but is usually only possible with small tumours that have not yet spread (stage I or II). In some cases, lobectomy may be more appropriate than limited resection.
If surgical treatment is to be given, the lymph nodes draining the tumour should be sampled and removed if the cancer has spread.Radiotherapy:
Patients with tumours which are not suitable for surgical resection can benefit from radiotherapy to the chest.
Patients with early disease (Stage I or II cancer) who have had the tumour completely surgically removed do not usually need radiotherapy.Chemotherapy:
Chemotherapy can increase survival for patients with advanced cancer who are otherwise medically fit. Chemotherapy may also have improve quality of life for these patients.
If chemotherapy is to be used, combination regimes (using more than one drug together) are better than single-drug regimes. Chemotherapy using platinum-based drugs produces the best results.New classes of treatment agents, such as biological therapies, are finding a place alongside chemotherapy. Watch this site for breaking news regarding this treatment. Palliative care Lung symptoms commonly reported by patients with incurable lung cancer include shortness of breath from pleural effusion, coughing, or haemoptysis (coughing up blood). Pain may be from the lung tumour itself, or from spread (metastasis) to other organs, including bone. Treatment is available for all of these symptoms. In some cases, radiotherapy may be used to manage cancer pain. Spinal cord compression is a complication of bony metastasis which requires urgent treatment.
Regimens used in the treatment of this disease:
Carboplatin + Docetaxel
Carboplatin + Paclitaxel
Carboplatin + Vinorelbine
Cisplatin + Docetaxel
Cisplatin + Paclitaxel
Cisplatin + Vinorelbine
Docetaxel
Gemcitabine
Gemcitabine + Carboplatin
Gemcitabine + Cisplatin
MIC (Mitomycin + Ifosfamide + Cisplatin)
Vineralbine
Symptoms of this disease:
Cough
Breathlessness in cancer
Chest Pain
Anaemia
Drugs used in the treatment of this disease
Carboplatin(Carboplatin Injection)
Cisplatin(Cisplatin Injection)
Gemcitabine hydrochloride(Gemzar)
Gefitinib(Iressa)
Vinorelbine tartrate(Navelbine)
Erlotinib(Tarceva)
Docetaxel(Taxotere)