mjl1717
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which is the most common lung cancer?
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| p53
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In the past 25 years adenocarcinoma has replaced squamous cell carcinoma as the most frequent histologic subtype (both for men and, especially, for women) - WHY?
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| mjl1717
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thats not the correct answer.
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| p53
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that's the correct answer to your question - who can answer my question?
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| robin082006
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Small and quamous cell carcinoma are most common because they are related to smoking. (Kaplan)
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| tolito
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my kaplan says adenocarcinoma (35%), squamous (30), small cell (20%)
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| p53
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I guess, you, guys, are reading different Kaplans. 
Adenocarcinoma - 32%; Bronchioloalveolar carcinoma - 3%
Squamous cell carcinoma - 29%
Small cell carcinoma - 18%
HPIM, 16th ed. 2004.
'The incidence of adenocarcinoma has increased significantly in the last two decades; it is now the most common form of lung cancer in women and, in many studies, men as well.'
RCPBD, 7th ed. 2004.
again - who can answer my question?
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| robin082006
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I've just done a question in Qbank 2 days ago and answer is small and squamous cell carcinoma, I chose adenocarcinoma but it was wrong, I was surprised.
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| robin082006
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Just want to say that i did an online qbank. answer is small and squamous maybe due to they add both types of cancers together.
Yeah, Adenocarcinoma is most common.
Edited by robin082006 on 05/21/06 - 10:45 PM
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| mjl1717
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you are all wrong!
1) An astute clinician which we are not yet would say. {this is where communication (and i cant stress this enough) is very important would verbalize properly "do you mean primary or secondary lung cancer" usmle would have to tell you this or imply if its primary or secondary by the choices.
2)Metastatic disease to the lung is the most common lung cancer (breast cancer is the leading cause)
3)Moral of the story- a good doc to be able to communicate (i find especially when you dont want to and you may have to relay negative info to your patient.)
4)end of story. I rest my case. 
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| p53
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ha-ha-ha-ha - you made me laugh - when they say the term 'lung cancer', clinicians and scientists ALWAYS mean primary malignant tumors of the lung; if they want to imply both primary and metastatic tumors, they are using the terms 'neoplasms of the lung' or 'tumors of the lung':
'The term lung cancer is used for tumors arising from the respiratory epithelium (bronchi, bronchioles, and alveoli).' - Harrison's Principles of Internal Medicine, 16th ed. 2004, page 506.
'The incidence of adenocarcinoma has increased significantly in the last two decades; it is now the MOST COMMON form of LUNG CANCER in women and, in many studies, men as well.' - Robbins and Cotran Pathologic Basis of Disease, 7th ed. 2004, page 759.
Moral of the story - know medical terminology, or otherwise you'll have the problems when communicating with the colleagues or taking USMLE.
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| doc179
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p53 the Q you were asking abt why adenocarcinoma is the most common compared to squamous ......is it to do anything about the use of filters in cigarettes?
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| mjl1717
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p53 wrote:
ha-ha-ha-ha - you made me laugh - when they say the term 'lung cancer', clinicians and scientists ALWAYS mean primary malignant tumors of the lung; if they want to imply both primary and metastatic tumors, they are using the terms 'neoplasms of the lung' or 'tumors of the lung':
'The term lung cancer is used for tumors arising from the respiratory epithelium (bronchi, bronchioles, and alveoli).' - Harrison's Principles of Internal Medicine, 16th ed. 2004, page 506.
'The incidence of adenocarcinoma has increased significantly in the last two decades; it is now the MOST COMMON form of LUNG CANCER in women and, in many studies, men as well.' - Robbins and Cotran Pathologic Basis of Disease, 7th ed. 2004, page 759.
Moral of the story - know medical terminology, or otherwise you'll have the problems when communicating with the colleagues or taking USMLE.
the word neoplasm means new growth in that case the most common lung neoplasm would most likely be coin lesion with 75% of them being benign. An attending physician can always ask an intern "whats the most common form of lung ca, awaiting his answer to a tricky q.
Edited by mjl1717 on 05/22/06 - 12:26 PM
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| p53
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mjl1717 - medical terms mean not what you think they SHOULD mean, but what they REALLY mean.
if you want to imply only malignant tumors of the lung (both primary and metastatic) you should use the terms 'malignant neoplasms of the lung' or 'malignant tumors of the lung', NOT 'lung cancer'!
again - the answer to the 'tricky' question 'what's the most common form of lung cancer' is ADENOCARCINOMA - if an attending physician will say 'no', you can bring 'Harrison' or 'Robbins' and show him the pages I have told you - I guarantee that he will never ask this 'tricky' question again, so don't warry about it any more.
doc179 - yes - and so?
why the use of filters (and 'light' cigarettes) have increased the frequency of adenocarcinomas?
mechanisms, mechanisms, as Dr. Goljan likes to say...
Edited by p53 on 05/22/06 - 08:10 PM
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| doc179
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these filters filter out the large particles and the smaller particles get thru into the lungs of a smoker and get into the farthest place ( because of their smaller size ) so we have adenocarcinomas and not squamous or small cell.
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| p53
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no, that's not the correct mechanism - try again!
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| doc179
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I dont know  
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| abs
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The predominance of AC over SCC may be due in part to the fact that smokers of very low yield cigarettes tend to compensate for the lower nicotine levels by inhaling more deeply and frequently, leading to greater exposure of the peripheral lung to the carcinogens in tobacco smoke, and in part to the increased concentration of nitrosamines that preferentially produce AC in laboratory animals.
Got it from pubmed.gov
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| p53
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yes, that's right - congrats!
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| doc179
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 hmm
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