essay on lung cancer

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Causes and symptoms

Types of lung cancer, small-cell lung cancer.

• Non-small-cell lung cancer

Does smoking cause lung cancer?

What are the common symptoms of lung cancer.

lung cancer

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• National Center for Biotechnology Information - Lung Cancer
• MedicineNet - Lung Cancer: SCLC and NSCLC
• Mount Sinai - Lung cancer
• Healthline - Lung Cancer: Everything You Need to Know
• NHS - Lung cancer
• Centers for Disease Control and Prevention - What Is Lung Cancer?
• Cleveland Clinic - Lung Cancer
• Table Of Contents

Between 80 to 90 percent of lung cancer cases are caused by smoking in countries with a prolonged history of tobacco smoking. Heavy smokers have a greater likelihood of developing the disease than light smokers. Also, people who started smoking at a young age are at greater risk. Passive inhalation of cigarette smoke has been linked to lung cancer in nonsmokers.

Lung cancer symptoms do not usually appear until the disease has reached an advanced stage. Common symptoms include shortness of breath, a persistent cough or wheeze, chest pain, bloody sputum, unexplained weight loss, and susceptibility to lower respiratory infections. Visible lumps, jaundice, or bone pain may occur in cases where cancer has spread beyond the lungs.

Are there different types of lung cancer?

There are two basic forms of lung cancer: small-cell lung cancer (SCLC), also called oat-cell carcinoma, and non-small-cell lung cancer (non-SCLC). SCLC accounts for 10 to 20 percent of all cases and is rarely found in people who have never smoked. The non-SCLCs are responsible for the remainder.

Can lung cancer be prevented?

The probability of developing lung cancer can be reduced by avoiding smoking. Smokers who quit also reduce their risk significantly. Testing for radon gas and avoiding exposure to coal products, asbestos, and other airborne carcinogens also lowers risk.

Recent News

lung cancer , disease characterized by uncontrolled growth of cells in the lungs . Lung cancer was first described by doctors in the mid-19th century. In the early 20th century it was considered relatively rare, but by the end of the century it was the leading cause of cancer-related death among men in more than 25 developed countries. In the 21st century lung cancer emerged as the leading cause of cancer deaths worldwide. By 2012 it had surpassed breast cancer as the leading cause of cancer death among women in developed countries. The rapid increase in the worldwide prevalence of lung cancer was attributed mostly to the increased use of cigarettes following World War I , though increases in environmental air pollution were suspected to have been a contributing factor as well.

Lung cancer occurs primarily in persons between the ages of 45 and 75 years. In countries with a prolonged history of tobacco smoking , between 80 and 90 percent of all cases are caused by smoking. Heavy smokers have a greater likelihood of developing the disease than do light smokers. The risk is also greater for those who started smoking at a young age.

Passive inhalation of cigarette smoke (sometimes called secondhand smoke ) is linked to lung cancer in nonsmokers. According to the American Cancer Society, about 3,400 deaths from lung cancer occur each year in nonsmokers in the United States . Other risk factors include exposure to radon gas and asbestos; smokers exposed to these substances run a greater risk of developing lung cancer than do nonsmokers. Uranium and pitchblende miners, chromium and nickel refiners, welders, and workers exposed to halogenated ethers also have an increased incidence , as do some workers in hydrocarbon-related processing, such as coal processors, tar refiners, and roofers. Lung cancer is rarely caused directly by inherited mutations.

Tumours can begin anywhere in the lung, but symptoms do not usually appear until the disease has reached an advanced stage or spread to another part of the body. The most common symptoms include shortness of breath, a persistent cough or wheeze, chest pain, bloody sputum, unexplained weight loss, and susceptibility to lower respiratory infections. In cases where the cancer has spread beyond the lungs, visible lumps, jaundice, or bone pain may occur.

Lung cancers are often discovered during examinations for other conditions. Cancer cells may be detected in sputum; a needle biopsy may be used to remove a sample of lung tissue for analysis; or the large airways of the lungs (bronchi) can viewed directly with a bronchoscope for signs of cancer. Noninvasive methods include X-rays, computerized axial tomography (CAT) scans, positron emission tomography (PET) scans, and magnetic resonance imaging (MRI). There are also several blood tests that may be used to detect proteins and other substances known to be associated with lung cancer. For example, abnormal fluctuations in the serum levels of parathormone or the presence in the blood of a protein called cytokeratin 19 fragment or of substances known as carcinogenic antigens may be indicative of malignant lung disease. Researchers are also developing blood tests to detect DNA shed by cells carrying genetic mutations associated with lung cancer; such tests raise the possibility of detecting lung tumours before they become malignant.

Most cases are usually diagnosed well after the disease has spread (metastasized) from its original site. For this reason, lung cancer has a poorer prognosis than many other cancers. Even when it is detected early, the five-year survival rate is about 50 percent.

Once diagnosed, the tumour’s type and degree of invasiveness are determined. There are two basic forms: small-cell lung cancer, which accounts for 10–20 percent of all cases, and non-small-cell lung cancer, which is responsible for the remainder.

Small-cell lung cancer (SCLC), also called oat-cell carcinoma , is rarely found in people who have never smoked. It is characterized by cells that are small and round, oval, or shaped like oat grains. SCLC is the most aggressive type of lung cancer; because it tends to spread quickly before symptoms become apparent, the survival rate is very low.

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Lung cancer

• Lung cancer is the leading cause of cancer-related deaths worldwide, accounting for the highest mortality rates among both men and women.
• Smoking is the leading cause of lung cancer, responsible for approximately 85% of all cases.
• Lung cancer is often diagnosed at advanced stages when treatment options are limited.
• Screening high risk individuals has the potential to allow early detection and to dramatically improve survival rates.
• Primary prevention (such as tobacco control measures and reducing exposure to environmental risk factors) can reduce the incidence of lung cancer and save lives.

Lung cancer is a type of cancer that starts when abnormal cells grow in an uncontrolled way in the lungs. It is a serious health issue that can cause severe harm and death.

Symptoms of lung cancer include a cough that does not go away, chest pain and shortness of breath.

It is important to seek medical care early to avoid serious health effects. Treatments depend on the person’s medical history and the stage of the disease.

The most common types of lung cancer are non-small cell carcinoma (NSCLC) and small cell carcinoma (SCLC). NSCLC is more common and grows slowly, while SCLC is less common but often grows quickly.

Lung cancer is a significant public health concern, causing a considerable number of deaths globally. GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer (IARC) show as lung cancer remains the leading cause of cancer death, with an estimated 1.8 million deaths (18%) in 2020.

Smoking tobacco (including cigarettes, cigars, and pipes) is the primary risk factor for lung cancer but it can also affect non-smokers. Other risk factors include exposure to secondhand smoke, occupational hazards (such as asbestos, radon and certain chemicals), air pollution, hereditary cancer syndromes, and previous chronic lung diseases.

Lung cancer can cause several symptoms that may indicate a problem in the lungs.

The most common symptoms include:

• cough that does not go away
• shortness of breath
• coughing up blood (haemoptysis)
• weight loss with no known cause
• lung infections that keep coming back.

Early symptoms may be mild or dismissed as common respiratory issues, leading to delayed diagnosis.

Not smoking tobacco is the best way to prevent lung cancer.

Other risk factors to avoid include:

• secondhand smoke
• air pollution
• workplace hazards like chemicals and asbestos.

Early treatment can prevent lung cancer from becoming worse and spreading to other parts of the body.

Prevention of lung cancer include primary and secondary prevention measures. Primary prevention aims to prevent the initial occurrence of a disease through risk reduction and promoting healthy behaviour. In public health, these preventive measures include smoking cessation, promoting smoke-free environments, implementing tobacco control policies, addressing occupational hazards, and reducing air pollution levels.

Secondary prevention for lung cancer involves screening methods that aim to detect the disease in its early stages, before symptoms become apparent and can be indicated for high-risk individuals. In this population, early detection can significantly increase the chances of successful treatment and improve outcomes. The primary screening method for lung cancer is low-dose computed tomography (LDCT).

Diagnostic methods for lung cancer include physical examination, imaging (such as chest X-rays, computed tomography scans, and magnetic resonance imaging), examination of the inside of the lung using a bronchoscopy, taking a sample of tissue (biopsy) for histopathology examination and definition of the specific subtype (NSCLC versus SCLC), and molecular testing to identify specific genetic mutations or biomarkers to guide the best treatment option.

Treatment and care

Treatments for lung cancer are based on the type of cancer, how much it has spread, and the person’s medical history. Early detection of lung cancer can lead to better treatments and outcomes.

Treatments include:

• radiotherapy (radiation)
• chemotherapy
• targeted therapy
• immunotherapy.

Surgery is often used in the early stages of lung cancer if the tumour has not spread to other areas of the body. Chemotherapy and radiation therapy can help shrink the tumour.

Doctors from several disciplines often work together to provide treatment and care of people with lung cancer.

Supportive care is important for people with lung cancer. It aims to manage symptoms, provide pain relief, and give emotional support. It can help to increase quality of life for people with lung cancer and their families.

Stages of care

a) Early stage disease : The primary treatment for early stage lung cancer (i.e. tumour limited to the lung, with no metastatic dissemination to distant organs or lymph nodes) is surgical removal of the tumour through procedures such as lobectomy, segmentectomy, or wedge resection. Neoadjuvant therapy (chemotherapy and/or radiation therapy before surgery) can help reduce tumour size, making it more manageable for surgical removal. Adjuvant treatment (chemotherapy and/or radiation therapy) is very often recommended after surgery to reduce the risk of cancer recurrence. In cases where surgery is not feasible, radiation therapy or stereotactic body radiation therapy (SBRT) may be used as the primary treatment. Targeted therapy and immunotherapy may also be considered based on specific tumour characteristics. Individualized treatment plans should be discussed with healthcare professionals.

b) Advanced disease: The treatment for metastatic stage lung cancer, where the cancer has spread to distant organs or lymph nodes, is based on various factors, including the patient's overall health, the extent and location of metastases, histology, genetic profile, and individual preferences. The primary goal is to prolong survival, alleviate symptoms, and improve quality of life. Systemic therapies, such as chemotherapy, targeted therapy, and immunotherapy, play a crucial role in the treatment of metastatic lung cancer.

Chemotherapy is often the first-line treatment for the majority of patients around the world and involves the use of drugs that circulate throughout the body to kill cancer cells. Combination chemotherapy regimens are commonly used, and the choice of drugs depends on factors such as the histological type of the cancer and the patient's general health conditions. Targeted therapy, designed to block the signalling pathways that drive the growth of cancer cells, is an important option for patients with specific genetic mutations or biomarkers identified in their tumour. Immunotherapy, specifically immune checkpoint inhibitors, has revolutionized the treatment of metastatic lung cancer. These drugs help to stimulate the immune system to recognize and attack cancer cells. Local treatments, such as radiation therapy and surgery, may be used to manage specific metastatic sites or alleviate symptoms caused by tumour growth.

Clinical Trials

Clinical trials offer opportunities to access novel treatments or experimental therapies for patients. Participation in clinical trials helps advance medical knowledge and potentially offers new treatment options.

WHO response

WHO recognizes the significant impact of lung cancer on global health and has implemented several initiatives to address the disease comprehensively. The WHO's response focuses on tobacco control, cancer prevention, early detection, and improving access to quality treatment and care. WHO supports countries in implementing evidence-based tobacco control policies, including increasing tobacco taxes, enforcing comprehensive bans on tobacco advertising, promotion, and sponsorship, and implementing strong graphic health warnings on tobacco products.

The Organization also promotes cancer prevention strategies by advocating for healthy lifestyles, including regular physical activity, a healthy diet, and minimizing exposure to environmental risk factors. Additionally, WHO supports early detection programs and encourages countries to implement screening measures for high-risk populations to detect lung cancer at earlier stages when treatment options are more effective. Last, WHO works towards ensuring access to quality treatment and care for lung cancer patients by providing technical guidance to member states, promoting equitable access to essential cancer medicines, and fostering international collaboration to share best practices and improve cancer care outcomes.

International Agency for Research on Cancer: Lung cancer

WHO's work on tobacco cessation

WHO's work on cancer

ESMO Clinical Practice Guidelines: Lung and Chest Tumours

• Patient Care & Health Information
• Diseases & Conditions
• Lung cancer

Lung cancer begins in the cells of the lungs.

Lung cancer is a kind of cancer that starts as a growth of cells in the lungs. The lungs are two spongy organs in the chest that control breathing.

Lung cancer is the leading cause of cancer deaths worldwide.

People who smoke have the greatest risk of lung cancer. The risk of lung cancer increases with the length of time and number of cigarettes smoked. Quitting smoking, even after smoking for many years, significantly lowers the chances of developing lung cancer. Lung cancer also can happen in people who have never smoked.

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Lung cancer typically doesn't cause symptoms early on. Symptoms of lung cancer usually happen when the disease is advanced.

Signs and symptoms of lung cancer that happen in and around the lungs may include:

• A new cough that doesn't go away.
• Chest pain.
• Coughing up blood, even a small amount.
• Hoarseness.
• Shortness of breath.

Signs and symptoms that happen when lung cancer spreads to other parts of the body may include:

• Losing weight without trying.
• Loss of appetite.
• Swelling in the face or neck.

When to see a doctor

Make an appointment with your doctor or other healthcare professional if you have any symptoms that worry you.

If you smoke and haven't been able to quit, make an appointment. Your healthcare professional can recommend strategies for quitting smoking. These may include counseling, medicines and nicotine replacement products.

There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.

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Lung cancer happens when cells in the lungs develop changes in their DNA. A cell's DNA holds the instructions that tell a cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In cancer cells, the DNA changes give different instructions. The changes tell the cancer cells to make many more cells quickly. Cancer cells can keep living when healthy cells would die. This causes too many cells.

The cancer cells might form a mass called a tumor. The tumor can grow to invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.

Smoking causes most lung cancers. It can cause lung cancer in both people who smoke and in people exposed to secondhand smoke. But lung cancer also happens in people who never smoked or been exposed to secondhand smoke. In these people, there may be no clear cause of lung cancer.

How smoking causes lung cancer

Researchers believe smoking causes lung cancer by damaging the cells that line the lungs. Cigarette smoke is full of cancer-causing substances, called carcinogens. When you inhale cigarette smoke, the carcinogens cause changes in the lung tissue almost immediately.

At first your body may be able to repair this damage. But with each repeated exposure, healthy cells that line your lungs become more damaged. Over time, the damage causes cells to change and eventually cancer may develop.

Types of lung cancer

Lung cancer is divided into two major types based on the appearance of the cells under a microscope. Your healthcare professional makes treatment decisions based on which major type of lung cancer you have.

The two general types of lung cancer include:

• Small cell lung cancer. Small cell lung cancer usually only happens in people who have smoked heavily for years. Small cell lung cancer is less common than non-small cell lung cancer.
• Non-small cell lung cancer. Non-small cell lung cancer is a category that includes several types of lung cancers. Non-small cell lung cancers include squamous cell carcinoma, adenocarcinoma and large cell carcinoma.

Risk factors

A number of factors may increase the risk of lung cancer. Some risk factors can be controlled, for instance, by quitting smoking. Other factors can't be controlled, such as your family history.

Risk factors for lung cancer include:

Your risk of lung cancer increases with the number of cigarettes you smoke each day. Your risk also increases with the number of years you have smoked. Quitting at any age can significantly lower your risk of developing lung cancer.

Exposure to secondhand smoke

Even if you don't smoke, your risk of lung cancer increases if you're around people who are smoking. Breathing the smoke in the air from other people who are smoking is called secondhand smoke.

Previous radiation therapy

If you've had radiation therapy to the chest for another type of cancer, you may have an increased risk of developing lung cancer.

Exposure to radon gas

Radon is produced by the natural breakdown of uranium in soil, rock and water. Radon eventually becomes part of the air you breathe. Unsafe levels of radon can build up in any building, including homes.

Exposure to cancer-causing substances

Workplace exposure to cancer-causing substances, called carcinogens, can increase your risk of developing lung cancer. The risk may be higher if you smoke. Carcinogens linked to lung cancer risk include asbestos, arsenic, chromium and nickel.

Family history of lung cancer

People with a parent, sibling or child with lung cancer have an increased risk of the disease.

Complications

Lung cancer can cause complications, such as:

Shortness of breath

People with lung cancer can experience shortness of breath if cancer grows to block the major airways. Lung cancer also can cause fluid to collect around the lungs and heart. The fluid makes it harder for the affected lung to expand fully when you inhale.

Coughing up blood

Lung cancer can cause bleeding in the airway. This can cause you to cough up blood. Sometimes bleeding can become severe. Treatments are available to control bleeding.

Advanced lung cancer that spreads can cause pain. It may spread to the lining of a lung or to another area of the body, such as a bone. Tell your healthcare professional if you experience pain. Many treatments are available to control pain.

Fluid in the chest

Lung cancer can cause fluid to accumulate in the chest, called pleural effusion. The fluid collects in the space that surrounds the affected lung in the chest cavity, called the pleural space.

Pleural effusion can cause shortness of breath. Treatments are available to drain the fluid from your chest. Treatments can reduce the risk that pleural effusion will happen again.

Cancer that spreads to other parts of the body

Lung cancer often spreads to other parts of the body. Lung cancer may spread to the brain and the bones.

Cancer that spreads can cause pain, nausea, headaches or other symptoms depending on what organ is affected. Once lung cancer has spread beyond the lungs, it's generally not curable. Treatments are available to decrease symptoms and to help you live longer.

There's no sure way to prevent lung cancer, but you can reduce your risk if you:

Don't smoke

If you've never smoked, don't start. Talk to your children about not smoking so that they can understand how to avoid this major risk factor for lung cancer. Begin conversations about the dangers of smoking with your children early so that they know how to react to peer pressure.

Stop smoking

Stop smoking now. Quitting reduces your risk of lung cancer, even if you've smoked for years. Talk to your healthcare team about strategies and aids that can help you quit. Options include nicotine replacement products, medicines and support groups.

Avoid secondhand smoke

If you live or work with a person who smokes, urge them to quit. At the very least, ask them to smoke outside. Avoid areas where people smoke, such as bars. Seek out smoke-free options.

Test your home for radon

Have the radon levels in your home checked, especially if you live in an area where radon is known to be a problem. High radon levels can be fixed to make your home safer. Radon test kits are often sold at hardware stores and can be purchased online. For more information on radon testing, contact your local department of public health.

Avoid carcinogens at work

Take precautions to protect yourself from exposure to toxic chemicals at work. Follow your employer's precautions. For instance, if you're given a face mask for protection, always wear it. Ask your healthcare professional what more you can do to protect yourself at work. Your risk of lung damage from workplace carcinogens increases if you smoke.

Eat a diet full of fruits and vegetables

Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best. Avoid taking large doses of vitamins in pill form, as they may be harmful. For instance, researchers hoping to reduce the risk of lung cancer in people who smoked heavily gave them beta carotene supplements. Results showed the supplements increased the risk of cancer in people who smoke.

Exercise most days of the week

If you don't exercise regularly, start out slowly. Try to exercise most days of the week.

Lung cancer care at Mayo Clinic

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• Cairns LM. Managing breathlessness in patients with lung cancer. Nursing Standard. 2012; doi:10.7748/ns2012.11.27.13.44.c9450.
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• Dunning J, et al. Microlobectomy: A novel form of endoscopic lobectomy. Innovations. 2017; doi:10.1097/IMI.0000000000000394.
• Leventakos K, et al. Advances in the treatment of non-small cell lung cancer: Focus on nivolumab, pembrolizumab and atezolizumab. BioDrugs. 2016; doi:10.1007/s40259-016-0187-0.
• Dong H, et al. B7-H1, a third member of the B7 family, co-stimulates T-cell proliferation and interleukin-10 secretion. Nature Medicine. 1999;5:1365.
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• Infographic: Lung Cancer
• Lung cancer surgery
• Lung nodules: Can they be cancerous?
• Super Survivor Conquers Cancer

Associated Procedures

• Ablation therapy
• Brachytherapy
• Bronchoscopy
• Chemotherapy
• Lung cancer screening
• Positron emission tomography scan
• Proton therapy
• Radiation therapy
• Stop-smoking services

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Lung cancer

Affiliations.

• 1 Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, VIC, Australia.
• 2 Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
• 3 Department of Medicine, Massachusetts General Hospital, Boston, MA, USA. Electronic address: [email protected].
• PMID: 34273294
• DOI: 10.1016/S0140-6736(21)00312-3

Lung cancer is one of the most frequently diagnosed cancers and the leading cause of cancer-related deaths worldwide with an estimated 2 million new cases and 1·76 million deaths per year. Substantial improvements in our understanding of disease biology, application of predictive biomarkers, and refinements in treatment have led to remarkable progress in the past two decades and transformed outcomes for many patients. This seminar provides an overview of advances in the screening, diagnosis, and treatment of non-small-cell lung cancer and small-cell lung cancer, with a particular focus on targeted therapies and immune checkpoint inhibitors.

Copyright © 2021 Elsevier Ltd. All rights reserved.

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Conflict of interest statement

Declaration of interests BJS reports personal fees from Pfizer, Novartis, Roche/Genentech, AstraZeneca, Merck, Bristol Myers Squibb, Amgen, and Loxo Oncology outside the submitted work. JFG has served as a consultant or received honoraria from Bristol-Myers Squibb, Genentech, Ariad/Takeda, Loxo/Lilly, Blueprint, Oncorus, Regeneron, Gilead, Helsinn, EMD Serono, AstraZeneca, Pfizer, Incyte, Novartis, Merck, Agios, Amgen, and Array; has had research support from Novartis, Genentech/Roche, Ariad/Takeda, Bristol-Myers Squibb, Tesaro, Moderna, Blueprint, Jounce, Array Biopharma, Merck, Adaptimmune, and Alexo; and has an immediate family member who is an employee of Ironwood Pharmaceuticals. LVS reports grants and personal fees from AstraZeneca; grants from Novartis and Boehringer Ingelheim; grants and consulting fees from Genentech Blueprint and Merrimack Pharmaceuticals; and consulting fees from Janssen and grants from LOXO, all outside the submitted work. LVS has a patent about treatment of EGFR-mutant cancer pending. RSH reports honoraria from Novartis, Merck KGaA, Daichii Sankyo, Pfizer, Roche, Apollomics, Tarveda, and Boehringer Ingelheim; and grants from Novartis, Genentech Roche, Corvus, Incyte, Exelixis, Abbvie, Daichii Sankyo, Agios, Mirati, Turning Point, and Lilly when writing this Seminar. AAT declares no competing interests.

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Health Encyclopedia

Lung cancer: introduction, what is cancer.

Cancer may seem complex. But at its core, cancer is simple. Normal cells grow and die when your body needs them to. Cancer is what happens when certain cells grow even though your body doesn’t need them.

In many cases, these cancerous cells form a lump or mass called a tumor. Since cancerous cells don’t act like normal cells, tumors can prevent your body from working correctly. Given time, they can also spread, or metastasize, to other parts of the body.

Lung cancer is cancer that starts in the cells that make up the lungs. It isn’t cancer that spreads to the lungs from other parts of the body. This is key because treatment is based on the original site of the tumor. For example: If a tumor begins in the breast and spreads to the lungs, it would be treated as metastatic breast cancer—not lung cancer.

Understanding the lungs

The lungs are sponge-like organs in your chest. Their job is to bring oxygen into the body and to get rid of carbon dioxide. When you breathe air in, it goes into your lungs through your windpipe (trachea). The trachea divides into tubes called bronchi, which enter the lungs. These divide into smaller branches called bronchioles. At the end of the bronchioles are tiny air sacs called alveoli. The alveoli move oxygen from the air into your blood. They take carbon dioxide out of the blood. This leaves your body when you breathe out (exhale).

Your right lung is divided into 3 sections (lobes). Your left lung has 2 lobes.

Types of lung cancer

There are two main types of lung cancer: non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Understanding the differences between these types may lessen anxiety about your diagnosis and treatment.

Non-small cell lung cancer

NSCLC accounts for 85% to 90% of lung cancer cases. There are 3 main subtypes. Each subtype is named for the type of cell it develops in:

Adenocarcinoma. This is the most common type of lung cancer—particularly among the minority of non-smokers who get the disease. It tends to appear on the outer edges of the lungs and grows more slowly than the other subtypes. 

Squamous cell carcinoma (epidermoid carcinoma). This type of cancer develops more often in smokers or former smokers than lifetime nonsmokers. It tends to start in the center of the lungs near the bronchial tubes.

Large cell carcinoma.  The least common NSCLC, large cell carcinoma can begin anywhere in the lung. It tends to grow more quickly than the other subtypes, which can make it harder to treat.

Despite minor differences, they are often treated the same way.

Small cell lung cancer

Only about 1 in 10 to 3 in 20 people diagnosed with lung cancer have small-cell lung cancer (also called oat cell cancer). It's also almost exclusively found in smokers. It tends to grow more quickly than NSCLC. It often spreads to other parts of the body at an earlier stage.

How lung cancer spreads

Lung cancer acts differently in different people. But when it spreads, it tends to go to the same places. First: lymph nodes in the center of the chest. It may also spread to lymph nodes in the lower neck.

Lymph nodes are small clusters of immune system cells.

During later stages, lung cancer may spread to more distant parts of the body, such as the liver, brain, or bones.

Talk with your healthcare provider

If you have questions about lung cancer, talk with your healthcare provider. They can help you understand more about this cancer. 

Medical Reviewers:

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Lung cancer articles from across Nature Portfolio

Lung cancer arises in tissues of the lung, usually in the cells lining air passages. The two main types are small-cell lung cancer and non-small-cell lung cancer, according to the shape of cells under a microscope. The most common symptoms are coughing, shortness of breath and chest pains.

The MARIPOSA trials — implications for the treatment of EGFR -mutant NSCLC

In the past 2 years, substantial improvements have been made in the management of advanced-stage EGFR -mutant non-small-cell lung cancer. Recent studies have suggested added benefit from the combination of third-generation tyrosine-kinase inhibitors with either chemotherapy or a bispecific antibody targeting EGFR and MET. Herein, we summarize these advances and their implications for clinical practice.

• Fatemeh Ardeshir-Larijani
• Suresh S. Ramalingam

Related Subjects

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Stimulation of cGAS-STING pathway as a challenge in the treatment of small cell lung cancer: a feasible strategy?

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M2 macrophage-derived lncRNA NORAD in EVs promotes NSCLC progression via miR-520g-3p / SMIM22 / GALE axis

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RAS-ON inhibition overcomes clinical resistance to KRAS G12C-OFF covalent blockade

KRAS G12C mutant selective inhibitors targeting inactive state have been approved for use in non-small cell lung cancer (NSCLC). Here, using models derived from a patient with NSCLC who progressed on sotorasib (KRAS G12C inhibitor), the authors identify increased KRAS GTP loading as an adaptive resistance mechanism which could be targeted with KRAS G12C inhibitors selective to the GTP active state.

• Marie-Julie Nokin
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The epidemiology of lung cancer in Hungary based on the characteristics of patients diagnosed in 2018

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CTDSPL2 promotes the progression of non-small lung cancer through PI3K/AKT signaling via JAK1

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Histological transformation to small-cell carcinoma

In this Journal Club, Oh and Kim discuss a study demonstrating the mechanisms underlying histological transformation of lung adenocarcinoma to neuroendocrine small-cell lung cancer.

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Adjuvant alectinib improves outcomes in ALK -mutant NSCLC

Pegargiminase improves outcomes in nonepithelioid mpm, quick links.

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Advances in Lung Cancer Research

Lung cancer cells driven by the KRAS oncogene, which is highlighted in purple.

NCI-funded researchers are working to advance our understanding of how to prevent, detect, and treat lung cancer. In particular, scientists have made progress in identifying many different genetic alterations that can drive lung cancer growth.

This page highlights some of the latest research in non-small cell lung cancer (NSCLC), the most common form of lung cancer, including clinical advances that may soon translate into improved care, NCI-supported programs that are fueling progress, and research findings from recent studies.

Early Detection of Lung Cancer

A great deal of research has been conducted in ways to find lung cancer early. Several methods are currently being studied to see if they decrease the risk of dying from lung cancer.

The NCI-sponsored  National Lung Screening Trial (NLST)  showed that low-dose CT scans can be used to screen for lung cancer in people with a history of heavy smoking. Using this screening can decrease their risk of dying from lung cancer. Now researchers are looking for ways to refine CT screening to better predict whether cancer is present. 

Markers in Blood and Sputum

Scientists are trying to develop or refine tests of sputum and blood that could be used to detect lung cancer early. Two active areas of research are:

• Analyzing blood samples to learn whether finding tumor cells or molecular markers in the blood will help diagnose lung cancer early.
• Examining sputum samples for the presence of abnormal cells or molecular markers that identify individuals who may need more follow-up.

Machine Learning

Machine learning is a method that allows computers to learn how to predict certain outcomes. In lung cancer, researchers are using computer algorithms to create computer-aided programs that are better able to identify cancer in CT scans than radiologists or pathologists. For example, in one artificial intelligence study , researchers trained a computer program to diagnose two types of lung cancer with 97% accuracy, as well as detect cancer-related genetic mutations.

Lung Cancer Treatment

Treatment options for lung cancer are surgery , radiation , chemotherapy , targeted therapy ,  immunotherapy , and combinations of these approaches. Researchers continue to look for new treatment options for all stages of lung cancer.

Treatments for early-stage lung cancer

Early-stage lung cancer can often be treated with surgery. Researchers are developing approaches to make surgery safer and more effective.

• When lung cancer is found early, people usually have surgery to remove an entire section ( lobe ) of the lung that contains the tumor. However, a recent clinical trial showed that, for certain people with early-stage NSCLC, removing a piece of the affected lobe is as effective as surgery to remove the whole lobe . 
• The targeted therapy  Osimertinib (Tagrisso ) was approved by the Food and Drug Administration (FDA) in 2021 to be given after surgery—that is, as adjuvant therapy —to people with early-stage NSCLC that has certain mutations in the EGFR gene.
• Two immunotherapy drugs, atezolizumab (Tecentriq)  and pembrolizumab (Keytruda) have been approved by the FDA to be used as adjuvant treatments after surgery and chemotherapy, for some patients with early-stage NSCLC. 
• The immunotherapy drug nivolumab (Opdivo) is approved to be used, together with chemotherapy, to treat patients with early-stage lung cancer before surgery (called neoadjuvant ). This approval, which came in 2022, was based on the results of the CheckMate 816 trial, which showed that patients at this stage who received neoadjuvant nivolumab plus chemotherapy lived longer than those who received chemotherapy alone . 
• In another trial (Keynote-671), patients with early-stage NSCLC who received pembrolizumab plus chemotherapy before surgery and pembrolizumab after surgery  had better outcomes than those who received just neoadjuvant or just adjuvant treatment.  

Treatments for advanced lung cancer

Newer therapies are available for people with advanced lung cancer. These primarily include immunotherapies and targeted therapies, which continue to show benefits as research evolves.  

Immunotherapy

Immunotherapies work with the body's immune system to help fight cancer. They are a major focus in lung cancer treatment research today. Clinical trials are ongoing to look at new combinations of immunotherapies with or without chemotherapy  to treat  lung cancer.

JAK Inhibitors Boost Immunotherapy in Clinical Trials

The combination shrank lymphoma and lung tumors in people and in mice.

Immune checkpoint inhibitor s are drugs that block an interaction between proteins on immune cells and cancer cells which, in turn, lowers the immune response to the cancer. Several immune checkpoint inhibitors have been approved for advanced lung cancer, including  p embrolizumab (Keytruda) ,  a tezolizumab (Tecentriq) , c emiplimab (Libtayo) , d urvalumab (Imfinzi) , and  n ivolumab (Opdivo) .

A key issue with immunotherapies is deciding which patients are most likely to benefit. There is some evidence that patients whose tumor cells have high levels of an immune checkpoint protein called PD-L1 may be more responsive to immune checkpoint inhibitors. Another  marker for immunotherapy response is tumor mutational burden , or TMB, which refers to the amount of mutations in the DNA of the cancer cells. In some lung cancer trials, positive responses to immune checkpoint inhibitors have been linked with a high TMB. However, these markers cannot always predict a response and there is ongoing work to find better markers.

To learn more, see Immunotherapy to Treat Cancer .

Targeted Therapies

Targeted treatments identify and attack certain types of cancer cells with less harm to normal cells. In recent years, many targeted therapies have become available for advanced lung cancer and more are in development. Targeted treatments for lung cancer include the below.

Anaplastic lymphoma kinase (ALK) Inhibitors

ALK inhibitors target cancer-causing rearrangements in a protein called ALK. These drugs continue to be refined for the 5% of NSCLC patients who have an ALK gene alteration. Approved treatments include   ceritinib (Zykadia) , alectinib (Alecensa) , brigatinib   (Alunbrig) , and lorlatinib  (Lorbrena) .

These ALK inhibitors are improvements from previous ones in their enhanced ability to cross the blood–brain barrier. This progress is critical because, in non-small cell lung cancer patients with  ALK  alterations, disease progression tends to occur in the brain.   Based on clinical trial results, in 2024 the FDA approved alectinib as adjuvant therapy for people with ALK-positive NSCLC .

EGFR Inhibitors

Lung cancer trial of osimertinib draws praise—and some criticism.

The drug improved survival in a large clinical trial, but some question the trial’s design.

EGFR inhibitors block the activity of a protein called epidermal growth factor receptor (EGFR). Altered forms of EGFR are found at high levels in some lung cancers, causing them to grow rapidly.  Osimertinib (Tagrisso) is the most effective and most widely used EGFR inhibitor. It is also used for adjuvant therapy after surgery for resectable NSCLC. Other drugs that target EGFR that are approved for treating NSCLC include afatinib (Gilotrif) , dacomitinib (Vizimpro) , erlotinib (Tarceva) , gefitinib (Iressa) . For people with Exon 20 mutations, amivantamab (Rybrevant)   is an approved targeted therapy.

ROS1 Inhibitors

The ROS1 protein is involved in cell signaling and cell growth. A small percentage of people with NSCLC have rearranged forms of the ROS1 gene. Crizotinib (Xalkori) and entrectinib (Rozlytrek) are approved as treatments for patients with these alterations. In late 2023, the FDA approved repotrectinib (Augtyro) for advanced or metastatic NSCLC with ROS1 fusions as an initial treatment and as a second-line treatment in those who previously received a ROS1-targeted drug.

BRAF Inhibitors

The B-Raf protein is involved in sending signals in cells and cell growth. Certain changes in the B-Raf gene can increase the growth and spread of NSCLC cells.

The combination of the B-Raf-targeted drug dabrafenib (Tafinlar)  and trametinib (Mekinist ), which targets a protein called MEK, has been approved as treatment for patients with NSCLC that has a specific mutation in the BRAF gene.

Encorafenib (Braftovi) combined with binimetinib (Mektovi) is approved for patients with metastatic NSCLC with a BRAF V600E mutation .

Other Inhibitors

Some NSCLCs have mutations in the genes NRTK-1 and NRTK-2 that can be treated with the targeted therapy larotrectinib (Vitrakvi). Those with certain mutations in the MET gene can be treated with tepotinib (Tepmetko) or capmatinib (Tabrecta) . And those with alterations in the RET gene are treated with selpercatinib (Retevmo)  and pralsetinib (Gavreto) . A 2023 clinical trial showed that treatment with selpercatinib led to longer progression-free survival compared with people who received chemotherapy with or without pembrolizumab. Inhibitors of other targets that drive some lung cancers are being tested in clinical trials.

See a complete list of  targeted therapies for lung cancer . 

NCI-Supported Research Programs

Many NCI-funded researchers at the NIH campus, and across the United States and the world, are seeking ways to address lung cancer more effectively. Some research is basic, exploring questions as diverse as the biological underpinnings of cancer and the social factors that affect cancer risk. And some is more clinical, seeking to translate basic information into improved patient outcomes. The programs listed below are a small sampling of NCI’s research efforts in lung cancer.

• The Pragmatica-Lung Study is a randomized trial that will compare the combination of the targeted therapy ramucirumab (Cyramza) and the immunotherapy pembrolizumab (Keytruda) with standard chemotherapy in people with advanced NSCLC whose disease has progressed after previous treatment with immunotherapy and chemotherapy. In addition to looking at an important clinical question, the trial will serve as a model for future trials because it is designed to remove many of the barriers that prevent people from joining clinical trials.
• Begun in 2014, ALCHEMIST is a multicenter NCI trial for patients with early stage non-small cell lung cancer. It tests to see whether adding a targeted therapy after surgery, based on the genetics of a patient’s tumor, will improve survival.
• The Lung MAP trial is an ongoing multicenter trial for patients with advanced non-small cell lung cancer who have not responded to earlier treatment. Patients are assigned to specific targeted therapies based on their tumor’s genetic makeup.
• The Small Cell Lung Cancer Consortium  was created to coordinate efforts and provide a network for investigators who focus on preclinical studies of small-cell lung cancer. The goal of the consortium is to accelerate progress on this disease through information exchange, data sharing and analysis, and face-to-face meetings.
• NCI funds eight  lung cancer Specialized Programs of Research Excellence (Lung SPOREs) . These programs are designed to quickly move basic scientific findings into clinical settings. Each SPORE has multiple lung cancer projects underway.

Clinical Trials

NCI funds and oversees both early- and late-phase clinical trials to develop new treatments and improve patient care. Trials are available for both non-small cell lung cancer treatment  and small cell lung cancer treatment .

Lung Cancer Research Results

The following are some of our latest news articles on lung cancer research:

• Lorlatinib Slows Growth of ALK-Positive Lung Cancers, May Prevent Brain Metastases
• Durvalumab Extends Lives of People with Early-Stage Small Cell Lung Cancer
• Alectinib Approved as an Adjuvant Treatment for Lung Cancer
• Repotrectinib Expands Treatment Options for Lung Cancers with ROS1 Fusions
• Tarlatamab Shows Promise for Some People with Small Cell Lung Cancer
• Selpercatinib Slows Progression of RET-Positive Lung, Medullary Thyroid Cancers

View the full list of Lung Cancer Research Results and Study Updates .

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The top 100 cited articles in lung cancer – a bibliometric analysis

Aim of the study.

To analyze the 100 most cited lung cancer articles published in biomedical literature in the last 44 years. We pointed out developments in lung cancer and aimed to create convenient access for the researchers of this dynamic field.

Material and methods

We accessed the WoS database (accessed: 15.07.2019) using the keyword “lung cancer” between 1975 and 2019. The top 100 cited articles were analyzed by topic, journal, author, year, institution, level of evidence, adjusted citation index and also the correlations between citation, adjusted citation index, impact factor and length of time since publication.

A total of 240,701 eligible articles were identified and we chose the top 100 articles cited in the field of lung cancer. The mean number of citations for these articles was 1879.82 ±1264.78. The most cited article was (times cited: 7751) a study by Lynch et al. The New England Journal of Medicine (NEJM) made the greatest contribution to the top 100 list with 32 articles, and the most cited article also originated from NEJM. The highest number of citations was seen in 2017 with 18,393 citations while the highest number of publications was seen in 2005 with 12 publications.

Conclusions

Oncology is a developing field and we have seen the evolution in this area through the treatment of lung cancer in recent years. The first 100 articles in our analysis not only reflect the landmark articles with the greatest impact on lung cancer research, but also acknowledge the most productive authors and institutions that have contributed to the list with their articles.

Introduction

Lung cancer is an important health problem with an increasing incidence. In most European countries, lung cancer has increased so dramatically that it may be considered one of the major health problems in the last century [ 1 ]. The most common causes of cancer-related death are cancers of the lung and bronchus (24%), prostate (10%) and colorectum (9%) in men, and lung and bronchus (23%), breast (15%), and colorectum (8%) in women [ 2 ]. Although lung cancer has long been characterized by late-stage diagnosis and poor survival, encouraging results have been achieved for lung cancer screening in high-risk populations in the last decade and there has been significant progress in systemic treatments for molecular subgroups of patients with advanced disease. Furthermore, within the last ten years, new molecular targets have emerged, next-generation drugs with more specific target effects have been introduced, and targeting specific resistant mutations is expected to advance the treatment of lung cancer by creating a chronic therapeutic pathway [ 3 ]. This bibliometric study demonstrates the development of lung cancer treatment over the years.

Bibliometric studies represent an important study type showing the trend topics in a given field. Numerous medical and surgical specialists have published the most cited articles in their specialties in the form of bibliometric analysis such as general surgery [ 4 ], anesthesiology [ 5 ], orthopedics [ 6 ], otolaryngology [ 7 ], radiology [ 8 ] and plastic surgery [ 9 ]. The first bibliometric analysis was penned by Garfield and published in JAMA in 1987 [ 10 ]. He also continued with new bibliometric studies in different fields of medical science.

The purpose of our study was to identify and analyze the 100 most cited lung cancer articles published in biomedical literature in the last 44 years. We determined the number of citations with ranking, average citations per year (ACY), citations and publications by year, publishing journal, institution and country of origin, the most common subject of frequently cited articles, authorship status of classical papers and correlation analyses between citation, ACY, Impact Factor (IF) and length of time since publication in years.

Study design

Study type: retrospective clinical study, Level of evidence: 3 or Group B (Scottish Intercollegiate Guidelines Network; SIGN) [ 11 ].

Data collection and inclusion criteria: In this paper reporting a bibliometric citation analysis, data were obtained from Thomson Reuters’ WoS Core Collection database (Philadelphia, Pennsylvania, USA) and PubMed (US National Library of Medicine-National Institutes of Health). We accessed the WoS database (accessed: 15.07.2019) using the keyword “lung cancer” between 1975 and 2019. We identified 240,701 articles and conducted an analysis of the top 100 cited articles among these hits shown in Table 1 [ 12 – 111 ]. Articles not relevant to lung cancer were excluded from our study and we included original research articles, editorials, correspondences, review articles and case reports. We also utilized the PubMed database to obtain additional data related to the study. Two of the authors (NSS and EC) independently identified T100 with consensus. The difference in time since publication among the top 100 articles may cause a bias as older articles may be more likely to have obtained more citations owing to a longer citable period. The Web of Science, Citation Report feature displays bar charts for the number of items published each year and calculates the average number of citations per year per publication. Due to this bias, we used the ACY for each article.

The top 100 cited articles in lung cancer

ACY – average citations per year

Statistical analysis

A commercial software (SPSS version 16.0, SPSS, Chicago IL, USA) was used for the statistical analysis. The Kolmogorov-Smirnov test was used to analyze the normal distribution of data. Spearman’s correlation was used to evaluate the associations between citation, ACY, IF and length of time since publication. A p- value < 0.05 was accepted as statistically significant.

Ethical statement

All authors declare that the study was conducted according to the principles of the World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. This study did not require approval from an ethics committee as it was designed as a bibliometric analysis or citation analysis of existing published classical studies.

We identified 240,701 articles from 1975 to 2019. The language was English for all articles. The 100 most cited articles in lung cancer are listed in Table 1 , arranged in descending order according to the number of times cited. The number of citations ranged from 7751 to 889, and the mean number of citations per article was 1879.82 ±1264.78 (range: 7751–889). We found that the most cited article (times cited: 7751) on lung cancer was a study by Lynch et al. with the following title: “Activating mutations in the epidermal growth factor receptor underlying responsiveness of nonsmallcell lung cancer to gefitinib” published in N Engl J Med 2004; 350: 2129-1239. The least cited article (times cited: 889) on lung cancer was penned by Imielinski et al. with the following title: “Mapping the hallmarks of lung adenocarcinoma with massively parallel sequencing” and published in Cell 2012; 150: 1107-1120. Additionally, we determined that there were 84 articles that got more than 1000 citations and the article with the highest ACY was the article that ranked 16 in the T100 list. The article with the highest ACY was a randomized phase 3 trial by Borghaei et al. , titled “Nivolumab versus docetaxel in advanced nonsquamous non-smallcell lung cancer” and published in N Engl J Med 2015; 373: 1627-1639. The highest number of citations was seen in 2017 with 18,393 citations while the highest number of publications was seen in 2005 with 12 publications.

The oldest article was a review published in Nature 1985; 316: 823-826 titled “Bombesin-like peptides can function as autocrine growth factors in human small-cell lung cancer” by Cuttitta et al. with 1280 citations and ACY 36.57 ACY. The newest study in the T100 list was a phase 3 trial conducted by Rittmeyer et al. published in Lancet 2017; 389: 255-265 with the following title: “Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial”, with 926 citations and ACY 308.67.

In the T100 list, 82 were clinical studies and 18 were experimental studies. The 82 clinical articles included 42 randomized controlled studies, 8 review articles, 4 meta-analyses, 2 case reports and other clinical studies. Fifty-nine of these 82 clinical articles were treatment-based studies. The treatment-based studies are classified in Table 2 according to the level of evidence.

Type of treatment and level of evidence of the treatment based clinical articles ( n = 59)

EGFR – epidermal growth factor receptor, ALK – anaplastic lymphoma kinase

While 32 of these articles were published in NEJM, 16 were published in the Journal of Clinical Oncology , 7 in The Lancet , 7 in Science , etc. ( Table 3 ).

List of journals with published articles

All of the T100 articles were published across 23 different journals. Eighty-five of the T100 articles were published in 14 journals that had IF ≥ 10.336. We determined that the mean IF of these 23 journals was 23.42 ±19.90 (range: 79.26–2.12) (according to Clarivate Analytics, 2017). The “Quartile Score” category was Q1 for all the journals (according to SCImago Journal and Country Rank, 2019). Most of the articles were published in NEJM, and NEJM was also the journal with the highest IF. The correlation analysis for the number of citations, ACY, IF and length of time since publication parameters in the T100 list revealed a positive correlation between citation and ACY ( r = 0.744, p = 0.00) and between ACY and IF ( r = 0.236, p = 0.018), whereas a negative correlation was observed between ACY and length of time since publication ( r = –0.562, p = 0.00) and between IF and length of time since publication ( r = –0.266, p = 0.008). There was no correlation between citation and length of time since publication or between citation and IF ( Fig. 1 ).

Correlation analysis for the citation numbers, ACY, IF, length of time since publication parameters

According to the geographic origin of the T100 list, the USA ( n = 74) was the most contributing country, followed by Japan and Canada ( Table 4 ). We determined that the most commonly listed institution was the University of Harvard (USA), which was listed 27 times in the top 100 cited articles ( Table 5 ). Moreover, 11/19 of the institutions that published eight or more publications were found to be in USA.

Geographic origin of the top 100 articles

Institutions of origin with 8 or more of the top 100 cited articles

It was seen that 3 authors were the first author in more than one article in the T100 list’s top 12 authors ( Table 6 ). Herbst RS contributed to 8 articles and was the first author in 4 of them. Janne PA, Johnson BE and Johnson DH also contributed to 8 articles. However, Herbst RS had the highest number of articles as first author. The “Web of Science” category analysis of the T100 in the field of the lung cancer revealed that these articles ranked under general internal medicine ( n = 47), oncology ( n = 33), multidisciplinary sciences ( n = 13), cell biology ( n = 8) and respiratory system ( n = 6) as the most featured branches.

The most common authors with 6 or more in the top 100 cited articles

Lung cancer is the major cause of cancer-related deaths worldwide. There are two main types of this cancer: small-cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC accounts for 80% of all lung cancers. Despite the advances in surgical methods and advances in radiotherapy and chemotherapy, non-small-cell lung cancer continues to account for the majority of lung cancers and is associated with a 5-year survival rate of 15% [ 112 ].

There have been significant advances in the treatment of lung cancer in the last 40 years, and this is reflected in the scientific literature. A better understanding of disease progression coupled with targeted immunological therapies has led to increased survival rates.

We found that in our top 100, 28% of the articles were less than 10 years old while 72% of them were older than 10 years. Articles with a higher number of citations are indeed expected to be older. Year of publication and number of citations for an article are closely linked, and the number of citations grows over time. Needless to say, citation is an important metric, which shows the quality and attractiveness of an article; however, a certain amount of time should be allowed to pass after the publication of an article for it to reach a higher number of citations. For that reason, number of citations alone is inadequate to determine the quality of an article. In this study, ACY was used to eliminate the time bias when evaluating older articles against newer articles. Of the T100, 18% were comparative studies, and there were 2 case reports in the T100 list. The two case reports were published in 2005. One of them was published in NEJM (times cited: 2549), and the other in Plos Med (times cited: 2073). Both were about EGFR mutations. It is noteworthy that a case report receives such a high number of citations. This may be due to the fact that EGFR mutations were popular in the 2000s. In the T100, 29% of the articles were noted to concern erlotinib (anti-EGFR), gefitinib (anti-EGFR) and EGFR mutations. The 1 st study with the highest number of citations was a study related to EGFR mutations, showing that EGFR mutations play an important role in the development stages of lung cancer treatments.

Immunotherapy has become one of the most promising treatments for several human cancers. In fact, James P. Allison and Tasuku Honjo were awarded with the Nobel Prize in medicine for their research on immune checkpoint blockade [ 113 , 114 ]. As a result, the immune check-point inhibitor (ICPI) may be regarded as an immunotherapy modality that started a new era in cancer treatment and remains a new trend topic. Especially in advanced non-small cell lung cancer (NSCLC), significant improvement has been observed in survival results with anti-PD-1 and PDL-1 drugs compared to chemotherapy. That shows the changing trends in cancer immunotherapy during the last decade. We can also see studies on immunotherapy in the T100 list. The most cited immunotherapy-related study in T100 was published in 2015 and received 2966 citations (ACY 593.2). It was published in N Engl J Med 2015; 373: 123-135 by Brahmer et al. with the following title: “Nivolumab versus docetaxel in advanced squamouscell non-smallcell lung cancer”. This study currently remains a new study of only 4 years old, and despite being a very young article, the number of citations it has received shows that the study in question involves a very important innovation. Moreover, this article has the highest ACY score in the T100 list. This shows that scientists are currently focused on immunotherapy. There are only 7 studies about immunotherapy in the T100, and the newest article in the T100 was published in Lancet 2017; 389: 255-265 by Rittmeyer, titled “Atezolizumab versus docetaxel in patients with previously treated non-small-cell lung cancer (OAK): a phase 3, open-label, multicentre randomised controlled trial”. It is only a 2-year-old article; however, it has 926 citations with an ACY score of 308.67. When we list the articles based on ACY scores in descending order, the first 4 articles are immunotherapy-related and recent articles.

The correlation analysis showed a positive correlation between citation and ACY and between ACY and IF, whereas a negative correlation was found between ACY and length of time since publication and between IF and length of time since publication. This indicates that articles with high ACY scores have been published in journals with a high IF. Furthermore, younger articles have higher ACY scores and have been published in journals with a higher IF.

When we looked at the T100 list, another point of interest also caught our attention: there were very few articles related to small-cell lung cancer (SCLC). Only 3 articles were on small-cell lung cancer [ 115 – 117 ]. This either means that there has not been any significant advance in SCLC or scientists are less interested in this topic.

To the best of our knowledge, this is the first report of a citation analysis of lung cancer in the English literature. The first 100 articles in our analysis not only identify landmark articles that have the greatest impact on lung cancer research, but also acknowledge the most productive authors and institutions that contributed to the list with their articles. Oncology is a developing field in science, and we have seen its evolution through the treatment of lung cancer over the years. Briefly, bibliometric analyses for different medical disciplines and sub-specialties demonstrate the improvements in a given field from a nominative perspective. The present bibliometric citation analysis on lung cancer has covered several scientific fields, and we believe it enables the systematic identification of true landmark publications as well as the distribution of citations of these publications by year, main topic, institution, scientific journal, level of evidence, and correlation analysis, thereby providing a substantial contribution for oncological research.

The authors declare no conflict of interest.

Lung Cancer Essay

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Brief Description: Lung cancer, as with all cancers, is an uncontrollable increase of cells. It happens within the lung tissue, but it could also go on to affect other nearby tissue and spread to further out than just the lungs. Cellular / Molecular Basis: Lung cancer has two types; small cell and non small cell. The two types can be identified by their appearance when looked at with a microscope. It usually affects the cells that are lined along air passages in the lungs. Causes: The foremost reason for lung cancer is cigarette smoking which causes around 90% of all deaths caused by lung cancer in the world. However, smoking is not the only way to get it. The second most frequent cause of lung cancer is exposure to radon gas, which …show more content…

Treatment: As long as the cancer has not spread to outside of the lung, it can be removed with surgical resection. There are now less invasive ways to remove cancer from the lungs, such as using a small video camera to see inside the chest, resulting in smaller incisions. There has very recently been a new way to treat non small cell lung cancer that would otherwise be inoperable. Shown to be more effective than normal radiation therapy and simply observing the cancers progress, stereotatic body radiation therapy can ???. Laser treatment is sometimes used to unblock air passages that are blocked by a tumour and attempt to control some spreading of the cancer cells. It is different to the other ‘treatments’ as it doesn’t actually provide a solution to getting rid of the cancer, but makes the symptoms more bearable for the patient. Preventative Measures: The main way to avoid having lung cancer is not to smoke and to avoid taking in second hand smoke, but also stay away from radon gas and asbestos. Certain types of mining and farming can cause exposure to harmful asbestos and radon. It is best to stay away from these kinds of fumes, dust and other dangerous chemicals. A certain nutrient called phytoestrogen which is found in legumes, whole grains, soy products and vegetables reduces the risk of developing lung cancer. Coal products,

Morbidity: Lung Cancer

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Small Cell Lung Cancer Essay

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Cigarette smoking is the major cause, although some people diagnosed with lung cancer have never smoked. Occupational exposures to asbestos, radon, hydrocarbons and metals (e.g. chromium, nickel) are also associated with lung cancer. The major way to prevent lung cancer is by not smoking or quitting smoking. However about 37% of Australians

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For this project I decided to research lung cancer. My grandfather had lung cancer for years and is cleared for now. One main cause of lung cancer is smoking. Heavier smokers have a bigger chance of getting this disease unlike light smokers. Young smokers also have a increasing risk of getting lung cancer too. When you are exposed to gases or if you are a welder; have an increasing chance. People ages 45 and 75 get lung cancer primarily.

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Lung cancer is one of the most common types of cancer. There are many ways that lung cancer is caused, it can be inherited, you could be exposed to chemicals that damage the cells and tissue in your lungs/air pollution and smoking. Smoking is the main cause of lung cancer as the chemical ‘carcinogens’ damages the cells within your lungs and is pumped out to the other organs in your body.

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Lung cancer is one of the leading causes of death around the world because of its high mortality rate. Smoking is a very common risk factor for lung cancer and other pulmonary diseases. Asthma, pulmonary tuberculosis (TB), and pneumonia are diseases in the lungs, which cause inflammation in the passages of air the lungs and are said to increase the risk of lung cancer, these diseases also affect people at any age.

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Lung cancer is the number one leading cause of cancer deaths in both American women and men in the US. Smoking causes most cases. If you smoke more cigarettes, or started smoking earlier, you have a greater risk of getting lung cancer (“Lung Cancer”). Too many people, 45 percent, believe that the disease is something people “bring on themselves” from either smoking or having smoked previously (“Lung Cancer; More than Half”). Even though smoking is the greatest risk factor for cancer, there are many other ways to get the disease, including exposure to second-hand smoke, radon, asbestos, and other chemicals (“Lung Cancer; Learning the Signs”). According to the site Obesity, Fitness, & Wellness Week, approximately 15 percent of newly diagnosed patients

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Smoking is not the only risk factor that causes lung cancer though. Asbestos and radon gas are other risk factors on getting lung cancer. Even work environments are areas that you can breathe in stuff that you aren’t suppose to. Air pollution can also be another risk factor on getting lung cancer as well. Experts believe that pollution from factories, power plants, and cars can affect the lungs like second hand smoke does. In the world air pollution has probably caused 223,000 lung cancer deaths.

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Recent advances in lung cancer research: unravelling the future of treatment

• Review Article
• Published: 06 April 2024

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• Luca Bertolaccini   ORCID: orcid.org/0000-0002-1153-3334 1 ,
• Monica Casiraghi 1 , 2 ,
• Clarissa Uslenghi 1 ,
• Sebastiano Maiorca 1 &
• Lorenzo Spaggiari 1 , 2  

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Lung cancer, a multifaceted disease, demands tailored therapeutic approaches due to its diverse subtypes and stages. This comprehensive review explores the intricate landscape of lung cancer research, delving into recent breakthroughs and their implications for diagnosis, therapy, and prevention. Genomic profiling and biomarker identification have ushered in the era of personalised medicine, enabling targeted therapies that minimise harm to healthy tissues while effectively combating cancer cells. The relationship between pulmonary tuberculosis and lung cancer is examined, shedding light on potential mechanisms linking these two conditions. Early detection methods, notably low-dose computed tomography scans, have significantly improved patient outcomes, emphasising the importance of timely interventions. There has been a growing interest in segmentectomy as a surgical intervention for early-stage lung cancer in recent years. Immunotherapy has emerged as a transformative approach, harnessing the body's immune system to recognise and eliminate cancer cells. Combining immunotherapy with traditional treatments, such as chemotherapy and targeted therapies, has shown enhanced efficacy, addressing the disease's heterogeneity and overcoming drug resistance. Precision medicine, guided by genomic profiling, has enabled the development of targeted therapies like tyrosine kinase inhibitors, offering personalised treatments tailored to individual patients. Challenges such as drug resistance and limited accessibility to advanced therapies persist, emphasising the need for collaborative efforts and innovative technologies like artificial intelligence. Despite challenges, ongoing interdisciplinary collaborations and technological advancements offer hope for a future where lung cancer is treatable and preventable, reducing the burden on patients and healthcare systems worldwide.

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Acknowledgements

This work was partially supported by the Italian Ministry of Health with Ricerca Corrente and 5x1000 funds.

Ministero della Salute, 5 × 1000, Ricerca Corrente.

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Bertolaccini, L., Casiraghi, M., Uslenghi, C. et al. Recent advances in lung cancer research: unravelling the future of treatment. Updates Surg (2024). https://doi.org/10.1007/s13304-024-01841-3

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Master of Science in Nursing in Psychiatric Mental Health Nurse Practitioner

The Master of Science in Nursing – Psychiatric Mental Health Nurse Practitioner online  from Ohio State prepares nurses to become psychiatric mental health nurse practitioners. Graduates can provide mental health and addiction services in various settings. The program focuses on evidence-based knowledge and skills necessary for their roles and accommodates part-time and full-time students. It meets the nurse practitioner curriculum guidelines and offers access to research and interdisciplinary collaboration.

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Each Ohio State Online Program is unique and have their own timelines for completion. This also varies based on how many credits you choose to take each semester. For more information or to estimate how long it will take to complete your degree, contact an enrollment advisor   https://online.osu.edu/request-information

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State authorization refers to regulations that impact online and on-ground education offered across state lines and programs that lead to state licenses or certifications. Compliance with these regulations ensures that an Ohio State degree will be recognized and that a student will be eligible to sit for licensure in states other than Ohio. Each state has unique authorization requirements, so Ohio State must review each state’s laws to ensure that the university is in compliance. At Ohio State, we have a team dedicated to researching regulations, seeking and maintaining compliance, communicating changes in authorization status, and disclosing state licensure and certification information.

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Ohio State’s MSN program admits online students once-per-year for the Autumn semester.

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Students must have a  Bachelor  of Science in Nursing ( BSN) degree from an ACEN/CCNE/CNEA-accredited institution to be eligible to apply . Applicants must also have an active RN license and a minimum of a 3.0 cumulative GPA on a 4.0 scale in the last degree earned relevant to the program of study.

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Your application will be reviewed comprehensively, considering all aspects of your qualifications. The list below outlines the attributes and experiences we consider:

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To apply for the online Master of Science in Nursing program applicants must complete the following prior to the application deadline:

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Ohio State is committed to treating applicants fairly and with dignity and respect. Please review Ohio State’s new  post-admissions policy .

The State Authorization Reciprocity Agreement, also known as  SARA , establishes uniform standards for distance education for all participating states and institutions. Ohio State joined SARA in 2015, which means Ohio State can offer most online and on-ground courses and programs in  SARA member states, districts and territories without seeking authorization in each state.

Career Outlook

The Master of Science in Nursing – Psychiatric Mental Health Nurse Practitioner at Ohio State prepares graduates for a robust and growing field. As mental health needs continue to rise, there is increasing demand for The Master of Science in Nursing Psychiatric Mental Health Nurse Practitioners who can provide specialized care and support. Graduates are well-positioned for roles in various settings, including hospitals, private practices, mental health clinics, and community health organizations. With their advanced skills in diagnosing and treating mental health conditions, Psychiatric Mental Health Nurse Practitioners are essential in improving patient outcomes and addressing mental health disparities. The program’s comprehensive training ensures graduates are ready to lead in the field and make a significant impact on mental health care.

Whether you’re looking to grow in your current career or make a career change altogether, Ohio State’s online programs can help you achieve your goals. Learn what the outlook is for your current or next career move using O*Net’s My Next Move tool.

NURSING 7410 – Advanced Health Assessment

Development of advanced health assessment skills. Emphasis on acquisition of pertinent assessment data across the life span for advanced nursing care for multiple specialties.

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Analysis of organizational leadership and ethical essentials necessary to deliver high quality patient care in diverse settings.

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Explores advanced concepts of collaboration, design, leadership, implementation and evaluation of quality improvement initiatives in health care utilizing information technology strategies.

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Kristine Browning PhD, APRN-CNP, FAANP

Dr. Kristine Browning’s national program of research includes the examination of underlying determinants of tobacco use in order to further understand tobacco use behavior. Her work has examined socioeconomic disparities among the delivery of smoking cessation assistance by healthcare providers. Evidence-based smoking cessation interventions, including assistance, should be systematically delivered to all patients who are current smokers. Dr. Browning’s other work in tobacco control includes examining how principles of acculturation contribute to how Hispanic men and women misclassify their smoking status and state of the science papers that summarize salient tobacco control topics in special populations such as HIV-positive, low socioeconomic, and immigrants. Continued smoking after a lung cancer diagnosis remains a significant problem as it contributes to poor disease and treatment-related outcomes. Although lung cancer is the leading cause of cancer mortality for both men and women, there is a paucity of smoking cessation intervention research with lung cancer patients. Dr. Browning’s research has examined smoking behaviors of lung cancer patients from the perspective of the Self-Regulation of Illness Representation and found that understanding the context in which a patient perceives their disease and smoking behavior may contribute to influencing behavior change. In addition, Dr. Browning has combined her clinical experience as an adult nurse practitioner in oncology care with examining salient patient related topics in cancer survivorship care.

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Samantha Ault PhD, APRN-CNOP, PMHNP-BC

Brandy McKinney DNP, APRN-BC, PMHNP-BC, FNP-C

Allison Brauch DNP, APRN-CNP, PMHNP-BC, AGNP-BC, CARN-AP

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