non small cell lung cancer prognosis



voiceover: i'm sure thatyou've heard people say things like "she's battling lung cancer". or "i'm fighting lung cancer". so, why don't you and i follow this idea? think about a strategy that you would use



non small cell lung cancer prognosis

non small cell lung cancer prognosis, if you were battling an enemy in a town. i know the first thing that i would do is figure out where my enemies are hiding so i know where to go to fight them.


and i'd also like to know ifi'm fighting a few enemies in one place, or a few groups of enemies in several locations,because this is gonna change the way that i fight them, right? well, this information onwhere and how many locations a mass of cancer cells islocated is called the "stage". well, i might use some sortof surveillance in the town to collect this information,like cameras or binoculars. i'm gonna use medical imaging instead,


in the lung cancer patient, to gain the informationon the cancer cells in the body that i'm looking for. the type of medical imaging that i'd use is computerized tomography scan. this is also frequently called a ct, or some people call it a cat scan. and it's just severalx-rays compiled together to generate a 3d view of the cancer cells.


or i might use an mri, whichis a magnetic resonance image. and it gives a similarimage to the ct scan, but it doesn't use radiationto take the picture. and finally, maybe i'd use a pet scan, or a positron emission tomography. it also gives a 3dimage, but it's based on highlighting the high metabolic activity of these rapidly dividing cancer cells. the first thing i'm gonnaask of these images is,


tell me the size of thecancer or the tumor, and where in the lung, or immediatelynear the lung, is it located? then i'll represent this information with a "t" for "tumor size". makes sense right? and i'll follow it with anumber one through four, where one means the tumoris less than the size of a quarter in american currency, and only in one smallconfined location in the lung.


all the way to four, where the cancer is in multiple locations in the same lung or it's begun to spreaddirectly nearby the lung. so, like here, in thefluid around the heart. and just like enemies inthe town would use streets to get around to new locations,cancer cells will migrate into lymph vessels and spread out. do you remember what lymph vessels are? they're vessels thatpick up the immune cells


and proteins that we'd findin tissues and bring them to lymph nodes located all over the body where fluid is screened for infections. in the chest, there's several lymph nodes. the mediastinal lymph nodes, here. and the hilar lymph nodes, here. and these lymph nodes are often the first places in thelymphatic system that the cancer cells fromthe lungs will travel.


makes sense, because they're so close. so, it's important to know if cancer cells are in lymph nodes here, or if they're in lymph nodes even furtheraway from the lungs. for this category ofinformation, i'm gonna use an "n" for node, followedby a number zero to three, where zero is gonna mean that there are no cancer cells present, currently. and three would mean thatcancer cells are present


in lymph nodes on both sides of the chest. but cancer cells in thelymph nodes nearby the lung is very different fromcancer cells that are spread to the bone or to the liveror to the brain, right? this happens in a processcalled metastasis. so the last categoryhere, that i'm interested in representing with an"m", will be followed by a number, either zeroor one, where zero means no metastasis has occurredand one means the cancer


has spread to one or manylocations outside the chest. so, this is really thorough information. and with so many combinations of numbers and letters, it mightget pretty confusing. if i told you that aperson's stage of cancer is "t4 n1 m0", and even though i know you understand what i'm saying now, sometimes medicalprofessionals will group these different combinations together and simply


tell a patient that theyhave "stage three" cancer. i'm not gonna go through the groupings because it gets messy,but i did wanna mention that tnm staging can be simplified. okay, but there are twotypes of lung cancers, non-small cell and small cell. and up until this moment,i haven't indicated that there's a differencein the staging systems between the two, but actually there is.


tnm staging is used mostly innon-small cell lung cancer. and there's a good reason for this. it's because non-small cell lung cancer tends to divide and spread a little bit slower than small cell lung cancer. so it's often diagnosedbefore it's too far advanced, meaning it hasn't spread all over. but a diagnosed small celllung cancer tends to be in multiple locations in the body already.


so, detailed information onstage isn't as important here. what's important is simply knowing. is the cancer contained to the chest, meaning the lungs and the lymph nodes? and if it is, it's called "limited stage". but if the cancer is alreadyspread outside the chest and in multiple locations in the body, it's called "extensive stage". in either case, thestage of the lung cancer


is gonna help decide things like prognosis and plan of attack with treatment.


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