VISION HEALTH

Vision Health
Whether you're interested in finding out more about what constitutes low vision, what macular degeneration is, or whether vision rehabilitation is something you should consider, Lighthouse International offers information and resources that can help. Learn more about our services and some of the most common eye disorders.

Macular Degeneration

As the most common cause of vision loss among people over the age of 60, macular degeneration impacts millions of older adults every year. The disease affects central vision and can sometimes make it difficult to read, drive or perform other activities requiring fine, detailed vision. Here, you'll find all you need to know about the disease, symptoms, diagnosis and treatments.

Read more about Macular Degeneration and other view simulations of other vision disorders.


Low Vision Defined

Vision loss that cannot be corrected by ordinary glasses, contact lenses, medication or surgery is called "low vision." Signs of low vision include:

•Difficulty recognizing a familiar face
•Difficulty reading - print appears broken or distorted
•Difficulty seeing objects and potential obstacles such as steps, curbs, walls and furniture
But people with low vision retain some usable vision. Ophthalmologists and optometrists specializing in low vision care can evaluate patients and prescribe optical devices to maximize remaining vision.



What Do You Do When You Meet Someone Who Can't See?

It's only natural to feel awkward when dealing with new situations. And, meeting someone with a vision impairment or any disability often causes feelings of discomfort and uncertainty. A little knowledge can go a long way in making you feel more at ease and better able to provide help if it's needed.

EYE DISEASES

When you think about it, the very act of actually seeing the world around us is an astonishing thing. It relies on the interaction between the brain and the eyeball, two extraordinarily complex organs, so it's hardly surprising that there are so many ways in which we can suffer sight loss or reduction.
Cataract
Cataract is the clouding of the eye's lens - the part of the eye responsible for focusing light and producing clear, sharp images.

Childhood blindness
Of the 45 million people worldwide who are blind, around 1.4 million are children under 16. The vast majority of childhood blindness happens before the age of five - a period when 75 per cent of learning is through sight.

Diabetic retinopathy
Diabetic retinopathy is the sixth most common cause of blindness globally, affecting 1.8 million people. It is caused by damage to the small blood vessels in the retina at the back of the eye.
Glaucoma
Glaucoma is the third biggest cause of blindness worldwide. It affects around 60 million people, of whom about 4.5 million have become blind. It is common in both developed and developing countries
Low vision
Low vision is when, even after medical treatment, people have difficulty distinguishing objects and/or distances. People with low vision can be helped by changes made to their environment, such as painting the edges of stairs white so they can be seen more easily, or specially made devices.
River blindness
River blindness is caused by a worm that breeds in fast-flowing rivers. It is a major cause of blindness in west and central Africa. Sightsavers is combating it with the drug Mectizan....

Trachoma
Trachoma is one of the most common causes of blindness in the developing world. It is linked to extreme poverty and poor sanitation.

TOP 10 MEDICAL SCHOOLS

1. Harvard University
2. Johns Hopkins University
3. University of Pennsylvania
4. Washington University in St. Louis
5. University of California San Francisco
6. University of Washington
7. Stanford University
8. Duke University
9. Yale University
10. Baylor College of Medicine (TX)
Columbia University College of Physicians and Surgeons (NY)


Top 10 medical schools (primary care)

1. University of Washington
2. University of North Carolina - Chapel Hill
3. University of Colorad-Denver and Health Sciences Center
4. Oregon Health and Science University
5. Mich. State U. Coll. of Osteopathic Medicine
6. East Carolina University (Brody, NC)
7. University of Vermont
8. University of California - San Francisco
9. University of Wisconsin Madison
10. University of Nebraska College of Medicine.

SPIDER VEINS

Laser treatment of spider veins

During laser treatment, a laser is applied to the skin over your spider veins. Laser energy causes your spider veins to coagulate and shrink. Laser therapy is most effective for small and medium size spider veins. Large spider veins respond poorly and are best treated with sclerotherapy. You are likely to experience mild discomfort similar to having a small rubber band snapping against skin. Treatments usually do not require sedatives, pain medications, or injections of local anesthetic. Immediately following treatment, spider veins will be darker and more visible. Over two to six weeks, your spider veins usually fade. After each treatment, you will see a 70% to 80% improvement in the appearance of face spider veins and 30-40% improvement in leg spider veins. An average of three treatments will be required at three-month
intervals to produce desired results. Combination therapy can be considered and beneficial if you have small, medium and large spider veins. You may wish to start with sclerotherapy, because sometimes all veins will be improved after injecting the larger ones. This may reduce the number of veins that need to be treated by laser and minimize your overall cost.

laser treatment spider veins

Spider Veins
Spider Veins vs. Varicose Veins
Spider veins, also called telangiectasias, are tiny visible vessels just underneath the skin. They develop most commonly on the face and legs. Varicose veins are distended veins beneath the skin. They may appear as bluish bumps and often cause discomfort. Those with unsightly varicose veins and aching pain often choose to have surgery to remove their varicose veins. Varicose veins are veins that are no longer functional, and their presence is not missed by the body. Ask your general surgeon about varicose vein treatment. If you have both varicose and spider veins, your varicose veins must be
treated first. Treating spider veins first is generally futile because, in the presence of varicose veins, they are bound to return soon.
Treatment Choices for Spider Veins of the Legs
The two options for spider vein treatment are sclerotherapy and laser. They can be employed independently or in combination.

Sclerotherapy (spider vein injection)

Sclerotherapy involves injecting a liquid agent through a tiny needle directly into your spider veins, causing them to contract and collapse. This procedure is best suited for medium to large spider veins because it relies upon fitting a tiny needle into a tiny vein. The procedure is performed in the office by a plastic surgeon or nurse and is relatively painless. Depending on the number of spider veins, the procedure may require five minutes to one hour. Afterward, you will wear ace bandages or compression hose for three to ten days as recommended by your plastic surgeon. You may resume sedentary activities immediately but should avoid exercise, hot baths and alcohol for two to three days. You should anticipate 50% improvement in spider veins following each sclerotherapy session. Expect that two to six sclerotherapy sessions at one to two month intervals may be necessary to achieve your desired results. Understand that some
spider veins may never be successfully treated through sclerotherapy.

LIST OF HOSPITALS IN PAKISTAN(SINDH)

Public institutions
Abbasi Shaheed Hospital, Karachi
Civil Hospital, Karachi
Civil Hospital, Sukkur
Civil Hospital - Burns Centre, Karachi, [6]
Habib Medical Centre, Karachi
Jinnah Postgraduate Medical Centre Karachi
Karachi Institute of Heart Diseases, Karachi
Kunri Christian Hospital, Umarkot
Lady Dufferin Hospital, Karachi
Leprosy Hospital, Karachi
Liaqat University of Health Sciences, Hyderabad
Lyari General Hospital, Karachi
National Institute of Cardiovascular Diseases, Karachi, [7]
National Institute of Child Health, Karachi
PNS Shifa, Karachi
Police Hospital, Karachi
Sindh Government Qatar Hospital, Karachi
Sindh Government Hospital New Karachi, Karachi
Sindh Institute of Skin Diseases, Karachi
Sindh Institute of Urology and Transplantation (SIUT), Karachi, [8]
Sindh Institute of Skin Diseases, Karachi
Sir Cowasjee Jehangir Institute of Psychiatry, Hyderabad
Sobhraj Maternity Home, Karachi
Spencer Eye Hospital, Karachi

[edit] Private institutions
ABM Hospital, Hyderabad
Aga Khan Hospital, Hyderabad
Aga Khan University Hospital, Karachi, [9]
Baqai Hospital,Karachi
Bismillah Taqee Institute of Health Sciences & Blood Diseases Centre, Karachi, [10]
Bantwa Memon Hospital, Karachi
Burhani Hospital, Karachi, [11]
Children Cancer Hospital, Karachi, [12]
CityCare Hospital, Hyderabad
Dar-ul-Sehat Hospital, (Liaquat Medical & Dental College) Karachi, [13]
Hamdard University Hospital, Karachi
Health Care Hospital, Karachi
Hilal-e-Ahmar Hospital, Hyderabad
Holy Family Hospital, Karachi
Al-Ibrahim Eye Hospital, Karachi [14]
Ibne-Sina (Avicenna) Hospital, Karachi
Imam Clinic and General Hospital, Karachi
Indus Hospital, Karachi, [15]
Isra University Hospital, Hyderabad
Ibrahim hospital Sargodha, Pakistan
Jinnah Medical College Hospital, Karachi
Karachi Adventist Hospital, Karachi, [16]
Kharadar General Hospital, Karachi
Kidney Centre Post Graduate Training Institute, Karachi, [17]
Kiran Hospital for Nuclear Medicine, Karachi
Kutiana Memon Hospital, Karachi
Layton Rahmatulla Benevolent Trust Eye Hospital, (LRBT) Karachi, [18]
Liaquat National Hospital, Karachi[19]
Majee Hospital, Hyderabad
Marie Adelaide Leprosy Centre (MALC), Karachi, [20]
Al-Mehrab Tibbi Imdad, Karachi
Masoomeen Hospital, Karachi
MidEast Hospital, Karachi
MediConnect, Karachi, [21]
Murshid Hospital and Health Care Center, Karachi
OMI Hospital, Karachi
Patel Hospital, Karachi
Saifee Hospital (Karachi), Karachi, [22]
Shilokh Mission Hospital, Jalapur Jattan, Gujrat
South City Hospital, Karachi
Tabba Heart Institute, Karachi, [23]

LIST OF HOSPITALS IN PAKISTAN(PRIVATE)

Punjab.

Aadil Hospital, Lahore
Ali General Hospital, Multan
Ali Hospital, Lahore
Alle-Hussain Trust Hospital , Lahore
Al-Shifa Trust Eye Hospital, Rawalpindi
Ammar Medical Complex, Lahore
Aziz Bhatti Shaheed Hospital, Gujrat
Aziz Medical Complex, Sialkot, [2]
Al-Arsalan Clinic, Rawalpindi
Bahawal Victoria Hospital, Bahawalpur
Bait-Ul-Shifa Trust, Township, Lahore
Bakhtawar Amin Memorial Trust Hospital, Multan, [3]
Chattha Hospital Gujranwala
Doctor'S Hospital, Lahore
Doctor'S Hospital, Gujrat
Faisal Hospital,Multan
Family Hospital, Lahore
Fatima Medical Centre, Multan
Fatima Memorial, Lahore
Fauji Foundation Hospital, Lahore
Fauji Foundation Hospital, Rawalpindi
Fazal Hospital, Jhelum
Geo Hospital, Lahore
Gujrat Hospital, Gujrat
Gulberg Hospital, Lahore
Hameed Latif Hospital, Lahore
Healers Centre, Rawalpindi
Heart And City Scan Hospital, Lahore
Hearts International Hospital, Rawalpindi
Ihsan Mumtaz Hospital, Lahore
Idrees Hosipital,Sialkot
Iqraa Medical Complex, Lahore
Irshad Begum Chattha Hospital, Wazirabad
Ittefaq Hospital (Trust), Lahore
Jaanki Devi Hospital, Lahore
Khan Surgecal Center, Ali Pur Road, Muzaffar Garh
Life Medical Complex (Dr. Hafeez-Ur-Rehman), Gujrat
Malik Haider Hospital, Lady Dr. Salvi Malik, Gujrat
Malik Surgical Hospital, Lahore
Margalla Welfare Hospital, Rawalpindi
Maryam Memorial Hospital, Rawalpindi
Masood Children'S Clinic, Lahore
Masood Hospital,Gardentown, Lahore
Medicare Hospital, Multan
Mekki Hospital, Faisalabad
Memorial Christian Hospital, Paris Road, Sialkot
Mian Muhammad Trust Hospital, Faisalabad
Muazzam Shaheed Welfare Hospital, Jhelum
Mubarik Nursing Home, Rawalpindi
Mumtaz Bakhtawar Memorial Trust Hospital, Lahore
Nanotech Neurology Psychiatry and Joint Pain Center, Lahore
National Hospital, Faisalabad
National Hospital and Medical Centre, Lahore, [4]
Rasheed Hospital, Lahore
Razzaq Hospital, Lahore
Redo Hospital, Rawalpindi, [5]
Saahil Hospital, Faisalabad
Sadiq Hospital, Sargodha
Salamat Hospital, Gujranwala
Shalimar Hospital, Lahore
Sharif Meidcal City Hospital, Lahore
Shaukat Khanum Hospital, Lahore
Sialkot Medical Complex Sialkot
South Asia Institute for Human Sexuality, Rawalpindi
Sughra Hospital,Jhelum
Suhail Eye Hospital, Lahore
Surgimed Hospital, Zafar Ali Road, Lahore
Times Hospital, Lahore
Turab Hospital Complex, Township, Lahore
Umer Hospital, Wah
United Christian Hospital, Lahore
Valley Clinic, Rawalpindi
Wapda Hosital, Lahore
Zeenat Clinical Labs, Lahore, Lahore

LIST OF HOSPITALS IN PAKISTAN(PUNJAB)

Public institutions (government owned and operated)
Allama Iqbal Memorial Hospital Sialkot
D.H.Q Hospital,Muzaffargarh
Data Darbar Hospital, Lahore
District Headquarters Hospital, Rawalpindi
Fatima Memorial Hospital, Shadman-Lahore
Gulaab Devi Hospital, Lahore
Holy Family Hospital, Rawalpindi
HOPE Rehabilitation Center for disabled, Lahore
DAWN REHABILITATION CENTER FOR DISABLED, Lahore
www.dawnrehabilitation.com
Jinnah Hospital, Lahore
Lady Aitchison Hospital, Lahore
Lady Willingdon Hospital, Lahore
Lahore General Hospital, Lahore
Mayo Hospital, Lahore
Nisthar Hospital, Multan
Psychiatric hospital, Lahore
Punjab Institute of Cardiology PIC, Lahore Pakistan
Railway Cairns Hospital, Lahore
Rawalpindi General Hospital, Rawalpindi
Sardar Begum Memorial Hospital Sialkot
Services Hospital, Lahore
Sheikh Zayed Hospital, Lahore
Sir Ganga Ram Hospital, Lahore
The Children's Hospital, Lahore

LIST OF HOSPITALS IN PAKISTAN(NWFP)

Public institutions
Lady Reading Hospital[citation needed]
Khyber Teaching Hospital[citation needed]
Hayatabad Medical Complex[citation needed]
Ayub Medical Complex[citation needed]
Mardan Medical Complex[citation needed]
Saidu Group Hospitals, Swat[citation needed]
Mufti Mehmood Complex, Dera Ismail Khan[citation needed]
Tank Christian Hospital, Tank, Dera Ismail Khan[citation needed]
Dr. Murad Ali Ultrasound Clinic, Dabgari Garden, Peshawar

LIST OF HOSPITALS IN PAKISTAN(ISLAMABAD)

Federal Government Services Hospital[citation needed]
Golra Welfare Hospital (Ghosia-Mahria Trust)[citation needed]
Pakistan Institute of Medical Sciences[2] (PIMS)
PAEC Hospital[citation needed]
Nescom Hospital[citation needed]
KRL Hospital[citation needed]
National Institute of Health[3]
CDA Hospital[citation needed]

Private institutions
Dr.Arshad Health Associates-Medical Facilities"Dr Arshad Health Associates". .
Integrated Health Services (IHS Pakistan)[citation needed]
IHS Children's Medical Center[citation needed]
Islamic International Medical Complex[citation needed]
Dar-ul-Shifa Hospital[citation needed]
Shifa International Hospital[4]
Ali Medical Centre,[citation needed], F-8 Markaz
Islamabad Specialist Clinic,[citation needed] F-8
Aslam Memorial Medicare Hospital[citation needed]
Islamabad Private Hospital[citation needed], Blue Area
Chee Chee Hospital[citation needed]
Elahi Medical Center,[citation needed] G-9/4

LIST OF HOSPITALS IN PAKISTAN(ISLAMABAD)

Federal Government Services Hospital[citation needed]
Golra Welfare Hospital (Ghosia-Mahria Trust)[citation needed]
Pakistan Institute of Medical Sciences[2] (PIMS)
PAEC Hospital[citation needed]
Nescom Hospital[citation needed]
KRL Hospital[citation needed]
National Institute of Health[3]
CDA Hospital[citation needed]

Private institutions
Dr.Arshad Health Associates-Medical Facilities"Dr Arshad Health Associates". .
Integrated Health Services (IHS Pakistan)[citation needed]
IHS Children's Medical Center[citation needed]
Islamic International Medical Complex[citation needed]
Dar-ul-Shifa Hospital[citation needed]
Shifa International Hospital[4]
Ali Medical Centre,[citation needed], F-8 Markaz
Islamabad Specialist Clinic,[citation needed] F-8
Aslam Memorial Medicare Hospital[citation needed]
Islamabad Private Hospital[citation needed], Blue Area
Chee Chee Hospital[citation needed]
Elahi Medical Center,[citation needed] G-9/4

LIST OF HOSPITALS IN PAKISTAN(ISLAMABAD)

Federal Government Services Hospital[citation needed]
Golra Welfare Hospital (Ghosia-Mahria Trust)[citation needed]
Pakistan Institute of Medical Sciences[2] (PIMS)
PAEC Hospital[citation needed]
Nescom Hospital[citation needed]
KRL Hospital[citation needed]
National Institute of Health[3]
CDA Hospital[citation needed]

Private institutions
Dr.Arshad Health Associates-Medical Facilities"Dr Arshad Health Associates". .
Integrated Health Services (IHS Pakistan)[citation needed]
IHS Children's Medical Center[citation needed]
Islamic International Medical Complex[citation needed]
Dar-ul-Shifa Hospital[citation needed]
Shifa International Hospital[4]
Ali Medical Centre,[citation needed], F-8 Markaz
Islamabad Specialist Clinic,[citation needed] F-8
Aslam Memorial Medicare Hospital[citation needed]
Islamabad Private Hospital[citation needed], Blue Area
Chee Chee Hospital[citation needed]
Elahi Medical Center,[citation needed] G-9/4

LIST OF HOSPITALS IN PAKISTAN(BALOCHISTAN)

Mid East Hospital , Al Gilani Road, Quetta Tel:081-2821103-5
Akram Hospital, Quetta[citation needed]
Children's Hospital, Quetta[1]
Sardar Bahadur Khan TB Sanatorium, Quetta[citation needed]
Civil Hospital, Quetta[citation needed]
Sahib-uz-Zaman Hospital, Alamdar Road, Quetta[citation needed]
Asghar Hospital, Alamdar Road, Quetta[citation needed]
Ali Hospital, Toghi Road, Quetta[citation needed]
Al-Noor Hospital, Toghi Road, Quetta[citation needed]
Saleem Medical Complex, Double Road, Quetta[citation needed]
Railway Hospital, Quetta[citation needed]

LUNGS CANCER PREVENTION AND TREATMENT

Prevention of lung cancer includes quitting smoking and avoiding exposure to potentially cancer-causing substances in the work environment.

Doctors use various treatments for both small cell and non–small cell lung cancer. Surgery, chemotherapy, and radiation therapy can be used individually or in combination. The precise combination of treatments depends on the type, location, and severity of the cancer, whether the cancer has spread, and the person's overall health. For example, in some people with advanced non–small cell lung cancer, treatment includes chemotherapy and radiation therapy before, after, or instead of surgical removal. Some people with non–small cell lung cancer survive significantly longer when treated with chemotherapy, radiation therapy, or some of the newer targeted therapies. Targeted therapies include drugs, such as biologic agents that specifically target lung tumors. Recent studies have identified proteins within cancer cells and the blood vessels that nourish the cancer cells. These proteins may be involved in regulating and promoting cancer growth and metastasis. Drugs have been designed to specifically affect the abnormal protein expression and potentially kill the cancer cells or inhibit their growth. For example, doctors may give epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors to people who have not responded to traditional chemotherapy regimens. Some people may receive vascular endothelial growth factor (VEGF) and VEGF receptor inhibitors in combination with standard chemotherapy regimens.

Laser therapy, in which a laser is used to remove or reduce the size of lung tumors, and photodynamic therapy, in which light is used to shrink tumors, are sometimes used. Radiofrequency ablation, in which an electrical current is used to destroy tumor cells, can sometimes be used in people who have small tumors or are unable to undergo surgery.

Surgery: Surgery is the treatment of choice for non–small cell lung cancer that has not spread beyond the lung (early-stage disease). In general, surgery is not used for early-stage small cell lung cancer, because this aggressive cancer requires chemotherapy and radiation therapy. Surgery may not be possible if the cancer has spread beyond the lungs, if the cancer is too close to the windpipe, or if the person has other serious conditions (such as severe heart or lung disease).

Before surgery, doctors do pulmonary function tests (see Symptoms and Diagnosis of Lung Disorders: Pulmonary Function Testing (PFT)) to determine whether the amount of lung remaining after surgery will be able to provide enough oxygen and breathing function. If the test results indicate that removing the cancerous part of the lung will result in inadequate lung function, surgery is not possible. The amount of lung to be removed is decided by the surgeon, with the amount varying from a small part of a lung segment to an entire lung.

Although non–small cell lung cancers can be removed surgically, removal does not always result in a cure. Supplemental (adjuvant) chemotherapy after surgery can help increase the survival rate.

Occasionally, cancer that begins elsewhere (for example, in the colon) and spreads to the lungs is removed from the lungs after being removed at the source. This procedure is recommended rarely, and tests must show that the cancer has not spread to any site outside of the lungs.

Radiation Therapy: Radiation therapy is used in both non-small cell and small cell lung cancers. It may be given to people who do not want to undergo surgery, who cannot undergo surgery because they have another condition (such as severe coronary artery disease), or whose cancer has spread to nearby structures, such as the lymph nodes. Although radiation therapy is used to treat the cancer, in some people, it may only partially shrink the cancer or slow its growth. Combining chemotherapy with radiation therapy improves survival in this group. People with limited or extensive-stage small cell lung cancer who have been responding well to chemotherapy may benefit from radiation therapy to the head to prevent spread of cancer to the brain. If the cancer has already spread to the brain, radiation therapy of the brain is commonly used to reduce symptoms such as headache, confusion, and seizures. Radiation therapy is also useful for controlling the complications of lung cancer, such as coughing up of blood, bone pain, superior vena cava syndrome, and spinal cord compression.

Chemotherapy: Chemotherapy is used in both non-small cell and small cell lung cancers. In small cell lung cancer, chemotherapy, sometimes coupled with radiation therapy, is the main treatment. This approach is preferred because small cell lung cancer is aggressive and has often spread to distant parts of the body by the time of diagnosis. Chemotherapy can prolong survival in people who have extensive-stage disease. Without treatment, the median survival is only 6 to 12 weeks.

In non–small cell lung cancer, chemotherapy also prolongs survival and treats symptoms. In people with non–small cell lung cancer that has spread to other parts of the body, the median survival increases to 9 months with treatment. Targeted therapies may also improve cancer patient survival.

Other Treatments: Other treatments are often needed for people who have lung cancer. Because many people who have lung cancer have a substantial decrease in lung function whether or not they undergo treatment, oxygen therapy (see Rehabilitation for Lung and Airway Disorders: Oxygen Therapy) and bronchodilators (drugs that widen the airways) may aid breathing. Many people with advanced lung cancer develop such extreme pain and difficulty in breathing that they require large doses of opioids in the weeks or months before their death. Fortunately, opioids can substantially relieve pain if adequate doses are used.

DIAGNOSIS

Doctors explore the possibility of lung cancer when a person, especially a smoker, has a persistent or worsening cough or other lung symptoms (such as shortness of breath or coughed-up sputum tinged with blood). Usually, the first test is a chest x-ray, which can detect most lung tumors, although it may miss small ones. Sometimes a shadow detected on a chest x-ray done for other reasons (such as before surgery) provides doctors with the first clue, although such a shadow is not proof of cancer.

A computed tomography (CT) scan may be done next. CT scans can show characteristic patterns that help doctors make the diagnosis. They also can show small tumors that are not visible on chest x-rays and reveal whether the lymph nodes inside the chest are enlarged. Newer techniques, such as positron emission tomography (PET—see Symptoms and Diagnosis of Lung Disorders: Chest Imaging) and a certain type of CT called helical (spiral) CT, are improving the ability to detect small cancers. Oncologists frequently use PET-CT scanners, which combine the PET and CT technology in one machine, to evaluate patients with suspected cancer. Magnetic resonance imaging (MRI) can also be used if the CT or PET-CT scans do not give doctors sufficient information.

A microscopic examination of lung tissue from the area that may be cancerous is usually needed to confirm the diagnosis. In rare cases, a sample of coughed-up sputum can provide enough material for an examination (called sputum cytology). Almost always, doctors need to obtain a sample of tissue directly from the tumor. One common way to obtain the tissue sample is with bronchoscopy. The person's airway is directly observed and samples of the tumor can be obtained (see Symptoms and Diagnosis of Lung Disorders: Bronchoscopy). If the cancer is too far away from the major airways to be reached with a bronchoscope, doctors can usually obtain a specimen by inserting a needle through the skin while using CT for guidance. This procedure is called a needle biopsy (see Symptoms and Diagnosis of Lung Disorders: Needle Biopsy of the Pleura or Lung). Sometimes, a specimen can only be obtained by a surgical procedure called a thoracotomy (see Symptoms and Diagnosis of Lung Disorders: Thoracotomy). Doctors may also perform a mediastinoscopy, in which they take and examine samples of enlarged lymph nodes (a biopsy) from the center of the chest to determine if inflammation or cancer is responsible for the enlargement.

Once cancer has been identified under the microscope, doctors usually do tests to determine whether it has spread. A PET-CT scan and head imaging (brain CT or MRI) may be done to determine if lung cancer has spread, especially to the liver, adrenal glands, or brain. If a PET-CT is not available, CT scans of the chest, abdomen, and pelvis and a bone scan are done. A bone scan may show that cancer has spread to the bones. Because small cell lung cancer can spread to the bone marrow, doctors sometimes also do a bone marrow biopsy.

Cancers are categorized on how large the tumor is, whether it has spread to nearby lymph nodes, and whether it has spread to distant organs. The different categories are used to determine the stage of the cancer (see Symptoms and Diagnosis of Cancer: Diagnostic Tests and Staging). The stage of a cancer suggests the most appropriate treatment and enables doctors to estimate the person's prognosis.

Screening: Clinical trials are underway to determine the value of screening tests to detect lung cancer in people who do not have any symptoms. These trials use chest x-rays, CT scans, sputum examinations, or all these methods to try to detect cancer when it is at an early stage. However, screening so far has not been shown to improve lung cancer detection, and therefore screening is not recommended for people who have no risk factors and no symptoms. Tests can be expensive and cause people undue worry if they produce false-positive results that incorrectly imply that a cancer is present. The opposite is also true. A screening test can give a negative result when a cancer really does exist. For these reasons, it is important for doctors to try to accurately determine a person's risk for a particular cancer before screening tests are done (see Symptoms and Diagnosis of Cancer: Screening).

LUNG CANCER SYMPTOMS

The symptoms of lung cancer depend on its type, its location, and the way it spreads. One of the more common symptoms is a persistent cough or, in people who have a chronic cough, a change in the character of the cough. Some people cough up blood or sputum streaked with blood (hemoptysis—see Symptoms and Diagnosis of Lung Disorders: Hemoptysis). Rarely, lung cancer grows into an underlying blood vessel and causes severe bleeding. Additional nonspecific symptoms of lung cancer include loss of appetite, weight loss, fatigue, chest pain, and weakness.

Complications: Lung cancer may cause wheezing by narrowing the airway. Blockage of an airway by a tumor may lead to the collapse of the part of the lung that the airway supplies, a condition called atelectasis (see Atelectasis). Other consequences of a blocked airway are shortness of breath and pneumonia, which may result in coughing, fever, and chest pain. If the tumor grows into the chest wall, it may produce persistent, unrelenting chest pain. Fluid containing cancerous cells can accumulate in the space between the lung and the chest wall (pleural effusions—see Pleural Disorders: Pleural Effusion). Large amounts of fluid can lead to shortness of breath. If the cancer spreads throughout the lungs, the levels of oxygen in the blood drop and become low, causing shortness of breath and eventually enlargement of the right side of the heart and possible heart failure (cor pulmonale—see Pulmonary Hypertension:Pulmonary Hypertension).

Lung cancer may grow into certain nerves in the neck, causing a droopy eyelid, small pupil, sunken eye, and reduced perspiration on one side of the face—together these symptoms are called Horner's syndrome (see Autonomic Nervous System Disorders: Horner's Syndrome). Cancers at the top of the lung may grow into the nerves that supply the arm, making the arm painful, numb, and weak. Tumors in this location are often called Pancoas't tumors. When the tumor grows into nerves in the center of the chest, the nerve to the voice box may become damaged, making the voice hoarse.

Lung cancer may grow into or near the esophagus, leading to difficulty swallowing or pain with swallowing.

Lung cancer may grow into the heart or in the midchest (mediastinal) region, causing abnormal heart rhythms, blockage of blood flow through the heart, or fluid in the sac surrounding the heart (pericardial sac).

The cancer may grow into or compress one of the large veins in the chest (the superior vena cava); this condition is called superior vena cava syndrome. Obstruction of the superior vena cava causes blood to back up in other veins of the upper body. The veins in the chest wall enlarge. The face, neck, and upper chest wall—including the breasts—can swell, causing pain. The condition can also produce shortness of breath, headache, distorted vision, dizziness, and drowsiness. These symptoms usually worsen when the person bends forward or lies down.

Lung cancer may also spread through the bloodstream to other parts of the body, most commonly the liver, brain, adrenal glands, spinal cord, or bones. The spread of lung cancer may occur early in the course of disease, especially with small cell lung cancer. Symptoms—such as headache, confusion, seizures, and bone pain—may develop before any lung problems become evident, making an early diagnosis more complicated.

Paraneoplastic syndromes (see What Are Paraneoplastic Syndromes?) consist of effects that are caused by cancer but occur far from the cancer itself, such as in nerves and muscles. These syndromes are not related to the size or location of the lung cancer and do not necessarily indicate that the cancer has spread outside the chest. These syndromes are caused by substances secreted by the cancer (such as hormones, cytokines, and various other proteins).

LUNG CANCER SYMPTOMS

The symptoms of lung cancer depend on its type, its location, and the way it spreads. One of the more common symptoms is a persistent cough or, in people who have a chronic cough, a change in the character of the cough. Some people cough up blood or sputum streaked with blood (hemoptysis—see Symptoms and Diagnosis of Lung Disorders: Hemoptysis). Rarely, lung cancer grows into an underlying blood vessel and causes severe bleeding. Additional nonspecific symptoms of lung cancer include loss of appetite, weight loss, fatigue, chest pain, and weakness.

Complications: Lung cancer may cause wheezing by narrowing the airway. Blockage of an airway by a tumor may lead to the collapse of the part of the lung that the airway supplies, a condition called atelectasis (see Atelectasis). Other consequences of a blocked airway are shortness of breath and pneumonia, which may result in coughing, fever, and chest pain. If the tumor grows into the chest wall, it may produce persistent, unrelenting chest pain. Fluid containing cancerous cells can accumulate in the space between the lung and the chest wall (pleural effusions—see Pleural Disorders: Pleural Effusion). Large amounts of fluid can lead to shortness of breath. If the cancer spreads throughout the lungs, the levels of oxygen in the blood drop and become low, causing shortness of breath and eventually enlargement of the right side of the heart and possible heart failure (cor pulmonale—see Pulmonary Hypertension:Pulmonary Hypertension).

Lung cancer may grow into certain nerves in the neck, causing a droopy eyelid, small pupil, sunken eye, and reduced perspiration on one side of the face—together these symptoms are called Horner's syndrome (see Autonomic Nervous System Disorders: Horner's Syndrome). Cancers at the top of the lung may grow into the nerves that supply the arm, making the arm painful, numb, and weak. Tumors in this location are often called Pancoas't tumors. When the tumor grows into nerves in the center of the chest, the nerve to the voice box may become damaged, making the voice hoarse.

Lung cancer may grow into or near the esophagus, leading to difficulty swallowing or pain with swallowing.

Lung cancer may grow into the heart or in the midchest (mediastinal) region, causing abnormal heart rhythms, blockage of blood flow through the heart, or fluid in the sac surrounding the heart (pericardial sac).

The cancer may grow into or compress one of the large veins in the chest (the superior vena cava); this condition is called superior vena cava syndrome. Obstruction of the superior vena cava causes blood to back up in other veins of the upper body. The veins in the chest wall enlarge. The face, neck, and upper chest wall—including the breasts—can swell, causing pain. The condition can also produce shortness of breath, headache, distorted vision, dizziness, and drowsiness. These symptoms usually worsen when the person bends forward or lies down.

Lung cancer may also spread through the bloodstream to other parts of the body, most commonly the liver, brain, adrenal glands, spinal cord, or bones. The spread of lung cancer may occur early in the course of disease, especially with small cell lung cancer. Symptoms—such as headache, confusion, seizures, and bone pain—may develop before any lung problems become evident, making an early diagnosis more complicated.

Paraneoplastic syndromes (see What Are Paraneoplastic Syndromes?) consist of effects that are caused by cancer but occur far from the cancer itself, such as in nerves and muscles. These syndromes are not related to the size or location of the lung cancer and do not necessarily indicate that the cancer has spread outside the chest. These syndromes are caused by substances secreted by the cancer (such as hormones, cytokines, and various other proteins).

LUNGS CANCER TREATMENT

Cigarette smoking is the most common cause of lung cancer.
One common presenting symptom is a persistent cough.
Chest x-rays can detect most lung cancers, but other additional imaging tests and biopsies are needed.
Surgery, chemotherapy, targeted agents, and radiation therapy may all be used to treat lung cancer.

Lung cancer is the leading cause of cancer death in both men and women. It occurs most commonly between the ages of 45 and 70, and has become more prevalent in women in the last few decades because more women are smoking cigarettes.

Cancer that originates from lung cells is called a primary lung cancer. Primary lung cancer can start in the airways that branch off the trachea to supply the lungs (the bronchi) or in the small air sacs of the lung (the alveoli). Cancer may also spread (metastasize) to the lung from other parts of the body (most commonly from the breasts, colon, prostate, kidneys, thyroid gland, stomach, cervix, rectum, testes, bone, or skin).

There are two main categories of lung cancer.

Non–small cell lung carcinoma: About 85 to 87% of lung cancers are in this category. This cancer grows more slowly than small cell lung carcinoma. Nevertheless, by the time about 40% of people are diagnosed, the cancer has spread to other parts of the body outside of the chest. The most common types of non–small cell lung carcinoma are squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.
Small cell lung carcinoma: Also called oat cell carcinoma, this cancer accounts for about 13 to 15% of all lung cancers. It is very aggressive and spreads quickly. By the time that most people are diagnosed, the cancer has metastasized to other parts of the body.


Causes

Cigarette smoking is the leading cause of cancer, accounting for about 85% of all lung cancer cases. About 10% of all smokers (former or current) eventually develop lung cancer, and both the number of cigarettes smoked and number of years of smoking seem to correlate with the increased risk. In people who quit smoking, the risk of developing lung cancer decreases, but former smokers will still always have a higher risk of developing lung cancer than people who never smoked.

About 15% of people who develop lung cancer have never smoked. In these people, the reason why they develop lung cancer is unknown. Recent studies have found that some people with lung cancer who have never smoked have genetic mutations in the epidermal growth factor receptor (EGFR) gene. Although an environmental association has not clearly been established, it is believed that exposure to radon gas in the home may be a risk factor. Other possible risk factors include exposure to secondhand smoke and exposure to carcinogens such as asbestos, radiation, arsenic, chromates, nickel, chloromethyl ethers, mustard gas, or coke-oven emissions, encountered or breathed in at work. It is believed that the risk of contracting lung cancer is greater in people who are exposed to these substances and who also smoke cigarettes. Air pollution and cigar smoke also contain carcinogens, and exposure to these substances is associated with an increased risk of cancer. In rare incidences, lung cancers, especially adenocarcinoma and bronchioloalveolar cell carcinoma (a type of adenocarcinoma), develop in people whose lungs have been scarred by other lung disorders, such as tuberculosis.