Cancer revised

Lung Cancer- Large-Cell Carcinoma (LCC )
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Institution

Contents
TOC o “1-3” h z u Abstract PAGEREF _Toc504198566 h 3INTRODUCTION PAGEREF _Toc504198567 h 4Background data PAGEREF _Toc504198568 h 4BODY PAGEREF _Toc504198569 h 6Getting cancer. PAGEREF _Toc504198570 h 6Morbidity Rates Related to Cancer PAGEREF _Toc504198571 h 7Problem PAGEREF _Toc504198572 h 8Lung Cancer PAGEREF _Toc504198573 h 9Primary Lung Cancer PAGEREF _Toc504198574 h 9Large-cell carcinoma (LCC) PAGEREF _Toc504198575 h 10Diagnosis PAGEREF _Toc504198576 h 12Patterns of Large-cell carcinoma PAGEREF _Toc504198577 h 12CONCLUSION PAGEREF _Toc504198578 h 13Hypothesis PAGEREF _Toc504198579 h 13Discussion PAGEREF _Toc504198580 h 13Data Gaps and Future Research PAGEREF _Toc504198581 h 17References PAGEREF _Toc504198582 h 19
AbstractThis paper depicts a clear understanding of the formation of cancerous cells and their general significance in the society. The different types of cancerous cell and their formation are further analyzed and the respective factors that predispose people to these cells also highlighted. It narrows down to Large-cell carcinoma which is an example of the Non-Small Cell Lung Cancer. Creates an understanding of the major epidemiology and demographic factors influencing identification, treatment and management of the disease. It also highlights why the disease is termed as a global epidemic. The paper further examines the trends in relation to medical practice in relation to Large-cell carcinoma and socio-demographic factors affecting the interaction of the two in relation to.

The paper further analyzes the different scholarly reviews in relation to the trends of Large-cell carcinoma and how they affect perception and medical practice in most health facilities. In conclusion the major challenges facing the study and justification of the identified hypothesis are discussed in relation to their relevance to management and control of LCC.
INTRODUCTIONThis is a disease that involves the abnormal growth of cells in a way that does not conform to the normal cell growth and cell division criteria. Cell division is determined by pre-exposed signals that determine the way they divide or die. Cancerous cells on the other side develop a certain proficiency and autonomy over these signals. Thus they grow and proliferate in an uncontrolled way throughout the body of the organism. This spreading process is referred to as metastasis. The autonomy of cancer over the cell management signals is as a result of certain changes in DNA composition (DNA mutations).
Background dataCancer originates from this change in the sequence of the DNA that gives the cells autonomy over signals responsible for their formation and disintegration. These mutations occur in a successive manner resulting in the growth of a tumor. The tumor mass grows in massive size due to the continued proliferation until it eventually explodes beyond the basal membrane and starts to affect other parts of the organism’s body. At this rate the tumor affects the functionality of the normal body tissues and the overall body organs resulting in death due to operational failure.
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Fig 1; Mutation of the cancerous cells
Source; https://www.elsevier.com/__data/assets/pdf_file/0019/230374/Elsevier-CancerResearchReport.pdfThe most predominantly raised question is how can we determine the prevalence of cancer and curb its growth using the most effective medical and psychological approaches. Early detection efforts and approaches are already in place to try and curb this menace.
Cancer is definitely among the most lethal of chronic diseases. This has fostered the establishment of techniques such as screening in order to curb the menace. For example, the successful screening tests and mammograms has facilitated the drastic reduction of breast cancer rates in the United States (WHO 2017). Cancer causes a very massive global economic impact significance with the recent estimation by the WHO ranging from $1.18 trillion dollars.
BODYGetting cancer.There are different cancer types and the resultant effects and ways of acquisition revolve around various factors. These factors are mainly categorized based on behavioral factors, genetic composition, and the environmental surroundings. Cancer is most prevalent to people with the following characteristics:
Genetic inherited cancerous genes.
The surrounding environment
Individual’s Lifestyle ; this involves factors such as Smoking tobacco, diet, alcohol drinking. The use of Tobacco forms the largest causal agent of cancer at 22%.

Fig 2; alcohol consumption and tobacco-related cancer cases in the USA
Source; WHO
Age- Mostly common in an aged population. Cancerous cells are common in the aged population due to long term exposure to polluted carcinogenic elements.

Fig 3; Age-related cancer cases per age group in the US
Source; WHO
The presence of viruses such as HIV and hepatitis virus such as hepatitis B also increases the chances of acquiring cancer.
Exposure to ultraviolet rays and ionizing radiation also possess a critical threat as a causal cancer agent. This cause also manifests due to prevention measures such as subsequent testing/ screening (Plummer at el 2012).
Morbidity Rates Related to CancerBeing the most feared disease in the world is attributed to the overall death toll it causes. The World health organization establishes that cancer has been on the leading front from 2012 as major chronic death attributed to the disease. With an expected occurrence of over 70% infections of cancer within the next 20 years (WHO). Globally the disease had amassed a total of 8.8 million deaths by 2015. Thus establishing that in six people there is the likelihood of one dying of cancer. Middle income developing nations are the largest victims of cancer deaths with at least 70% deaths. This is mainly due to not seeking early screening and treatment services for the disease and the lack of enough medical data and treatment equipment’s that could serve the low-income groups in these counties.
ProblemThe death toll of cancer is distributed based on the affected body parts of the victims. Thus, lung, stomach, colorectal, breast and stomach cancer. Lung cancer causes the most deaths globally. This is mainly because Tobacco use accounts for the largest percentage of lung cancer acquisition. Globally cancer is responsible for the second largest deaths. Thus marked as a global menace.
Body Parts Affected Death Toll (Number)
Lung 1690000
Liver 788 000
Colorectal 774 000
Stomach 754 000
Breast 571 000
By 2015 the following are some of the identified death tolls as a result of cancer.
Source; National Comprehensive Cancer Network
Lung CancerThis is the common and most menacing of the cancers. It develops no signs during the early stages of its development however with time victims develop specific characteristics such as inexplicable tiredness, pain experience as they breathe, coughing blood and weight loss. The persistence of these symptoms displays the likelihood of cancer infection. This type of cancer may originate within the lungs or spread to the lungs. Thus classification into the two basic categories- primary and secondary lung cancer respectively (National Comprehensive Cancer Network).
The most affected cases depend on the above-mentioned categories of lung cancer. Secondary lung cancer may result in all factors that are cancer causal. However, primary lung cancer is mainly attributed to;
Age. It mainly affects people who are at least 40 years and above; with the prevalence age group being 70-74 yrs. (National Comprehensive Cancer Network).
Tobacco smokers. This another group of individuals who are likely to affect due to the regular inhalation of different toxic materials as they smoke.
Primary Lung Cancer
It represents lung cancer originating from the lungs. This type is divided into the following subgroups;
non-small-cell lung cancer
The latter is the most common of lung cancer. It manifests in three main types; squamous cell carcinoma, Large-cell carcinoma or adenocarcinoma. It accounts for over 80% of cancer infections.
small-cell lung cancer
This is another type of Primary Lung Cancer. This type of cancer spreads quickly than non-small-cell lung cancer.
Large-cell carcinoma (LCC)This is a type of cancer that possesses an undifferentiated carcinoma that lacks the properties of the squamous cell or the adenocarcinomas. It manifests at a rapid rate and tends to be diagnosed after drastically developing in size (Iwasaki 2000). Large-cell carcinoma accounts for about 10% of non-small-cell lung cancer. Iwasaki reports that large cell carcinomas responsible for many of the colony factors giving rise to lung cancer. The same colony factors play a major gastrointestinal metastases role in the aggressive progression of cancer.
This type of cancer all portrays poor prognosis with occurring at late stages of the Large-cell carcinoma manifestation. It tends to manifest on the exterior parts of the lung and grows faster when compared with other types of lung cancer within the same group. The mass shows poorly lobulated and defining characteristics at the same time cavitation remains constant. Below is a figure showing a giant cell carcinoma on the lower side of patients left lung.
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Fig 4; Large-cell carcinoma tumor
https://www.health.harvard.edu/cancer/large-cell-cancer-of-the-lungThe American Cancer Society establishes the main risk predisposing people to large cell lung carcinoma to be a previous smoking habit. Previous smokers (30 years) have a higher probability of attaining the disease at 2.3 when compared to non-smokers. Increase smoking duration of above forty years increases these chances to up to 3.6 (Kenfield at el 2008).
The lungs of patients with Large-cell carcinoma causes the formation of a fluid between the pleural effusions in the lungs causing pain during breaths. The condition worsens and eventually invades the walls of the chest. The disease causes several symptoms like all the other cancerous lung diseases. However specific symptoms stand out among the patients.
Every deep breath taken worsens in terms of pain and struggle in air intake due to the latter.
Secretion of hormonal substances responsible for the paraneoplastic syndrome. This syndrome causes gynecomastia. A condition where men appear to have large breasts.
DiagnosisThe diagnosis of Large-cell carcinoma is largely dependent on the exclusion of other cancerous cells in the lungs with the help using light microscopy. This method is referred to as ‘’diagnosis of exclusion”. The method perfectly distinguishes the different non-small-cell lung cancer and also any other histologic lung cancer type. Large-cell carcinoma’s large anaplastic cells efficiently distinguish it from small-cell lung carcinoma. The cells possess a higher size ratio of cytoplasmic- cell nuclear. The appearance of a large-cell carcinoma cell is usually (above 4 cm) and the lack of chromatin.
Patterns of Large-cell carcinomaThere are several developing trends associated with the treatment, perception and administration care for patients with Large-cell carcinoma. The administration of radiation, chemotherapy, and surgery of large-cell carcinoma patient’s varies depending on socio-demographic factors and the different stages of progression of the disease. The influential factors determine the treatment procedures applicable to each individual stage in most medical facilities. This directly influences the increase or decrease of large-cell carcinoma.
The major trends entail the following.
The differential in the treatment of large-cell carcinoma patients based on different age groups.
Increased appreciation of the different treatment techniques and side effects consideration.
Impact of insurance cover and race in obtaining the best medical care
CONCLUSIONHypothesisInsurance cover such as Medicare directly affects the quality of services obtained by patients.
Gender and age are the major demographic factors that have affected the receipt of different treatment methods among large-cell carcinoma patients.
Treatment procedures among the aged are limited when compared to the youth.
There has been a tremendous improvement in treatment techniques of different stages of large-cell carcinoma stages
DiscussionSocial demographic factors have continued to play a major role in the recipient of treatment (Koyi at el 2015). Treatment of patients has continued to vary with the age of the individual. Most elderly patients are likely not to get the different methods. With the development of different treatment procedures older stage, I patients are undergoing successful surgeries (Palma at el 2010).
The race, however, is seen to play a negligible role in determining the increase or decrease of large-cell carcinoma. The incidences of age-related bias in the treatment of large-cell carcinoma continue to decrease in the US, but, not at the expected rate. The older patients fail to receive the appropriate treatments for their respective stages of the disease development. On the other hand, the utilization of different treatments procedures among the youth is fairly adequate.
The elderly are perceived to pose complication after treatments such as surgery and performance status after the surgery (Koyi et al 2015). Married patients also face a possibility of receiving chemotherapy when compared with unmarried patients. This is mainly attributed to the fact that they can have the required care for survival and battle the intense requirements of chemotherapy.
Gender plays a key role in the management and treatment of cancerous sales. It also determines who attains the treatment procedures in the society. Women are perceived not to be active smokers of tobacco. Therefore, screening and treatment techniques for the disease are ignored compared to their male counterparts. This has led to an almost equal population of women and men with large-cell carcinoma. However, in males since 1973 to 2010 the rates of males affected by large-cell carcinoma has reduced from 10% to < 3% due to the availability of obtaining the different treatment procedures. Which is a much higher decrease when compared to other NSCLC (Meza, Meernik, Jeon, and Cote2015). For example, small cell carcinomas which have remained fairly constant over the years.
Large-cell carcinomas covered with medical insurance covers are also unlikely to get different treatment services such as surgery. An attribute that has been influenced by the increased medical care and cases of DALY’s among patients at the advanced stages of the disease. This is mainly notable among patients with public insurance covers such as Medicare. Private insurances organizations depict a clearly different scenario (Koyi et al 2015). The expenses of treatments such as surgery pose financial constraints to most medical care facilities thus guiding their criteria in the selection of treatment methods to patients (Groth et al 2010). The later possess poor chances of survival among stage I and II patients. Therefore, altering the impact of survival possibilities among large-cell carcinoma patients.
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Fig 5; comparison of Large-cell carcinoma and other NSCLC among male and female white patients
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Fig 6; comparison of Large-cell carcinoma and other NSCLC among male and female groups African American patients.
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4905679/Stage I and II patients are likely to be not to be affected by sociodemographic factors in attaining treatment when compared to the other stages. However, stage IIIB/IV large-cell carcinoma patients also show increased chemotherapy over the past years (Rivera at el 2011). This is mainly due to the one-month increase in survival chances of the patients. The different methods of treatment and survival of large-cell carcinoma patients, in general, have also increased tremendously since 2005. This increase is mainly attributed to the use of systemic therapy. A good example is the efficiency of effectiveness of newly approved treatments i.e. bevacizumab and pemetrexed and improvements to care delivery in chemotherapy.
Furthermore, the creation of awareness and sensitization techniques in relation to cancer has tremendously increased research and performance of different treatment procedures. In the United States, there has been a recorded increase in surgeons of different cancer treatment stages. This has resulted in an increased performance with regards to surgery. The estimated 71.7% sage I and 62.2% stage II NSCLC patients who were diagnosed in 2001 received surgery (The American College of Surgeons). Recently Medicare has managed to record an increase of chemotherapy and radiography treatments to 45 and 55% respectively.
In conclusion, the receipt of treatment procedure by a patient has evolved to be majorly based on the age bracket they fall in and the type of insurance cover they have. These factors remain crucial to obtaining medical care even when all the other factors remain constant. The race has drastically lost its influence as a major factor influencing treatment services of large-cell carcinoma patients. The latter is due to the SEER programs implemented to curb the spread of cancer and create awareness. This has helped in shaping perspective of the disease as more of a humanity rather than ethnicity crisis. Besides the improvement in an overall understanding of the manifestation trends and preventive clinical measures in dealing with large-cell carcinoma, there is still need on further emphasis on managing the major factors determining who gets the right treatment at what stage?
Data Gaps and Future ResearchThere are several gaps in the understanding and management of Large-cell carcinoma. Little emphasis has also been given on the importance of public understanding of cancer testing techniques that can subject a healthy person to cancer causal radiative matter. There is limited data on the influence of radiation treatment applied to patients of suffering from Large-cell carcinoma. This is among the sensitive information that needs to be in cooperated in the treatment procedures of large-cell carcinoma.
There are gaps in data aimed at relating clinical procedures, evidence-practice, and management of large-cell carcinoma. Then finally relating the latter to the rates of mortality within the society. Therefore, there is need to interpret the relationship and diminish barriers between research available and practical examples in health facilities in relation to addressing the sociodemographic factors relating to the treatment of cancer patient (Carcinoma Group 2009).
There are also fewer data on the extents of Large-cell carcinoma with most developing. The prevalence and demographic characteristics of the disease cannot be related to most developing nations due to this factor. The latter also makes it difficult to understand the developing trends in battling the disease.
Therefore, there is need to assess the causal agents and important gene formations responsible for cancer progression. For example, so far there has not been a development of direct evidence that can help in suppressing the cancerous tumor cells. An understanding of these factors is important in determining the DLC1 embedded in cancer cells enabling growth (Zhou at el 2004). If the latter can be expressed in HCC then large-cell carcinoma progression possibilities can be minimized. Integration of an understanding of these elements in future research can help in the creation of a much-informed research aimed at improving the performance of existing treatment procedures.
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