Marisa Flanjak

Causes and Symptoms of Lung Carcinoma  

Lung carcinoma is the formation of a cancerous tumour in one or both lungs, which is caused by 

the uncontrolled growth and reproduction of epithelial cells which line the respiratory tract. 

 There are two types of lung 

cancer, small-cell lung cancer (SCLC) 

and non-small-cell lung cancer (NSCLC) in which each subtype is found in a 

different type of cell, in a different location of the lungs. 

NSCLC is the most common type of lung cancer making up around 85% of cases. SCLC accounts for around 15% of lung 

cancers and develops in the middle of the lungs in immature cells. It is mostly associated with smoking. SCLC spreads quicker than NSCLC, often 

metastasising beyond the lungs when diagnosed. It also grows faster into large tumours with multiple sites. 

 Lung cancer can be caused by a range of somatic mutations, such as in the TP53, EGFR, and KRAS genes. TP53 genes produce p53 proteins that regulate 

the growth and division of cells. It monitors DNA damage, controlling if the DNA in cells is repaired or will undergo apoptosis (self-destruction). When mutated it 

is no longer able to regulate cell proliferation, resulting in the uncontrolled division of these cells. 

 Tobacco smoking is the most common cause of lung cancer in Australia, with approximately 90% of cases in males and 

65% in females resulting from smoking 

cigarettes. The length of time someone smokes as well as the amount of cigarettes they smoke relates to 

their risk of developing lung cancer.  

Exposure to asbestos (fibrous silicate commonly found in insulating material) contributes to lung cancer by the inhalation of fibres. This does not become obvious until many years later when the fibres accumulate in the bronchi (narrow airways 

of lungs). Asbestos is the exclusive cause of pleural mesothelioma , which is cancer in the 

protective lining of the lung.  

Factors which increase the risk of lung cancer: ● Ionizing radiation from medical imaging with chest X-rays and CT scans 

● Exposure to arsenic, cadmium, steel, nickel, diesel fumes, soot (toxic carbon particles from burning fossil fuels) and radon (a radioactive 

gas) ● Having a lung disease such as lung fibrosis, chronic bronchitis, 

pulmonary tuberculosis or emphysema   

Small-cell lung cancer tumours secrete hormones which cause raised blood sugar levels and blood pressure, as well as, water retention and concentrated urine. Pain in the chest or rib can be persistent or sharp most commonly while breathing, due to the tumour compressing a nerve . This may also result in a 

change of voice and difficulty breathing. If the tumour obstructs an airway, a cough (maybe consistent) which can be dry 

or with phlegm may begin, along with a shortness of breath, wheezing or pneumonia. Immune responses may lead to recurring respiratory infections such as bronchitis, swollen lymph nodes, unexplained weight loss, fever and 

night sweats. If the tumour compresses blood vessels, facial swelling may be the result and if the tumour invades these blood vessels, mucus may become 

Treatment of Lung Carcinoma  

Lung cancer can be diagnosed by CT scans which can detect small tumors or chest X-rays 

which show large tumours wider than 1cm. 

A biopsy (small tissue sample) is taken using 

bronchoscopy, CT-guided fine needle aspiration (needle through chest directed by CT scan) or endobronchial ultrasound . A sputum (mucus) cytology may also be 

done to check for abnormal cells by taking a sputum sample from the lung and examining it under a microscope. Spirometry (lung function) test may be done by a respiratory physician to check how efficiently 

the lungs are working.  

Once lung cancer has been diagnosed a PET scan will be done to stage the cancer, so the correct treatment can be prescribed by an 

oncologist.  

Surgery is the most common treatment of non-small-cell lung cancer in its early stage, in which the tumour is 

removed. It is rarely used to treat small-cell lung cancer. Lung cancer involves a thoracic (chest) surgeon which 

specialises in surgery of the lungs and chest. Surgery may be done many ways such as video-assisted thoracoscopic surgery which is 

done by inserting a tiny camera into the chest through a small opening, allowing surgeons to see inside the lung without creating a large opening. 

Thoracotomy is a large surgical opening in the chest, in which the surgeon has access to the lungs, throat and heart. There are also many different types of surgery including wedge 

resection where a triangular piece of tissue is removed from the lung, pulmonary lobectomy where a part of the lobe (section of the lung) is 

removed, lobectomy where an entire lobe is removed or 

pneumonectomy where a whole lung is removed. 

 Radiation therapy (radiotherapy) can be used 

to treat early-stage or locally advanced non-small-cell lung cancer.  

 Thermal ablation is usually used to treat localised 

non-small-cell lung cancer when surgery or radiation therapy is unsuitable. Thermal ablation uses extreme temperature changes from high (burn) to low (freeze). This destroys cancer cells by vaporising them with the 

use of a needle inserted into the tumour.   

Chemotherapy can be used to treat both small-cell and non-small-cell lung cancer. It may be used before surgery to shrink tumours, after surgery to reduce the risks of cancer returning or with radiation therapy to 

improve its effectiveness.   

Immunotherapy may be used to treat non-small-cell lung cancer using drugs such as Pembrolizumab and Atezolizumab by blocking the activity of 

programmed cell death of T-cells. This better stimulates the immune system to find and attack cancer cells.  

 Targeted therapy is generally used for advanced non-small-cell lung cancer or 

if cancer has returned.   

Palliative care is an important aspect of managing lung cancer due to the low five-year survival rate of sufferers. Palliative care does not aim to cure cancer 

but seeks to improve the quality of life by reducing or managing symptoms such as pain and nausea, as well as slowing the spread of cancer around the 

body. It is most commonly used in advanced or terminal lung cancer, where the patient does not have long to live.  

“Causes, symptoms and treatments of cancers such as Malignant Melanoma and Lung 

Carcinoma”  

What is cancer?   

Cancer is a group of non-infectious diseases which can develop in almost any type of somatic cell around the 

body. DNA damage from exposure to carcinogens (cancer-causing 

substances) mutates the genes which control cell division (proliferation), 

differentiation or the repair of damaged DNA. This leads to the uncontrollable growth and reproduction of abnormal cells (ones that do not die) forming a mass of tissue, called a tumour.  

Carcinogens include chemicals in cigarettes, radiation such as UV, alcohol, processed and red meats. Lifestyle risks which increase the 

chance of developing cancer include having a diet high in saturated fat and physical factors such as being overweight or obese. 

 Malignant cancer cells can reach 

the deeper layers of the tissue and then spread to other areas of the 

body by metastasis, traveling through the blood and lymph 

vessels.  The cancer cells then form a metastatic location (from the 

primary site to a secondary site such as the surrounding organs) 

developing rapidly if not recognised and treated at an early 

stage. The tumour forms new blood vessels to supply itself with oxygen and nutrients, allowing it to go through a process called angiogenesis. 

    

   

*Diagram based off Lung Cancer*  

  

blood-tinged and blood clots may be coughed up. 

Causes and Symptoms of Melanoma  

Melanoma is the most serious and aggressive type of skin cancer .  

 The outermost layer of the skin is the epidermis, 

which is where melanocyte cells are found. Melanocytes produce a protein pigment called melanin which gives colour to the skin, hair and 

eyes.  

Everyone has the same number of melanocytes in their skin, but some people produce more melanin which results in a darker skin colour. 

People with naturally darker skin have more eumelanin where those with naturally fair skin have more pheomelanin . 

 Exposure to UV light 

found in the sun's rays such as UVA penetrate 

deep into the skin stimulating 

melanocytes to produce more melanin 

due to chemical reactions, resulting in tanning. UVB rays only reach the epidermis, resulting in the burning of the skin instead. UV rays are 

also man-made found in tanning beds and booths , which have the same effect as the UV rays the sun 

produces.  

DNA damage from burning or tanning 

results in uncontrolled skin cell growth 

(tumour) and the overproduction of 

melanin (darkening of the skin). 

 Factors which increase the risk of melanoma include: 

● Unprotected and excessive UV exposure  ● Use of tanning beds or booths  

● Having many large or atypical moles ● Having blonde or red hair and blue or green eyes 

● Having naturally fair skin, as darker skin is UV resistant 

● Having a history of melanoma or other 

skin cancers ● A family history of Familial Atypical 

Multiple Mole Melanoma syndrome (FAMMM), which is the inheritance of many atypical moles which have a high risk of becoming 

cancerous  

 Melanomas come in a variety of different 

shapes, sizes and colours and can be found anywhere on the body. Melanomas can be 

identified by using the “ ABCDE ” method.   

● A symmetrical  ● B order is an irregular or uneven shape  

● C olours such as red, white or blue  ● D iameter of 6mm or more or a D arker 

mole than surrounding ones ● E volving moles in size, shape, elevation 

or colour   Melanomas may begin as unusual growths or a change to existing moles. 

 

Treatment of Melanoma  

The diagnosis of melanoma involves taking a small biopsy sample of the tumour (and sometimes lymph nodes) and sending it to a dermatopathologist lab to determine if 

cancer cells are present.  If the disease is diagnosed an oncologist who specialises in cancer sends for other tests such as CT scans, MRIs, PET scans, and/or blood tests to identify the type and 

stage of melanoma, as well as treatment options depending on severity.  

The depth of the melanoma from the surface of the skin to the deepest point (Breslow 

depth) is measured to predict how much the cancer has spread. The degree of melanoma is from Stage 0 which is localized and has not 

spread, to Stage IV where the cancer has metastasised.  

 Melanoma can be avoided by wearing 

broad-spectrum SPF30 (minimum) sunscreen year-round and reapplying every two hours when in the sun. Avoiding going outside between 10am to 4pm and wearing protective 

clothing and sunglasses. Regularly examining the skin all over the body (including scalp) allows for early detection, if any changes are noticeable. 

 Early treatment of melanoma is done by a surgeon who removes the tumour as well as one to two centimetres of skin around it. If the draining lymph nodes are involved they 

are also removed. Cryotherapy is an option where the tumour is frozen off. Mohs surgery may be done instead of traditional surgery by removing one layer at a time of the tumour 

and analysing each until only healthy tissue is left, ensuring no cancerous cells are remaining. 

 Intermediate treatment includes immunotherapy, which 

triggers the body’s immune system to fight cancerous cells. T-cell transfer therapy involves T-cells (a type of lymphocyte 

which are white blood cells) being taken from the tumour and altered in a lab to attack cancerous cells in the body. The T-cells are then able to recognise cancer cells and kill them. They are then delivered 

back into the body intravenously (directly through a vein with a needle). “Checkpoint inhibitors” are specific 

drugs such as Ipilimumab, which also stimulate T-cells. Vaccines are also used as treatment by 

injecting melanoma cells (antigens) into the body, allowing the immune system to more 

easily identify and destroy melanoma cells in the body. 

 Radiation therapy is a localised treatment which may be done by externally directing 

X-rays and other high-energy radiation onto tumours or placing radioactive sources in or near the body, damaging the DNA of cancer cells, leading to cell death. 

 Advanced melanoma is the most difficult to treat due to 

being the most metastatic. Combination immunotherapy is used along with immunotherapies such as checkpoint 

blockade therapy, which suppresses T-cells from attacking normal cells in the body, enabling the immune system to 

send waves of T-cells which only attack cancer cells.  

Targeted therapies use personalised medicines to target specific mutations in cancer cells. Drugs are used to control and stop the growth of cancerous cells by interrupting the causes of uncontrolled cell division. BRAF is a gene which 

codes for proteins, allowing skin cells to multiply when needed, but when mutated it can cause uncontrollable tumour growth. Inhibitors can be taken to genetically alter BRAF, 

interrupting tumour growth by delaying the progression and shrinking tumours.   

Oncolytic virus therapy treats the skin and lymph nodes which cannot be surgically removed, by directly 

injecting Talimogene laherparepvec (T-VEC) into tumours. This drug generates an immune response that 

releases virions (viruses with a protein capsule) to destroy cancer cells. 

 Chemotherapy uses drugs to destroy and slow the growth of cancer cells by stopping 

them from dividing and growing. Chemotherapy drugs are unable to distinguish between cancerous cells and healthy cells and so healthy cells are affected by the drugs, but do recover with time. It is used if immunotherapy or targeted therapy fails, due to the many 

negative side effects such as fatigue, nausea, hair loss, weight loss or vomiting after each treatment. Four to eight cycles of the drug are commonly used in a course. Dacarbazine 

Campaigns for Melanoma and Lung Carcinoma    Campaigns are a useful strategy to educate people on the prevention of cancer, showing the negative side effects of participating in certain activities, which may scare people to 

not take those risks.   

The Cancer Council has campaigns for melanoma, such as the SunSmart “Five ways to Protect Yourself from Skin Cancer” which involves “Slip, Slop, Slap, Seek, Slide”.  

 National Skin Cancer Action Week, 

encourages teenagers to #OwnYourTone on their social media accounts to 

encourage their peers to protect their skin against the sun’s UV rays.  

 Lung cancer campaigns predominantly involve anti-smoking awareness, due to smoking being 

the major cause of lung cancer.  

Cigarette packets include pictures of real people which show the graphic side effects of smoking. This is done to educate people on the risks of smoking and the possible consequences of being an active smoker, aiming to prevent 

smoking by using scare tactics.  

The “Never Give Up Giving Up Anti-smoking Campaign” by Cancer Institute NSW, helps smokers 

understand that multiple quit attempts is normal and that people should not be 

discouraged. This encourages people in this situation to keep trying, because even 

though it may be tough to give up, it is worth it, clearly shown in the many benefits from 

doing so.  

“Cancer is a life-threatening non-infectious disease which has a low five-year survival rate if not diagnosed early on.” 

 The five-year survival rate is the percentage of people who survive cancer five years after diagnosis. This only 

accounts for deaths associated with cancer, without accounting for the deaths of cancer patients who die for other reasons such as another disease or an accident. 

The five-year relative survival rate of melanoma is 99% for localised cancer removed by surgery, 65% for regional 

and 25% for distant cancer. Lung cancer 

has the lowest five-year survival rate out of all of the most 

commonly occurring cancers such as breast, prostate, bowel and melanoma. The five-year survival rate for all people with all types of lung cancer is 19%. 

The five-year survival rate for men is 16% and the five-year survival rate for women is 23%. The five-year 

survival rate for SCLC is 6% compared to NSCLC which is 24%. For people 

with localized NSCLC, which means cancer has not spread outside of the lung, 

the overall five-year survival rate is 61%. For regional NSCLC, which means cancer has spread outside of the lung to nearby areas, the five-year 

survival rate is about 35%. When cancer has spread to distant parts of the body, called 

metastatic lung cancer, the five-year survival rate is 6%. 

 My hypothesis is supported by data used, showing a clear link between the stage of 

cancer and the survival rate, which indicates if cancer is not diagnosed early on (before metastasis), the five-year survival rate is low for both malignant melanoma (25% from 99%) and lung carcinoma (6% from 19% overall). Even though lung cancer already starts with a 

is the only FDA-approved chemotherapy for metastatic melanoma.  low five-year survival rate, it still drastically decreases over time if the disease is not diagnosed and treated early on.