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Tobacco Cessation: Curb the Deadliest Epidemic. Keith Bradley, MD Director, Research Associates Program at St . Vincent’s National Alliance of Research Associates Programs (NARAP). Nicotine-Related Pathology. coronary artery peripheral vascular disease hypertension
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Tobacco Cessation:Curb the Deadliest Epidemic Keith Bradley, MD Director, Research Associates Program atSt. Vincent’s National Alliance of Research Associates Programs (NARAP)
Nicotine-Related Pathology • coronary artery • peripheral vascular disease • hypertension • peptic ulcer disease • fetal mortality and morbidity • cancer
Lung Cancer All lung cancers begin as small focus of uncontrolled cell division → thickening/piling up of bronchial mucosa.
Lung Cancer • Small cell • Adenocarcinoma • Squamous carcinoma • Large cell carcinoma
Small Cell Carcinoma • 20% of all lung cancers
Small Cell Carcinoma • 20% of all lung cancers • highly aggressive, metastasizing early.
Small Cell Carcinoma • 20% of all lung cancers • highly aggressive, metastasizing early. • only 1% of cases occur in non-smokers
Small Cell Carcinoma • 20% of all lung cancers • highly aggressive, metastasizing early. • only 1% of cases occur in non-smokers • incurable by surgery
Small Cell Carcinoma • 90% of small cell carcinomas begin in central airways
Small Cell Carcinoma • 90% of small cell carcinomas begin in central airways • consistent with smoking association
Small Cell Carcinoma • 90% of small cell carcinomas begin in central airways • consistent with smoking association • Small cell staged as limited or extensive (spread outside chest)
Small Cell Carcinoma • 90% of small cell carcinomas begin in central airways • consistent with smoking association • Small cell staged as limited or extensive (spread outside chest) • 70% are extensive at diagnosis
Adenocarcinoma • About 40% of lung cancer cases in the US
Adenocarcinoma • About 40% of lung cancer cases in the US • The most common lung cancer among women
Adenocarcinoma • About 40% of lung cancer cases in the US • The most common lung cancer among women • number of new cases is increasing
Adenocarcinoma • About 40% of lung cancer cases in the US • The most common lung cancer among women • number of new cases is increasing • Usually starts near the outer edges of the lungs
Adenocarcinoma • About 40% of lung cancer cases in the US • The most common lung cancer among women, • number of new cases is increasing • Usually starts near the outer edges of the lungs • Often metastasized at diagnosis
Squamous Carcinoma • 25-30% of lung cancer cases in the US
Squamous Carcinoma • 25-30% of lung cancer cases in the US • Occurs most frequently in men and the elderly
Squamous Carcinoma • 25-30% of lung cancer cases in the US • Occurs most frequently in men and the elderly • Usually starts in one of the larger breathing tubes
Squamous Carcinoma • 25-30% of lung cancer cases in the US • Occurs most frequently in men and the elderly • Usually starts in one of the larger breathing tubes • Tends to grow relatively slowly
Squamous Carcinoma • 25-30% of lung cancer cases in the US • Occurs most frequently in men and the elderly • Usually starts in one of the larger breathing tubes • Tends to grow relatively slowly • Tends to remain localized in the chest longer than other types of lung cancer
Squamous Carcinoma • 25-30% of lung cancer cases in the US • Occurs most frequently in men and the elderly • Usually starts in one of the larger breathing tubes • Tends to grow relatively slowly • Tends to remain localized in the chest longer than other types of lung cancer • Does not metastasize early
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer • Incidence appears to be decreasing • may be due to improvements in determining the types of lung cancer
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer • Incidence appears to be decreasing • may be due to improvements in determining the types of lung cancer • 10-15% of lung cancer cases in the US
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer • Incidence appears to be decreasing • may be due to improvements in determining the types of lung cancer. • 10-15% of lung cancer cases in the US • Usually starts in the smaller breathing tubes
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer • Incidence appears to be decreasing • may be due to improvements in determining the types of lung cancer • 10-15% of lung cancer cases in the US • Usually starts in the smaller breathing tubes • May occur in any part of the lung
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer • Incidence appears to be decreasing • may be due to improvements in determining the types of lung cancer. • 10-15% of lung cancer cases in the US • Usually starts in the smaller breathing tubes • May occur in any part of the lung • Tumors are usually large at diagnosis
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer • Incidence appears to be decreasing • may be due to improvements in determining the types of lung cancer. • 10-15% of lung cancer cases in the US • Usually starts in the smaller breathing tubes • May occur in any part of the lung • Tumors are usually large at diagnosis • Tends to invade the mediastinum (chest area behind the breastbone)
Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer • Incidence appears to be decreasing • may be due to improvements in determining the types of lung cancer. • 10-15% of lung cancer cases in the US • Usually starts in the smaller breathing tubes • May occur in any part of the lung • Tumors are usually large at diagnosis • Tends to invade the mediastinum (chest area behind the breastbone) • Metastasizes to the central nervous system
Nicotine Addiction • Psychoactive
Nicotine Addiction • Psychoactive • dose-related changes in mood and feeling
Nicotine Addiction • Psychoactive • dose-related changes in mood and feeling • transient