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Tobacco Cessation: Curb the Deadliest Epidemic

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

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  1. Tobacco Cessation:Curb the Deadliest Epidemic Keith Bradley, MD Director, Research Associates Program atSt. Vincent’s National Alliance of Research Associates Programs (NARAP)

  2. Nicotine-Related Pathology • coronary artery • peripheral vascular disease • hypertension • peptic ulcer disease • fetal mortality and morbidity • cancer

  3. Lung Cancer All lung cancers begin as small focus of uncontrolled cell division → thickening/piling up of bronchial mucosa.

  4. Lung Cancer • Small cell • Adenocarcinoma • Squamous carcinoma • Large cell carcinoma

  5. Small Cell Carcinoma

  6. Small Cell Carcinoma • 20% of all lung cancers

  7. Small Cell Carcinoma • 20% of all lung cancers • highly aggressive, metastasizing early.

  8. Small Cell Carcinoma • 20% of all lung cancers • highly aggressive, metastasizing early. • only 1% of cases occur in non-smokers

  9. Small Cell Carcinoma • 20% of all lung cancers • highly aggressive, metastasizing early. • only 1% of cases occur in non-smokers • incurable by surgery

  10. Small Cell Carcinoma • 90% of small cell carcinomas begin in central airways

  11. Small Cell Carcinoma • 90% of small cell carcinomas begin in central airways • consistent with smoking association

  12. 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)

  13. 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

  14. Adenocarcinoma

  15. Adenocarcinoma • About 40% of lung cancer cases in the US

  16. Adenocarcinoma • About 40% of lung cancer cases in the US • The most common lung cancer among women

  17. Adenocarcinoma • About 40% of lung cancer cases in the US • The most common lung cancer among women • number of new cases is increasing

  18. 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

  19. 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

  20. Squamous Carcinoma

  21. Squamous Carcinoma • 25-30% of lung cancer cases in the US

  22. Squamous Carcinoma • 25-30% of lung cancer cases in the US • Occurs most frequently in men and the elderly

  23. 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

  24. 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

  25. 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

  26. 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

  27. Large Cell Carcinoma

  28. Large Cell Carcinoma • “Other” • tend to have larger cells than other types of lung cancer

  29. 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

  30. 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

  31. 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

  32. 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

  33. 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

  34. 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)

  35. 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

  36. Nicotine Addiction

  37. Nicotine Addiction • Psychoactive

  38. Nicotine Addiction • Psychoactive • dose-related changes in mood and feeling

  39. Nicotine Addiction • Psychoactive • dose-related changes in mood and feeling • transient

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