Carcinoma of the lung, including systemic manifestations

Abstract

In summary, the incidence of lung cancer has greatly increased in the past 50 years. Long-term survival data is poor. Evidence now suggests that bronchogenic carcinoma may be a long time evolving and that significant extension or wide-spread metastases may be present by the time the patient develops the first symptom. The routine chest film is an unsatis-factory method of uncovering truly early lung cancer, and we may have to await the development of a better diagnostic test if real inroads are to be made into this calamity. On the other hand, at least in part, the epidemic nature of this disorder may be prevented by elimination of atmospheric pollution, especially the personal one represented in the present-day cigarette. Many systemic signs occur in relation to lung cancer that appear to be mediated or influenced by something that the tumor makes or possesses. These systemic manifestations may sometimes precede symptoms relative to the tumor and divert the clinician's attention from the thorax or other primary sites. Once recognized for what they are, these manifestations may prompt a search for the silent underlying malignancy. Furthermore, it is possible that these manifestations may act to hasten demise, and the patient may be significantly benefited if these abnormalities can be eliminated or improved.