Lung cancer – causes, symptoms, treatment
Lung cancer was not even recognised medically until the 18th century, and as recently as only about cases were known in the published medical literature. The malady must have been occasionally misdiagnosed as tuberculosis phthisis or pneumonia or some other lung malaise, but we also know from detailed autopsy records in Germany that the disease cannot have been very common. Findings of primary lung tumours in the autopsied bodies of German research clinics rose dramatically in the second half of the 19th century, and even more dramatically in the first decade of the 20th.
Tobacco was apparently not even suspected as a cause of lung tumours until the final decade of the 19th century. Rottmann's mistake was not corrected until , when Adler proposed that smoking might be to blame for the growing incidence of pulmonary tumours. Lung cancer was still a very rare disease; so rare, in fact, that medical professors when confronted with a case sometimes told their students they might never see another. Smoking was commonly blamed, along with asphalt dust from newly tarred roads, industrial air pollution and latent effects from exposure to poison gas in the First World War or the global influenza pandemic of — These and a number of other theories were put forward as possible explanations for the rise of lung cancer, until evidence from multiple sources of enquiry made it clear that tobacco was by far and away the leading culprit.
In the middle decades of the 20th century, four distinct lines of evidence converged to establish cigarette smoking as the leading cause of lung cancer. These are outlined below. These were among the first and most convincing forms of evidence. Scholars started noting the parallel rise in cigarette consumption and lung cancer, and by the s had begun to investigate this relationship using the methods of case-control epidemiology.
All confirmed this growing suspicion, that smokers of cigarettes were far more likely to contract lung cancer than non-smokers.
Causes of Lung Cancer Essay - Words | Cram
The theory here was that by following two separate and initially healthy groups over time, one smoking and one non-smoking, matched by age, sex, occupation and other relevant traits, you could find out whether smoking was a factor in the genesis of lung disease. The results were unequivocal: Doll and Hill in concluded that smokers of 35 or more cigarettes per day increased their odds of dying from lung cancer by a factor of This was a second key line of evidence. The most active in this realm was the intrepid Angel H Roffo, founding director of Argentina's Institute of Experimental Medicine for the Study and Treatment of Cancer, who in showed that smoke condensed from the destructive distillation of tobacco could cause tumours when smeared on the hairless skins of rabbits.
In , a great deal of attention was given to an experiment by Ernst Wynder, Evarts Graham and Adele Croninger, showing that tumours could be generated by painting cigarette smoke tars onto the shaved backs of mice. That campaign was by and large a success, judging from the fact that per capita consumption rebounded from its dip in Cigarette consumption in the USA would in fact continue to grow throughout the s and s, peaking at about billion sticks in before starting to decline.
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A third line of evidence for the cigarette—cancer link came from cellular pathology. Pathologists in the s had started noticing the capacity of cigarette smoke to cause ciliastasis—the deadening of the tiny whip or hair-like structures lining the upper airway passages, structures known to be responsible for wafting particulate contaminants out of the lungs.
Pathologists also started exploring whether damage from smoking could be discerned at the level of the cell. Anderson C Hilding in confirmed that smokers were experiencing pulmonary ciliastasis, but also that cilia were being deadened at precisely those parts of the lung where cancers were most likely to develop.
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A fourth line of evidence stemmed from the discovery of cancer-causing chemicals in cigarette smoke. Polycyclic aromatic hydrocarbons had been identified as carcinogenic constituents of coal tar in the s, and the question then arose: might there not be similar compounds in cigarette smoke? Angel Roffo in Argentina was the first to identify polycyclic aromatic hydrocarbons in cigarette smoke from their distinctive spectrographic signatures, and for a time at least his was the most authoritative voice in this realm.
The confluence of these diverse forms of evidence—from epidemiology, animal experiments, clinical observation and chemical analysis, combined with diminishing evidence for alternative explanations, prompted health and medical authorities throughout the world to publicly acknowledge a cigarette—cancer link. The Public Health Cancer Association that same year advised stopping smoking as a way to prevent cancer, and cancer authorities in Norway, Sweden, Finland, Denmark and The Netherlands came to similar conclusions.
Researchers in the tobacco industry also became convinced of a cigarette—cancer link—though this was never admitted publicly. Teague was not the only tobacco insider conceding a hazard. Their conclusion, distributed only privately, was that tobacco—and not the paper—was the culprit. Tobacco industry insiders by the mid s clearly knew their product was dangerous. Wouldn't it be wonderful if our company was first to produce a cancer-free cigarette. What we could do to competition!
UK cigarette makers also commented on the lung cancer consensus. Three leading scientists from British American Tobacco BAT visited the USA in , for example, and found that with only one exception all of those consulted—including dozens of experts inside and outside the industry—believed that a cancer connection had been proved. No one can say precisely how many lives were lost as a result, but if the decline in per capita consumption that began with the US Surgeon General's report in had begun instead in , when the conspiracy to challenge the science was launched, millions of lives would have been saved.
The Surgeon General's report, which recognised smoking as a cause of lung cancer in men, is often regarded as a turning point in the recognition of health harms from smoking. But the Surgeon General's report was actually a kind of scientific anticlimax: from an evidentiary point of view the case against smoking had been closed by the end of the s, and it was only the truculence and obstinacy of cigarette manufacturers that forced a blue-ribbon review by the federal government.
Charles S Cameron, Medical and Scientific Director of the American Cancer Society, put the matter nicely in a overview for the Atlantic Monthly , noting that if the same level of evidence had been arrayed against, say, spinach, no one would have objected to the banning of that plant from the national diet. History is, among other things, the study of origins and outcomes—how things come to be and disappear. The presumption is often of a certain contingency: how things turn out is often the outcome of struggles among competing agents. We've reviewed here the rise of scholarly knowledge of cigarette carcinogenicity, but it is also important to realise that popular knowledge, too, has a history.
Scholars don't pay enough attention to what non-scholars think about the world, the proper study of which is agnotology. What efforts have been made to generate ignorance? One source of information for the history of ignorance is the polling data amassed by professional opinion research agencies and their tobacco industry counterparts. The tobacco industry was not innocent in this persistence of ignorance. Cigarette makers spent countless sums to deny and distract from the cigarette—cancer link, in some instances actually quantifying the impact of their denialist propaganda.
Anne Duffin at the Tobacco Institute was happy to report that the film had reduced by Global denialist campaigns have borne similar fruit. In China, cigarette consumption has risen from about billion to over four times that in , and it is not yet clear whether consumption has peaked. China is now manufacturing about 2. Consumption has been facilitated by the introduction of ultra high speed cigarette making machines: Hongta's Yuxi Cigarette Factory, for example, produces over 90 billion cigarettes per year, using 52 high-speed Molins cigarette making machines.
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Cigarette factories today produce death at a faster rate—and cheaper—than any previous form of industrial manufacture. And about twice that number from other diseases. There are about industrial-scale cigarette factories in the world, 36 each of which causes thousands of preventable deaths per year see box 1 and table 1. This relationship is fairly consistent in different parts of the world, given the homogeneity of cigarettes and how similarly they are smoked. It also means we can generate some interesting equivalences.
We can also think about this in terms of the rate at which cigarettes are smoked. Converting this, trillion mm is billion m, or million km. Cigarettes are smoked at a rate equal to the speed at which satellites orbit the earth. We can also think about the deaths caused per unit weight of stuffing. Cigarettes contain about two-thirds of a gram of tobacco, which means that if it takes 3 million cigarettes to cause one lung cancer, it takes about 2 million g—or 2 metric tonnes—to cause one lung cancer.
And 20 additional deaths from heart attacks, gangrene of the feet, cancers of the bladder and oral cavity, etc. Finally, we can also think about this in terms of the value of a life as assumed by tobacco manufacturers. The fact is that cigarette use persists, and on a massive scale. Writing a Letter Writing an Evaluation Letter 3. Writing Essentials. Grammar Handbook.
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What to know about lung cancer
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