This is Mr. Claude Levy (slide 13). "I've developed a tumor on top of my lung and it seemed that it came out of my lung and it's in a spot that is very dangerous because they can't see it too well. I should be operated on. Right now, it's a lung problem that I have". After years of smoking and feeling well, Mr. Levy suddenly coughed up streaks of blood. This led his doctor to get a chest x-ray that showed a large cancer in his right upper lung (slide 14). "This is the cancer, the white rounded mass the size of a small baseball". This led to a bronchoscopy. During the bronchoscopy, a slender tube with a small light at the end of it, called a bronchoscope, seen here (slide 6), is passed through the nose all the way down to the lungs where the cancer can be seen and biopsied. Here you see Mr. Levy undergoing a bronchoscopy (slide 15). The bronchoscope is being passed through his nose, into his lower throat to the level of the vocal cords. Then, through the vocal cords into the windpipe or trachea and then down to the right and left main bronchi which lead to the right and left lungs. At this level you can see a large cancer that is bleeding and almost completely plugging the right main bronchus (slide 16). Here you see a biopsy forceps pinching off a piece of the cancer to prove the diagnosis. The diagnosis of lung cancer was proven, but by this time the cancer had spread and couldn't be removed by surgery. Mr. Levy, therefore, received treatment with radiation in an attempt to burn away the cancer and chemotherapy in an attempt to poison the cancer with drugs. These treatments failed to control his cancer and also caused many toxic side effects including total hair loss and recurrent nausea and vomiting. He died shortly thereafter.

At autopsy, Mr. Levy's lungs looked like this. They were stained black from cigarette tars and a large whitish cancer was seen in the upper lung field (slide 17). A few weeks before he died, Mr. Levy asked if he could leave a message for kids who have started to smoke. "I started smoking when I was about fifteen years old. A friend of mine gave me a couple of cigarettes and that's how it all started. It's very hard to quit. I suppose we get addicted to the nicotine and there is some psychological involvement also. It's very, very hard to quit. If you did start, do your utmost to stop now because later on it's going to be extremely hard to do".