Granville Henry "Stick" McGhee (March 23, 1918 – August 15, 1961) was an American jump blues guitarist, singer and songwriter, best known for his blues song " Drinkin' Wine, Spo-Dee-O-Dee ", which he wrote with J. Mayo Williams .
143-777: McGhee was born in Knoxville, Tennessee , and grew up in Kingsport, Tennessee . He received his nickname when he was a child. He used a stick to push a wagon carrying his older brother Brownie McGhee , who had contracted polio . Granville began playing the guitar when he was thirteen years old. After his freshman year he dropped out of high school and worked with his father at the Eastman Kodak subsidiary, Tennessee Eastman Company in Kingsport. In 1940, Granville quit his job and moved to Portsmouth, Virginia , and then to New York City . He entered
286-437: A biopsy of the suspected tissue be histologically examined for cancer cells. Given the location of lung cancer tumors, biopsies can often be obtained by minimally invasive techniques: a fiberoptic bronchoscope that can retrieve tissue (sometimes guided by endobronchial ultrasound ), fine needle aspiration , or other imaging-guided biopsy through the skin. Those who cannot undergo a typical biopsy procedure may instead have
429-551: A liquid biopsy taken (that is, a sample of some body fluid) which may contain circulating tumor DNA that can be detected. Imaging is also used to assess the extent of cancer spread. Positron emission tomography (PET) scanning or combined PET-CT scanning is often used to locate metastases in the body. Since PET scanning is less sensitive in the brain, the National Comprehensive Cancer Network recommends magnetic resonance imaging (MRI) – or CT where MRI
572-634: A mixed-use baseball stadium complex in the Old City neighborhood. According to the United States Census Bureau , the city has a total area of 104.2 square miles (269.8 km ), of which 98.5 square miles (255.2 km ) is land and 5.6 square miles (14.6 km ), or 5.42%, is water. Elevations range from just over 800 feet (240 m) along the riverfront to just over 1,000 feet (300 m) on various hilltops in West Knoxville, with
715-408: A Union invasion, Buckner fortified Fort Loudon (in West Knoxville, not to be confused with the colonial fort to the southwest) and began constructing earthworks throughout the city. However, the approach of stronger Union forces under Ambrose Burnside in the summer of 1863 forced Buckner to evacuate Knoxville before the earthworks were completed. Burnside arrived in early September 1863, beginning
858-406: A chest radiograph or CT scan. In lung cancer screening studies as many as 30% of those screened have a lung nodule, the majority of which turn out to be benign. Besides lung cancer many other diseases can also give this appearance, including hamartomas , and infectious granulomas caused by tuberculosis , histoplasmosis , or coccidioidomycosis . At diagnosis, lung cancer is classified based on
1001-454: A daily average temperature of 38.2 °F (3.4 °C), with an average of 5 days where the high remains at or below freezing. The record high for Knoxville is 105 °F (41 °C) on June 30 and July 1, 2012 , while the record low is −24 °F (−31 °C) on January 21, 1985 . Annual precipitation averages just under 52 in (1,320 mm), and normal seasonal snowfall is 4.6 in (12 cm). The one-day record for snowfall
1144-433: A high-volume surgery clinic improve chances of survival. Those who are unable or unwilling to undergo surgery can instead receive radiation therapy. Stereotactic body radiation therapy is best practice, typically administered several times over 1–2 weeks. Chemotherapy has little effect in those with stage I NSCLC, and may worsen disease outcomes in those with the earliest disease. In those with stage II disease, chemotherapy
1287-672: A hotel, student housing, and 300 multi-family residential units. In June 2020, the Knoxville City Council announced the investment of over $ 5.5 million in federal and local funds towards the development of a business park along the Interstate 275 corridor in North Knoxville . The project was first proposed by a study prepared Knoxville-Knox County Metropolitan Planning Commission in 2007. In August 2020, UT President and Tennessee Smokies owner Randy Boyd announced plans of
1430-617: A judge and state senator, before being nominated by the state legislature to replace Andrew Jackson in the U.S. Senate in 1825. In 1836, White ran unsuccessfully for president, representing the Whig Party . Anti-slavery and anti-secession sentiment ran high in East Tennessee in the years leading up to the Civil War. William "Parson" Brownlow , the radical publisher of the Knoxville Whig ,
1573-517: A law school in an attempt to modernize the scope of the university. In 1879, the state changed its name to the University of Tennessee, at the request of the trustees, who hoped to secure more funding from the Tennessee state legislature. The post-war manufacturing boom brought thousands of immigrants to the city. The population of Knoxville grew from around 5,000 in 1860 to 32,637 in 1900. West Knoxville
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#17331063828881716-439: A mass inside the lung. The X-ray may reveal an obvious mass, the widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (lung collapse), consolidation ( pneumonia ), or pleural effusion ; however, some lung tumors are not visible by X-ray. Next, many undergo computed tomography (CT) scanning , which can reveal the sizes and locations of tumors. A definitive diagnosis of lung cancer requires
1859-462: A metro government failed, while school boards and the planning commissions would merge on July 1, 1987. With further annexation attempts stalling, Knoxville initiated several projects aimed at boosting revenue in its downtown area. The 1982 World's Fair —the most successful of these projects, with eleven million visitors—became one of the most popular expositions in U.S. history. The Rubik's Cube made its debut at this event. The fair's energy theme
2002-618: A new arts annex and gallery surrounded by many studios and new businesses as well. The Bijou and Tennessee Theatres underwent renovation, providing an initiative for the city and its developers to re-purpose the old downtown. Development has also expanded across the Tennessee River on the South Knoxville waterfront. In 2006, the city adopted the South Waterfront Vision Plan, a long-term improvement project to revitalize
2145-607: A new cough, or an increase in the frequency or strength of a pre-existing cough. Around one in four cough up blood , ranging from small streaks in the sputum to large amounts. Around half of those diagnosed with lung cancer experience shortness of breath, while 25–50% experience a dull, persistent chest pain that remains in the same location over time. In addition to respiratory symptoms, some experience systemic symptoms including loss of appetite , weight loss , general weakness, fever , and night sweats . Some less common symptoms suggest tumors in particular locations. Tumors in
2288-607: A regional merchandising center. Local agricultural products—especially tobacco, corn, and whiskey—were traded for cotton, which was grown in the Deep South . The population of Knoxville more than doubled in the 1850s with the arrival of the East Tennessee and Georgia Railroad in 1855. Among the most prominent citizens of Knoxville during the Antebellum years was James White's son, Hugh Lawson White (1773–1840). White first served as
2431-445: A reported 26 square miles of " shoestring annexation " under the administration of Mayor Victor Ashe . Ashe's efforts were controversial, largely consisting of annexation of interstate right-of-ways , highway-oriented commercial clusters, and residential subdivisions to increase tax revenue for the city. Residents voiced opposition, citing claims of urban sprawl and government overreach. Knoxville's downtown has been developing, with
2574-665: A repository of Appalachian culture and is one of the gateways to the Great Smoky Mountains National Park . The first people to form substantial settlements in what is now Knoxville were indigenous people who arrived during the Woodland period ( c. 1000 B.C. to 1000 A.D.). One of the oldest artificial structures in Knoxville is a burial mound constructed during the early Mississippian culture period ( c. 1000–1400 A.D.). The earthwork mound has been preserved, but
2717-506: A societal level, smoking cessation can be promoted by tobacco control policies that make tobacco products more difficult to obtain or use. Many such policies are mandated or recommended by the WHO Framework Convention on Tobacco Control , ratified by 182 countries, representing over 90% of the world's population. The WHO groups these policies into six intervention categories, each of which has been shown to be effective in reducing
2860-526: A state in 1796) until 1817, when the capital was moved to Murfreesboro . Early Knoxville has been described as an "alternately quiet and rowdy river town". Early issues of the Knoxville Gazette —the first newspaper published in Tennessee—are filled with accounts of murder, theft, and hostile Cherokee attacks. Abishai Thomas, a friend of William Blount, visited Knoxville in 1794 and wrote that, while he
3003-491: A symptom tend to have worse outcomes. Tumor mutations in KRAS are associated with reduced survival. The uncertainty of lung cancer prognosis often causes stress, and makes future planning difficult, for those with lung cancer and their families. Those whose cancer goes into remission often experience fear of their cancer returning or progressing, associated with poor quality of life, negative mood, and functional impairment. This fear
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#17331063828883146-589: A town. McClung drew up sixty-four 0.5-acre (0.20 ha) lots. The waterfront was set aside for a town common. Two lots were set aside for a church and graveyard (First Presbyterian Church, founded 1792). Four lots were set aside for a school. That school was eventually chartered as Blount College and it served as the starting point for the University of Tennessee , which uses Blount College's founding date of 1794 as its own. In 1790, President George Washington appointed North Carolina surveyor William Blount governor of
3289-427: A tumor, and eventually spreading within and then beyond the lung. Rampant tumor growth and spread causes the symptoms of lung cancer. If unstopped, the spreading tumor will eventually cause the death of affected individuals. Tobacco smoking is by far the major contributor to lung cancer, causing 80% to 90% of cases. Lung cancer risk increases with quantity of cigarettes consumed. Tobacco smoking's carcinogenic effect
3432-520: A variety of other toxic chemicals – typically encountered in certain occupations – is associated with an increased risk of lung cancer. Occupational exposures to carcinogens cause 9–15% of lung cancer. A prominent example is asbestos , which causes lung cancer either directly or indirectly by inflaming the lung. Exposure to all commercially available forms of asbestos increases cancer risk, and cancer risk increases with time of exposure. Asbestos and cigarette smoking increase risk synergistically – that is,
3575-1202: Is hypercalcemia (high blood calcium) caused by over-production of parathyroid hormone-related protein or parathyroid hormone . Hypercalcemia can manifest as nausea, vomiting, abdominal pain, constipation, increased thirst , frequent urination , and altered mental status. Those with lung cancer also commonly experience hypokalemia (low potassium) due to inappropriate secretion of adrenocorticotropic hormone , as well as hyponatremia (low sodium) due to overproduction of antidiuretic hormone or atrial natriuretic peptide . About one of three people with lung cancer develop nail clubbing , while up to one in ten experience hypertrophic pulmonary osteoarthropathy (nail clubbing, joint soreness, and skin thickening). A variety of autoimmune disorders can arise as paraneoplastic syndromes in those with lung cancer, including Lambert–Eaton myasthenic syndrome (which causes muscle weakness), sensory neuropathies , muscle inflammation , brain swelling , and autoimmune deterioration of cerebellum , limbic system , or brainstem . Up to one in twelve people with lung cancer have paraneoplastic blood clotting, including migratory venous thrombophlebitis , clots in
3718-544: Is 17.5 in (44 cm), which occurred on February 13, 1960. Knoxville is the central city in the Knoxville Metropolitan Area, an Office of Management and Budget (OMB) designated metropolitan statistical area (MSA) that covers Knox, Anderson , Blount , Campbell , Grainger , Loudon , Morgan , Roane and Union counties. Researchers have mapped the Knoxville Metropolitan area as one of
3861-641: Is also a risk of radiation-induced cancer . The United States Preventive Services Task Force recommends yearly screening using low-dose CT in people between 55 and 80 who have a smoking history of at least 30 pack-years . The European Commission recommends that cancer screening programs across the European Union be extended to include low-dose CT lung scans for current or previous smokers. Similarly, The Canadian Task Force for Preventative Health recommends that people who are current or former smokers (smoking history of more than 30 pack years) and who are between
4004-567: Is associated with the development of the rare lung cancer lymphoepithelioma-like carcinoma in people from Asia, but not in people from Western nations . A role for several other infectious agents – namely human papillomaviruses , BK virus , JC virus , human cytomegalovirus , SV40 , measles virus , and Torque teno virus – in lung cancer development has been studied but remains inconclusive as of 2020. Particular gene combinations may make some people more susceptible to lung cancer. Close family members of those with lung cancer have around twice
4147-413: Is due to various chemicals in tobacco smoke that cause DNA mutations, increasing the chance of cells becoming cancerous. The International Agency for Research on Cancer identifies at least 50 chemicals in tobacco smoke as carcinogenic , and the most potent is tobacco-specific nitrosamines . Exposure to these chemicals causes several kinds of DNA damage: DNA adducts , oxidative stress , and breaks in
4290-573: Is exacerbated by frequent or prolonged surveillance imaging, and other reminders of cancer risks. Lung cancer is caused by genetic damage to the DNA of lung cells. These changes are sometimes random, but are typically induced by breathing in toxic substances such as cigarette smoke. Cancer-causing genetic changes affect the cell's normal functions , including cell proliferation , programmed cell death ( apoptosis ), and DNA repair . Eventually, cells gain enough genetic changes to grow uncontrollably, forming
4433-497: Is impractical are treated with combination chemotherapy and radiotherapy along with the immunotherapy durvalumab . Combined chemotherapy and radiation enhances survival compared to chemotherapy followed by radiation, though the combination therapy comes with harsher side effects. Those with stage IV disease are treated with combinations of pain medication, radiotherapy, immunotherapy, and chemotherapy. Many cases of advanced disease can be treated with targeted therapies depending on
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4576-485: Is necessary due to the length of time it can take for lung cancer to develop following an exposure to carcinogens. The smoking of non-tobacco products is not known to be associated with lung cancer development. Marijuana smoking does not seem to independently cause lung cancer – despite the relatively high levels of tar and known carcinogens in marijuana smoke. The relationship between smoking cocaine and developing lung cancer has not been studied as of 2020. Exposure to
4719-506: Is not targetable by current molecular therapies instead can be treated with combination chemotherapy plus immune checkpoint inhibitors, which prevent cancer cells from inactivating immune T cells . The chemotherapeutic agent of choice depends on the NSCLC subtype: cisplatin plus gemcitabine for squamous cell carcinoma, cisplatin plus pemetrexed for non-squamous cell carcinoma. Immune checkpoint inhibitors are most effective against tumors that express
4862-407: Is present in many lung cancers, but absent from squamous cell carcinomas. Lung cancer staging is an assessment of the degree of spread of the cancer from its original source. It is one of the factors affecting both the prognosis and the treatment of lung cancer. SCLC is typically staged with a relatively simple system: limited stage or extensive stage. Around a third of people are diagnosed at
5005-402: Is stage IV. Each stage is further subdivided based on the combination of T, N, and M scores. Some countries recommend that people who are at a high risk of developing lung cancer be screened at different intervals using low-dose CT lung scans. Screening programs may result in early detection of lung tumors in people who are not yet experiencing symptoms of lung cancer, ideally, early enough that
5148-405: Is the most diagnosed and deadliest cancer worldwide, with 2.2 million cases in 2020 resulting in 1.8 million deaths. Lung cancer is rare in those younger than 40; the average age at diagnosis is 70 years, and the average age at death 72. Incidence and outcomes vary widely across the world, depending on patterns of tobacco use. Prior to the advent of cigarette smoking in the 20th century, lung cancer
5291-799: Is treated with radiation therapy and chemotherapy alongside drug treatments that target specific cancer subtypes. Even with treatment, only around 20% of people survive five years on from their diagnosis. Survival rates are higher in those diagnosed at an earlier stage, diagnosed at a younger age, and in women compared to men. Most lung cancer cases are caused by tobacco smoking . The remainder are caused by exposure to hazardous substances like asbestos and radon gas, or by genetic mutations that arise by chance. Consequently, lung cancer prevention efforts encourage people to avoid hazardous chemicals and quit smoking. Quitting smoking both reduces one's chance of developing lung cancer and improves treatment outcomes in those already diagnosed with lung cancer. Lung cancer
5434-442: Is typically treated with a combination of chemotherapy and radiotherapy. For chemotherapy, the National Comprehensive Cancer Network and American College of Chest Physicians guidelines recommend four to six cycles of a platinum-based chemotherapeutic – cisplatin or carboplatin – combined with either etoposide or irinotecan . This is typically combined with thoracic radiation therapy – 45 Gray (Gy) twice-daily – alongside
5577-420: Is unavailable – to scan the brain for metastases in those with NSCLC and large tumors, or tumors that have spread to the nearby lymph nodes. When imaging suggests the tumor has spread, the suspected metastasis is often biopsied to confirm that it is cancerous. Lung cancer most commonly metastasizes to the brain, bones, liver, and adrenal glands . Lung cancer can often appear as a solitary pulmonary nodule on
5720-564: Is usually initiated six to twelve weeks after surgery, with up to four cycles of cisplatin – or carboplatin in those with kidney problems, neuropathy , or hearing impairment – combined with vinorelbine , pemetrexed , gemcitabine, or docetaxel . Treatment for those with stage III NSCLC depends on the nature of their disease. Those with more limited spread may undergo surgery to have the tumor and affected lymph nodes removed, followed by chemotherapy and potentially radiotherapy. Those with particularly large tumors (T4) and those for whom surgery
5863-503: The Battle of Campbell's Station (now Farragut ). On November 18, Union General William P. Sanders was mortally wounded while conducting delaying maneuvers west of Knoxville, and Fort Loudon was renamed Fort Sanders in his honor. On November 29, following a two-week siege , the Confederates attacked Fort Sanders but failed after a fierce 20-minute engagement. On December 4, after word of
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6006-584: The Clinch River and Tennessee River (now Kingston ), but when the Cherokee refused to cede this land, Blount chose White's Fort. Blount named the new capital Knoxville after Revolutionary War General and Secretary of War Henry Knox , who at the time was Blount's immediate superior. Problems immediately arose from the Holston Treaty. Blount believed that he had "purchased" much of what is now East Tennessee when
6149-758: The Confederacy , General Felix Zollicoffer arrived in Knoxville as commander of the District of East Tennessee. While initially lenient toward the city's Union sympathizers, Zollicoffer instituted martial law in November, after pro-Union guerrillas burned seven of the city's bridges . The command of the district passed briefly to George Crittenden and then to Kirby Smith , who launched an unsuccessful invasion of Kentucky in August 1862. In early 1863, General Simon Buckner took command of Confederate forces in Knoxville. Anticipating
6292-718: The French and Indian War and confusion brought about by the American Revolution led to a drastic increase in Euro-American settlement west of the Appalachian Mountains . By the 1780s, white settlers were already established in the Holston and French Broad valleys. The U.S. Congress ordered all illegal settlers out of the valley in 1785 but with little success. As settlers continued to trickle into Cherokee lands, tensions between
6435-434: The Knoxville campaign . Like the Confederates, he immediately began fortifying the city. The Union forces rebuilt Fort Loudon and erected 12 other forts and batteries flanked by entrenchments around the city. Burnside moved a pontoon bridge upstream from Loudon , allowing Union forces to cross the river and to build a series of forts along the heights of south Knoxville, including Fort Stanley and Fort Dickerson. As Burnside
6578-634: The National Conservation Exposition in 1913. The latter is sometimes credited with giving rise to the movement to create a national park in the Great Smoky Mountains, some 20 miles (32 km) south of Knoxville. Around this time, several affluent Knoxvillians began purchasing summer cottages in Elkmont and began to pursue the park idea more vigorously. They were led by Knoxville businessman Colonel David C. Chapman , who, as head of
6721-606: The Tennessee River . As of the 2020 United States census , Knoxville's population was 190,740, making it the largest city in the East Tennessee Grand Division and the state's third-most-populous city after Nashville and Memphis . It is the principal city of the Knoxville metropolitan area , which had a population of 879,773 in 2020. First settled in 1786, Knoxville was the first capital of Tennessee. The city struggled with geographic isolation throughout
6864-593: The Underground Railroad . Business interests, however, guided largely by Knoxville's trade connections with cotton-growing centers to the south, contributed to the development of a strong pro-secession movement within the city. The city's pro-secessionists included among their ranks J. G. M. Ramsey , a prominent historian whose father had built the Ramsey House in 1797. Thus, while East Tennessee and greater Knox County voted decisively against secession in 1861,
7007-810: The Welsh Tract in Pennsylvania to work in a rolling mill. These Welsh families settled in an area now known as Mechanicsville . The Richards brothers also co-founded the Knoxville Iron Works beside the L&;N Railroad , also employing Welsh workers. Later, the site was used as the grounds for the 1982 World's Fair . Other companies that sprang up during this period were Knoxville Woolen Mills, Dixie Cement, and Woodruff's Furniture. Between 1880 and 1887, 97 factories were established in Knoxville, most of them specializing in textiles, food products, and iron products. By
7150-584: The cell division cycle , cellular stress responses , and chromatin remodeling . Some rare genetic disorders that increase the risk of various cancers also increase the risk of lung cancer, namely retinoblastoma and Li–Fraumeni syndrome . As with all cancers, lung cancer is triggered by mutations that allow tumor cells to endlessly multiply, stimulate blood vessel growth , avoid apoptosis (programmed cell death), generate pro-growth signalling molecules, ignore anti-growth signalling molecules, and eventually spread into surrounding tissue or metastasize throughout
7293-508: The spinal cord . Metastasis into the bone marrow can deplete blood cells and cause leukoerythroblastosis (immature cells in the blood). Liver metastases can cause liver enlargement , pain in the right upper quadrant of the abdomen , fever, and weight loss. Lung tumors often cause the release of body-altering hormones , which cause unusual symptoms, called paraneoplastic syndromes . Inappropriate hormone release can cause dramatic shifts in concentrations of blood minerals . Most common
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#17331063828887436-450: The thorax can cause breathing problems by obstructing the trachea or disrupting the nerve to the diaphragm ; difficulty swallowing by compressing the esophagus ; hoarseness by disrupting the nerves of the larynx ; and Horner's syndrome by disrupting the sympathetic nervous system . Horner's syndrome is also common in tumors at the top of the lung , known as Pancoast tumors , which also cause shoulder pain that radiates down
7579-628: The 18 major cities in the Piedmont Atlantic megaregion . The Knoxville Metropolitan area includes unincorporated communities such as Halls Crossroads , Powell , Karns , Corryton , Concord , and Mascot , which are located in Knox County outside of Knoxville's city limits. Along with Knoxville, municipalities in the Knoxville Metropolitan Area include Alcoa , Blaine , Maryville , Lenoir City , Loudon , Farragut , Oak Ridge , Rutledge , Clinton , Bean Station , and Maynardville . As of 2012,
7722-487: The 1890s, Knoxville was home to more than 50 wholesaling houses, making it the third largest wholesaling center by volume in the South. The Candoro Marble Works , established in the community of Vestal in 1914, became the nation's foremost producer of pink marble and one of the nation's largest marble importers. In 1896, Knoxville celebrated its achievements by creating its own flag. The Flag of Knoxville, Tennessee represents
7865-554: The 18th century, the Cherokee , an Iroquoian language people, had become the dominant tribe in the East Tennessee region; they are believed to have migrated centuries before from the Great Lakes region . They were frequently at war with the Creek and Shawnee . The Cherokee people called the Knoxville area kuwanda'talun'yi , which means "mulberry place". Most Cherokee habitation in the area
8008-402: The 1920s as the manufacturing sector collapsed , the downtown area declined and city leaders became entrenched in highly partisan political fights. Hosting the 1982 World's Fair helped reinvigorate the city, and revitalization initiatives by city leaders and private developers have had major successes in spurring growth in the city, especially the downtown area. Knoxville is the home of
8151-470: The 1950s and 1960s, and after the establishment of the Interstate Highway System in the 1960s, the railroad—which had been largely responsible for Knoxville's industrial growth—began to decline. The rise of suburban shopping malls in the 1970s drew retail revenues away from Knoxville's downtown area. While government jobs and economic diversification prevented widespread unemployment in Knoxville,
8294-476: The 1970s, were among Knoxville's first modern high-rise buildings. In 1947, John Gunther dubbed Knoxville the "ugliest city" in America in his best-selling book Inside U.S.A. Gunther's description jolted the city into enacting a series of beautification measures that helped improve the appearance of the downtown area. Knoxville's textile and manufacturing industries largely fell victim to foreign competition in
8437-431: The 750-acre waterfront fronting three miles of shoreline on the Tennessee River. The project's primary focus is the commercial and residential development over a 20-year timeline. Knoxville Baptist Hospital, located on the waterfront, was demolished in 2016 to make room for a mixed-use project called One Riverwalk. The development consisted of three office buildings, including a headquarters for Regal Entertainment Group ,
8580-695: The Bottom", and "Get Your Mind Out of the Gutter". However, he was unable to make money from his records, so he left King for Savoy Records in 1955. He retired from the music industry in 1960. In the late '50s McGhee recorded LP album tracks with Sonny Terry for the Folkways and Prestige-Bluesville labels. In 1960 he cut the songs "Sleep in Job" and "Money Fever" in New York with Sonny Terry. The tracks were released on Herald Records. This
8723-556: The CSA but not the Knoxville MSA, include Morristown, Rutledge, Dandridge , Jefferson City , Sevierville, Gatlinburg , Pigeon Forge , LaFollette, Jacksboro , Harriman, Kingston , Rockwood , and Newport. The combined population of the CSA as of the 2000 Census was 935,659. Its estimated 2008 population was 1,041,955. Knoxville is roughly divided into the Downtown area and sections based on
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#17331063828888866-485: The Confederate defeat at Chattanooga reached Longstreet, he broke his siege of Knoxville. The Union victories in the Knoxville campaign and at Chattanooga put much of East Tennessee under Union control for the rest of the war. After the war, northern investors such as brothers Joseph and David Richards helped Knoxville recover relatively quickly. The Richards brothers convinced 104 Welsh immigrant families to migrate from
9009-469: The DNA strands. Being around tobacco smoke – called passive smoking – can also cause lung cancer. Living with a tobacco smoker increases one's risk of developing lung cancer by 24%. An estimated 17% of lung cancer cases in those who do not smoke are caused by high levels of environmental tobacco smoke. Vaping may be a risk factor for lung cancer, but less than that of cigarettes, and further research as of 2021
9152-634: The Great Smoky Mountains Park Commission, was largely responsible for raising the funds for the purchase of the property that became the core of the park. The Great Smoky Mountains National Park opened in 1933. Knoxville's reliance on a manufacturing economy left it particularly vulnerable to the effects of the Great Depression . The Tennessee Valley also suffered from frequent flooding, and millions of acres of farmland had been ruined by soil erosion. To control flooding and improve
9295-625: The James White Parkway and includes the neighborhoods of Parkridge, Burlington, Morningside, and Five Points. This area, concentrated along Magnolia Avenue, is home to Chilhowee Park and Zoo Knoxville . North Knoxville consists of the areas north of Sharp's Ridge, namely the Fountain City and Inskip-Norwood areas. This area's major commercial corridor is located along Broadway. As of the 2020 United States census , there were 190,740 people, 83,492 households, and 40,405 families residing in
9438-702: The Knoxville area was the Timberlake Expedition , which passed through the confluence of the Holston and French Broad into the Tennessee River in December 1761. Henry Timberlake , an Anglo-American emissary from the Thirteen Colonies to the Overhill settlements, recalled being pleased by the deep waters of the Tennessee after his party had struggled down the relatively shallow Holston for several weeks. The end of
9581-638: The Tennessee in Knoxville include First Creek and Second Creek, which flow through the downtown area, Third Creek, which flows west of U.T., and Sinking Creek, Ten Mile Creek, and Turkey Creek, which drain West Knoxville. Knoxville falls in the humid subtropical climate ( Köppen : Cfa ) zone. Summers are hot and humid, with the daily average temperature in July at 78.4 °F (25.8 °C), and an average of 36 days per year with temperatures reaching 90 °F (32 °C). Winters are generally much cooler and less stable, with occasional small amounts of snow. January has
9724-624: The US, China, South Korea, Taiwan, Israel, Latvia, Iceland, Sweden, Austria, and Switzerland. SCLC is particularly aggressive. 10–15% of people survive five years after a SCLC diagnosis. As with other types of lung cancer, the extent of disease at diagnosis also influences prognosis. The average person diagnosed with limited-stage SCLC survives 12–20 months from diagnosis; with extensive-stage SCLC around 12 months. While SCLC often responds initially to treatment, most people eventually relapse with chemotherapy-resistant cancer, surviving an average 3–4 months from
9867-560: The Wine Last Night", "Venus Blues", "Let's Do It", and " One Monkey Don't Stop No Show ", but his music career overall was not successful. McGhee moved from Atlantic to Essex Records , for which he recorded "My Little Rose". The record was not commercially successful, so he moved to King Records in 1953. There he recorded a number of rock-and-roll songs, such a "Whiskey, Women and Loaded Dice", "Head Happy with Wine", "Jungle Juice", "Six to Eight", "Double Crossin' Liquor", "Dealin' from
10010-426: The affected individual loses the ability to swallow. Coughing is also common, and can be managed with opioids or cough suppressants . Some experience terminal delirium – confused behavior, unexplained movements, or a reversal of the sleep-wake cycle – which can be managed by antipsychotic drugs, low-dose sedatives, and investigating other causes of discomfort such as low blood sugar , constipation , and sepsis . In
10153-593: The ages of 55–74 years be screened for lung cancer. Treatment for lung cancer depends on the cancer's specific cell type, how far it has spread , and the person's health. Common treatments for early stage cancer includes surgical removal of the tumor, chemotherapy , and radiation therapy . For later-stage cancer, chemotherapy and radiation therapy are combined with newer targeted molecular therapies and immune checkpoint inhibitors . All lung cancer treatment regimens are combined with lifestyle changes and palliative care to improve quality of life. Limited-stage SCLC
10296-401: The areas west of U.T. and includes the suburban neighborhoods of Sequoyah Hills , West Hills , Bearden , Cumberland Estates , Westmoreland, Suburban Hills, Cedar Bluff , Rocky Hill , and Ebenezer. This area, concentrated largely around Kingston Pike, is home to thriving retail centers such as West Town Mall and Turkey Creek . East Knoxville consists of the areas east of First Creek and
10439-515: The average person's lifespan by around 2 months. For stage I and stage II NSCLC the first line of treatment is often surgical removal of the affected lobe of the lung. For those not well enough to tolerate full lobe removal, a smaller chunk of lung tissue can be removed by wedge resection or segmentectomy surgery. Those with centrally located tumors and otherwise-healthy respiratory systems may have more extreme surgery to remove an entire lung ( pneumonectomy ). Experienced thoracic surgeons , and
10582-399: The blocking tissue by bronchoscopy, sometimes aided by thermal or laser ablation . Other causes of lung cancer-associated shortness of breath can be treated directly, such as antibiotics for a lung infection, diuretics for pulmonary edema , benzodiazepines for anxiety, and steroids for airway obstruction. Up to 92% of those with lung cancer report pain, either from tissue damage at
10725-753: The body. Different tumors can acquire these abilities through different mutations, though generally cancer-contributing mutations activate oncogenes and inactivate tumor suppressors . Some mutations – called "driver mutations" – are particularly common in adenocarcinomas, and contribute disproportionately to tumor development. These typically occur in the receptor tyrosine kinases EGFR, BRAF, MET, KRAS , and PIK3CA . Similarly, some adenocarcinomas are driven by chromosomal rearrangements that result in overexpression of tyrosine kinases ALK, ROS1, NTRK, and RET. A given tumor will typically have just one driver mutation. In contrast, SCLCs rarely have these driver mutations, and instead often have mutations that have inactivated
10868-601: The campus of the University of Tennessee developed around it. Other prehistoric sites include an Early Woodland habitation area at the confluence of the Tennessee River and Knob Creek (near the Knox – Blount county line), and Dallas phase Mississippian villages at Post Oak Island (also along the river near the Knox–Blount line), and at Bussell Island (at the mouth of the Little Tennessee River near Lenoir City ). By
11011-739: The center of the lungs, in the major airways. Their cells appear small with ill-defined boundaries, not much cytoplasm , many mitochondria , and have distinctive nuclei with granular-looking chromatin and no visible nucleoli . NSCLCs comprise a group of three cancer types: adenocarcinoma , squamous-cell carcinoma , and large-cell carcinoma . Nearly 40% of lung cancers are adenocarcinomas. Their cells grow in three-dimensional clumps, resemble glandular cells, and may produce mucin . About 30% of lung cancers are squamous-cell carcinomas. They typically occur close to large airways. The tumors consist of sheets of cells, with layers of keratin . A hollow cavity and associated cell death are commonly found at
11154-438: The center of the tumor. Less than 10% of lung cancers are large-cell carcinomas, so named because the cells are large, with excess cytoplasm, large nuclei, and conspicuous nucleoli . Around 10% of lung cancers are rarer types. These include mixes of the above subtypes like adenosquamous carcinoma , and rare subtypes such as carcinoid tumors , and sarcomatoid carcinomas . Several lung cancer types are subclassified based on
11297-411: The city from the south, but lacking the necessary pontoon bridges he was forced to cross the river further downstream at Loudon on November 14 and march against the city's heavily fortified western section. On November 15, General Joseph Wheeler unsuccessfully attempted to dislodge Union forces in the heights of south Knoxville, and the following day Longstreet failed to cut off retreating Union forces at
11440-643: The city of Knoxville favored secession by a 2–1 margin. In late May 1861, just before the secession vote, delegates of the East Tennessee Convention met at Temperance Hall in Knoxville in hopes of keeping Tennessee in the Union . After Tennessee voted to secede in June, the convention met in Greeneville and attempted to create a separate Union-aligned state in East Tennessee. In July 1861, after Tennessee had joined
11583-579: The city sought to recover the massive loss of revenue by attempting to annex neighboring communities. Knoxville annexed the communities of Bearden and Fountain City , which were Knoxville's largest suburbs , in 1962. Knoxville officials attempted the annexation of the neighboring Farragut - Concord community in western Knox County, but the city failed following the incorporation of Farragut in 1980. These annexation attempts often turned combative, and several attempts to consolidate Knoxville and Knox County into
11726-502: The city's central business district and municipal offices, the Old City and Gay Street are mixed residential and commercial areas. South Knoxville consists of the parts of the city located south of the river and includes the neighborhoods of Vestal, Lindbergh Forest, Island Home Park , Colonial Hills, and Old Sevier. This area contains major commercial corridors along Chapman Highway and Alcoa Highway . West Knoxville generally consists of
11869-424: The city's progressive growth due to agriculture and industry. In 1869, Thomas Humes, a Union sympathizer and president of East Tennessee University, secured federal post-war damage reimbursement and state-designated Morrill Act funding to expand the college, which had been occupied by both armies during the war. Charles Dabney , who became president of the university in 1887, overhauled the faculty and established
12012-727: The city, and parts of McAnnally Ridge in the northeastern part of the city. The Tennessee River , which passes through the downtown area, is formed in southeastern Knoxville at the confluence of the Holston River , which flows southwest from Virginia, and the French Broad River , which flows west from North Carolina. The section of the Tennessee River that passes through Knoxville is part of Fort Loudoun Lake, an artificial reservoir created by TVA's Fort Loudoun Dam about 30 miles (48 km) downstream in Lenoir City . Notable tributaries of
12155-516: The city. As of the census of 2010, the population of Knoxville was 178,874, a 2.9% increase from 2000. The median age was 32.7, with 19.1% of the population under the age of 18, and 12.6% over the age of 65. The population was 48% male and 52% female. The population density was 1,815 persons per square mile. The racial and ethnic composition of the city was 76.1% white , 17.1% black , 0.4% Native American , 1.6% Asian , and 0.2% Pacific Islander . Hispanic or Latino of any race were 4.6% of
12298-711: The downtown area setting at just over 900 feet (270 m). High points include Sharp's Ridge in North Knoxville at 1,391 feet (424 m) and Brown Mountain in South Knoxville at 1,260 feet (380 m). Knoxville is situated in the Great Appalachian Valley (known locally as the Tennessee Valley), about halfway between the Great Smoky Mountains to the east and the Cumberland Plateau to
12441-485: The early 19th century; the arrival of the railroad in 1855 led to an economic boom. The city was bitterly divided over the issue of secession during the American Civil War and was occupied alternately by Confederate and Union armies, culminating in the Battle of Fort Sanders in 1863. Following the war, Knoxville grew rapidly as a major wholesaling and manufacturing center. The city's economy stagnated after
12584-662: The economy in the Tennessee Valley, the federal government created the Tennessee Valley Authority (TVA) in 1933. Beginning with Norris Dam , TVA constructed a series of hydroelectric dams and other power plants throughout the valley over the next few decades, bringing flood control, jobs, and electricity to the region. The Federal Works Projects Administration , which also arrived in the 1930s, helped build McGhee Tyson Airport and expand Neyland Stadium . TVA's headquarters, which consists of twin high rises built in
12727-405: The extent of local spread: with the cancer metastasized to no lymph nodes (N0), pulmonary or hilar nodes (along the bronchi) on the same side as the tumor (N1), mediastinal or subcarinal lymph nodes (in the middle of the lungs, N2), or lymph nodes on the opposite side of the lung from the tumor (N3). Metastases are staged as no metastases (M0), nearby metastases (M1a; the space around the lung or
12870-545: The first two chemotherapy cycles. First-line therapy causes remission in up to 80% of those who receive it; however most people relapse with chemotherapy-resistant disease. Those who relapse are given second-line chemotherapies. Topotecan and lurbinectedin are approved by the US FDA for this purpose. Irinotecan, paclitaxel , docetaxel , vinorelbine , etoposide, and gemcitabine are also sometimes used, and are similarly efficacious. Prophylactic cranial irradiation can reduce
13013-645: The flagship campus of the University of Tennessee , whose sports teams, the Tennessee Volunteers , are popular in the surrounding area. Knoxville is also home to the headquarters of the Tennessee Valley Authority , the Tennessee Supreme Court 's courthouse for East Tennessee, and the corporate headquarters of several national and regional companies. As one of the largest cities in the Appalachian region, Knoxville has positioned itself in recent years as
13156-500: The four cardinal directions: North Knoxville , South Knoxville , East Knoxville , and West Knoxville . Downtown Knoxville traditionally consists of the area bounded by the river on the south, First Creek on the east, Second Creek on the west, and the railroad tracks on the north, though the definition has expanded to include the U.T. campus and Fort Sanders neighborhood, and several neighborhoods along or just off Broadway south of Sharp's Ridge ("Downtown North"). While primarily home to
13299-687: The genetic makeup of the cancerous cells. Up to 30% of tumors have mutations in the EGFR gene that result in an overactive EGFR protein; these can be treated with EGFR inhibitors osimertinib , erlotinib , gefitinib , afatinib , or dacomitinib – with osimertinib known to be superior to erlotinib and gefitinib, and all superior to chemotherapy alone. Up to 7% of those with NSCLC harbor mutations that result in hyperactive ALK protein, which can be treated with ALK inhibitors crizotinib , or its successors alectinib , brigatinib , and ceritinib . Those treated with ALK inhibitors who relapse can then be treated with
13442-487: The growth characteristics of the cancer cells. Adenocarcinomas are classified as lepidic (growing along the surface of intact alveolar walls), acinar and papillary , or micropapillary and solid pattern. Lepidic adenocarcinomas tend to be least aggressive, while micropapillary and solid pattern adenocarcinomas are most aggressive. In addition to examining cell morphology, biopsies are often stained by immunohistochemistry to confirm lung cancer classification. SCLCs bear
13585-425: The growth of a tumor. Without treatment, tumors spread throughout the lung, damaging lung function. Eventually lung tumors metastasize , spreading to other parts of the body. Early lung cancer often has no symptoms and can only be detected by medical imaging . As the cancer progresses, most people experience nonspecific respiratory problems: coughing , shortness of breath , or chest pain . Other symptoms depend on
13728-465: The heart , arrhythmia (irregular heartbeat), and heart failure . About one in three people diagnosed with lung cancer have symptoms caused by metastases in sites other than the lungs. Lung cancer can metastasize anywhere in the body, with different symptoms depending on the location. Brain metastases can cause headache , nausea , vomiting , seizures , and neurological deficits . Bone metastases can cause pain, bone fractures , and compression of
13871-409: The heart, and disseminated intravascular coagulation (clots throughout the body). Paraneoplastic syndromes involving the skin and kidneys are rare, each occurring in up to 1% of those with lung cancer. A person suspected of having lung cancer will have imaging tests done to evaluate the presence, extent, and location of tumors. First, many primary care providers perform a chest X-ray to look for
14014-423: The heart, or the opposite lung), a single distant metastasis (M1b), or multiple metastases (M1c). These T, N, and M scores are combined to designate a stage grouping for the cancer. Cancer limited to smaller tumors is designated stage I. Disease with larger tumors or spread to the nearest lymph nodes is stage II. Cancer with the largest tumors or extensive lymph node spread is stage III. Cancer that has metastasized
14157-473: The last few days of life, many develop terminal secretions – pooled fluid in the airways that can cause a rattling sound while breathing. This is thought not to cause respiratory problems, but can distress family members and caregivers. Terminal secretions can be reduced by anticholinergic medications . Even those who are non-communicative or have reduced consciousness may be able to experience cancer-related pain, so pain medications are typically continued until
14300-500: The limited stage, meaning cancer is confined to one side of the chest, within the scope of a single radiotherapy field. The other two thirds are diagnosed at the "extensive stage", with cancer spread to both sides of the chest, or to other parts of the body. NSCLC – and sometimes SCLC – is typically staged with the American Joint Committee on Cancer 's Tumor, Node, Metastasis (TNM) staging system . The size and extent of
14443-403: The little-finger side of the arm as well as destruction of the topmost ribs . Swollen lymph nodes above the collarbone can indicate a tumor that has spread within the chest. Tumors obstructing bloodflow to the heart can cause superior vena cava syndrome (swelling of the upper body and shortness of breath), while tumors infiltrating the area around the heart can cause fluid buildup around
14586-494: The location and size of the tumor. Those suspected of having lung cancer typically undergo a series of imaging tests to determine the location and extent of any tumors. Definitive diagnosis of lung cancer requires a biopsy of the suspected tumor be examined by a pathologist under a microscope . In addition to recognizing cancerous cells, a pathologist can classify the tumor according to the type of cells it originates from. Around 15% of cases are small-cell lung cancer (SCLC), and
14729-1057: The lower levels of radon that seep into residential spaces can increase occupants' risk of lung cancer. Like asbestos, cigarette smoking and radon exposure increase risk synergistically. Radon exposure is responsible for between 3% and 14% of lung cancer cases. Several other chemicals encountered in various occupations are also associated with increased lung cancer risk including arsenic used in wood preservation , pesticide application, and some ore smelting ; ionizing radiation encountered during uranium mining ; vinyl chloride in papermaking ; beryllium in jewelers , ceramics workers, missile technicians, and nuclear reactor workers; chromium in stainless steel production, welding , and hide tanning ; nickel in electroplaters , glass workers, metal workers, welders, and those who make batteries, ceramics, and jewelry; and diesel exhaust encountered by miners. Exposure to air pollution , especially particulate matter released by motor vehicle exhaust and fossil fuel -burning power plants, increases
14872-550: The lung increase one's risk of lung cancer. This association is strongest for chronic obstructive pulmonary disorder – the risk is highest in those with the most inflammation, and reduced in those whose inflammation is treated with inhaled corticosteroids . Other inflammatory lung and immune system diseases such as alpha-1 antitrypsin deficiency , interstitial fibrosis , scleroderma , Chlamydia pneumoniae infection, tuberculosis , and HIV infection are associated with increased risk of developing lung cancer. Epstein–Barr virus
15015-410: The markers of neuroendocrine cells , such as chromogranin , synaptophysin , and CD56 . Adenocarcinomas tend to express Napsin-A and TTF-1 ; squamous cell carcinomas lack Napsin-A and TTF-1 , but express p63 and its cancer-specific isoform p40. CK7 and CK20 are also commonly used to differentiate lung cancers. CK20 is found in several cancers, but typically absent from lung cancer. CK7
15158-675: The military in 1942 and served in the U.S. Army during World War II . After being discharged in 1946, he settled in New York. In the military, McGhee often played his guitar. One of the songs he performed was "Drinkin' Wine, Spo-Dee-O-Dee". The original lyrics of the song were as follows: Drinkin' that mess is our delight, And when we get drunk, start fightin' all night. Knockin' out windows and tearin' down doors, Drinkin' half-gallons and callin' for more. Drinkin' wine motherfucker, drinkin' wine! Goddam! Drinkin' wine motherfucker, drinkin' wine! Goddam! Drinkin' wine motherfucker, drinkin' wine! Goddam! Pass that bottle to me!" It
15301-512: The most-advanced stage, IVB, have a two-year survival of 10% and a five-year survival of 0%. Five-year survival is higher in women (22%) than men (16%). Women tend to be diagnosed with less-advanced disease, and have better outcomes than men diagnosed at the same stage. Average five-year survival also varies across the world, with particularly high five-year survival in Japan (33%), and five-year survival above 20% in 12 other countries: Mauritius, Canada,
15444-531: The new version in January 1947. It sold for 49 cents. It did not get much airplay until two years later, when Stick re-created the song for Atlantic Records . It was on the Billboard R&;B chart for almost half a year, rising to number 2, where it stayed for four weeks. Numerous cover versions of his songs were recorded over the years. The first cover was by Lionel Hampton , featuring Sonny Parker ; next
15587-500: The newly created Territory South of the River Ohio . One of Blount's first tasks was to meet with the Cherokee and establish territorial boundaries and resolve the issue of illegal settlers. This he accomplished almost immediately with the Treaty of Holston , which was negotiated and signed at White's Fort in 1791. Blount originally wanted to place the territorial capital at the confluence of
15730-431: The nicotine replacement varenicline as first-line therapies to aid in smoking cessation. Clonidine and nortriptyline are recommended second-line therapies. The majority of those diagnosed with lung cancer attempt to quit smoking; around half succeed. Even after lung cancer diagnosis, smoking cessation improves treatment outcomes, reducing cancer treatment toxicity and failure rates, and lengthening survival time. At
15873-596: The opening of the Women's Basketball Hall of Fame and the Knoxville Convention Center , the redevelopment of Market Square , a new visitors center, a regional history museum , a Regal Cinemas theater, several restaurants and bars, and many new and redeveloped condominiums. Since 2000, Knoxville has successfully brought business back to the downtown area. The arts in particular have begun to flourish; there are multiple venues for outdoor concerts, and Gay Street hosts
16016-645: The population of the Knoxville Metropolitan Area was 837,571. The Knoxville MSA is the chief component of the larger OMB-designated Knoxville- Sevierville - La Follette Combined Statistical Area (CSA). The CSA also includes the Morristown Metropolitan Statistical Area ( Hamblen , Grainger , and Jefferson counties) and the Sevierville ( Sevier County ), La Follette (Campbell County), Harriman (Roane County), and Newport ( Cocke County ) micropolitan statistical areas . Municipalities in
16159-430: The population. People reporting more than one race formed 2.5% of the population. Lung cancer Lung cancer , also known as lung carcinoma , is a malignant tumor that begins in the lung . Lung cancer is caused by genetic damage to the DNA of cells in the airways, often caused by cigarette smoking or inhaling damaging chemicals. Damaged airway cells gain the ability to multiply unchecked, causing
16302-526: The protein PD-L1 , but are sometimes effective in those that do not. Treatment with pembrolizumab , atezolizumab , or combination nivolumab plus ipilimumab are all superior to chemotherapy alone against tumors expressing PD-L1. Those who relapse on the above are treated with second-line chemotherapeutics docetaxel and ramucirumab . Integrating palliative care (medical care focused on improving symptoms and lessening discomfort) into lung cancer treatment from
16445-459: The remaining 85% (the non-small-cell lung cancers or NSCLC) are adenocarcinomas , squamous-cell carcinomas , and large-cell carcinomas . After diagnosis, further imaging and biopsies are done to determine the cancer's stage based on how far it has spread. Treatment for early stage lung cancer includes surgery to remove the tumor, sometimes followed by radiation therapy and chemotherapy to kill any remaining cancer cells. Later stage cancer
16588-412: The risk of brain metastases and improve survival in those with limited-stage disease. Extensive-stage SCLC is treated first with etoposide along with either cisplatin or carboplatin. Radiotherapy is used only to shrink tumors that are causing particularly severe symptoms. Combining standard chemotherapy with an immune checkpoint inhibitor can improve survival for a minority of those affected, extending
16731-400: The risk of developing lung cancer as an average person, even after controlling for occupational exposure and smoking habits. Genome-wide association studies have identified many gene variants associated with lung cancer risk, each of which contributes a small risk increase. Many of these genes participate in pathways known to be involved in carcinogenesis, namely DNA repair , inflammation ,
16874-420: The risk of lung cancer. Indoor air pollution from burning wood , charcoal , or crop residue for cooking and heating has also been linked to an increased risk of developing lung cancer. The International Agency for Research on Cancer has classified emission from household burning of coal and biomass as "carcinogenic" and "probably carcinogenic" respectively. Several other diseases that cause inflammation of
17017-455: The risk of someone who smokes and has asbestos exposure dying from lung cancer is much higher than would be expected from adding the two risks together. Similarly, exposure to radon , a naturally occurring breakdown product of the Earth's radioactive elements , is associated with increased lung cancer risk. Radon levels vary with geography. Underground miners have the greatest exposure; however even
17160-413: The same lobe of the lung, or invade the chest wall , diaphragm (or the nerve that controls it ), or area around the heart. Tumors that are larger than 7 cm, have nodules spread in different lobes of a lung, or invade the mediastinum (center of the chest cavity), heart, largest blood vessels that supply the heart, trachea , esophagus , or spine are designated T4. Lymph node staging depends on
17303-419: The settlers and the Cherokee rose steadily. In 1786, James White , a Revolutionary War officer, and his friend James Connor built White's Fort near the mouth of First Creek, on land White had purchased three years earlier. In 1790, White's son-in-law, Charles McClung —who had arrived from Pennsylvania the previous year—surveyed White's holdings between First Creek and Second Creek for the establishment of
17446-678: The third-generation ALK inhibitor lorlatinib . Up to 5% with NSCLC have overactive MET , which can be inhibited with MET inhibitors capmatinib or tepotinib . Targeted therapies are also available for some cancers with rare mutations. Cancers with hyperactive BRAF (around 2% of NSCLC) can be treated by dabrafenib combined with the MEK inhibitor trametinib ; those with activated ROS1 (around 1% of NSCLC) can be inhibited by crizotinib, lorlatinib, or entrectinib ; overactive NTRK (<1% of NSCLC) by entrectinib or larotrectinib ; active RET (around 1% of NSCLC) by selpercatinib . People whose NSCLC
17589-442: The time of death. Around 19% of people diagnosed with lung cancer survive five years from diagnosis , though prognosis varies based on the stage of the disease at diagnosis and the type of lung cancer. Prognosis is better for people with lung cancer diagnosed at an earlier stage; those diagnosed at the earliest TNM stage, IA1 (small tumor, no spread), have a two-year survival of 97% and five-year survival of 92%. Those diagnosed at
17732-419: The time of diagnosis improves the survival time and quality of life of those with lung cancer. Particularly common symptoms of lung cancer are shortness of breath and pain. Supplemental oxygen, improved airflow, re-orienting an affected person in bed, and low-dose morphine can all improve shortness of breath. In around 20 to 30% of those with lung cancer – particularly those with late-stage disease – growth of
17875-443: The time of relapse. Those with limited stage SCLC that go into complete remission after chemotherapy and radiotherapy have a 50% chance of brain metastases developing within the next two years – a chance reduced by prophylactic cranial irradiation. Several other personal and disease factors are associated with improved outcomes. Those diagnosed at a younger age tend to have better outcomes. Those who smoke or experience weight loss as
18018-489: The treaty was signed in 1791. However, the terms of the treaty came under dispute, culminating in ongoing violence on both sides. When the government invited Cherokee chief Hanging Maw for negotiations in 1793, Knoxville settlers attacked the Cherokee against orders, killing the chief's wife. Peace was renegotiated in 1794. Knoxville served as capital of the Southwest Territory and as capital of Tennessee (admitted as
18161-531: The tumor (T), spread to regional lymph nodes (N), and distant metastases (M) are scored individually, and combined to form stage groups. Relatively small tumors are designated T1, which are subdivided by size: tumors ≤ 1 centimeter (cm) across are T1a; 1–2 cm T1b; 2–3 cm T1c. Tumors up to 5 cm across, or those that have spread to the visceral pleura (tissue covering the lung) or main bronchi , are designated T2. T2a designates 3–4 cm tumors; T2b 4–5 cm tumors. T3 tumors are up to 7 cm across, have multiple nodules in
18304-494: The tumor can narrow or block the airway , causing coughing and difficulty breathing. Obstructing tumors can be surgically removed where possible, though typically those with airway obstruction are not well enough for surgery. In such cases the American College of Chest Physicians recommends opening the airway by inserting a stent , attempting to shrink the tumor with localized radiation ( brachytherapy ), or physically removing
18447-1309: The tumor site(s) or nerve damage. The World Health Organization (WHO) has developed a three-tiered system for managing cancer pain. For those with mild pain (tier one), the WHO recommends acetominophen or a nonsteroidal anti-inflammatory drug . Around a third of people experience moderate (tier two) or severe (tier three) pain, for which the WHO recommends opioid painkillers. Opioids are typically effective at easing nociceptive pain (pain caused by damage to various body tissues). Opioids are occasionally effective at easing neuropathic pain (pain caused by nerve damage). Neuropathic agents such as anticonvulsants , tricyclic antidepressants , and serotonin–norepinephrine reuptake inhibitors , are often used to ease neuropathic pain, either alone or in combination with opioids. In many cases, targeted radiotherapy can be used to shrink tumors, reducing pain and other symptoms caused by tumor growth. Individuals who have advanced disease and are approaching end-of-life can benefit from dedicated end-of-life care to manage symptoms and ease suffering. As in earlier disease, pain and difficulty breathing are common, and can be managed with opioid pain medications, transitioning from oral medication to injected medication if
18590-529: The tumor suppressors p53 and RB . A cluster of tumor suppressor genes on the short arm of chromosome 3 are often lost early in the development of all lung cancers. Those who smoke can reduce their lung cancer risk by quitting smoking – the risk reduction is greater the longer a person goes without smoking. Self-help programs tend to have little influence on success of smoking cessation, whereas combined counseling and pharmacotherapy improve cessation rates. The US FDA has approved antidepressant therapies and
18733-478: The tumors can be successfully treated and result in decreased mortality. There is evidence that regular low-dose CT scans in people at high risk of developing lung cancer reduces total lung cancer deaths by as much as 20%. Despite evidence of benefit in these populations, potential harms of screening include the potential for a person to have a 'false positive' screening result that may lead to unnecessary testing, invasive procedures, and distress. Although rare, there
18876-417: The type of cells the tumor is derived from; tumors derived from different cells progress and respond to treatment differently. There are two main types of lung cancer, categorized by the size and appearance of the malignant cells seen by a histopathologist under a microscope : small cell lung cancer (SCLC; 15% of cases) and non-small-cell lung cancer (NSCLC; 85% of cases). SCLC tumors are often found near
19019-475: The west. The Great Valley is part of a sub-range of the Appalachian Mountains known as the Ridge-and-Valley Appalachians , which is characterized by long narrow ridges flanked by broad valleys. Prominent Ridge-and-Valley structures in the Knoxville area include Sharp's Ridge and Beaver Ridge in the northern part of the city, Brown Mountain in South Knoxville, parts of Bays Mountain just south of
19162-457: Was McGhee's last recording session. He became ill shortly afterward and died in August 1961. McGhee died of lung cancer in The Bronx , New York, on August 15, 1961, at the age of forty-three. He left his old guitar to Brownie's son before he died. With Sonny Terry Knoxville, Tennessee Knoxville is a city in and the county seat of Knox County, Tennessee , United States, on
19305-447: Was a cover by Wynonie Harris , followed by a hillbilly-bop version by Loy Gordon & His Pleasant Valley Boys. "Drinkin' Wine, Spo-Dee-O-Dee" continued to be popular throughout the 1950s in cover versions by various artists, including Malcolm Yelvington in 1954, Johnny Burnette in 1957, and Jerry Lee Lewis in 1959. McGhee continued to make records for Atlantic and created popular songs such as "Tennessee Waltz Blues", "Drank Up All
19448-453: Was a rare disease. In the 1950s and 1960s, increasing evidence linked lung cancer and tobacco use, culminating in declarations by most large national health bodies discouraging tobacco use. Early lung cancer often has no symptoms. When symptoms do arise they are often nonspecific respiratory problems – coughing , shortness of breath , or chest pain – that can differ from person to person. Those who experience coughing tend to report either
19591-483: Was annexed in 1897, and over 5,000 new homes were built between 1895 and 1904. In 1901, train robber Kid Curry (whose real name was Harvey Logan), a member of Butch Cassidy 's Wild Bunch was captured after shooting two deputies on Knoxville's Central Avenue. He escaped from the Knoxville jail and rode away on a horse stolen from the sheriff. Knoxville hosted the Appalachian Exposition in 1910 and 1911 and
19734-573: Was concentrated in what the American colonists called the Overhill settlements along the Little Tennessee River , southwest of Knoxville. The first white traders and explorers were recorded as arriving in the Tennessee Valley in the late 17th century. There is significant evidence that Spanish explorer Hernando de Soto visited Bussell Island in 1540. The first major recorded Euro-American presence in
19877-509: Was fortifying Knoxville, a Confederate army under Braxton Bragg defeated Union forces under William Rosecrans at the Battle of Chickamauga (near the Tennessee-Georgia line) and laid siege to Chattanooga . On November 3, 1863, the Confederates sent General James Longstreet to attack Burnside at Knoxville and prevent him from reinforcing the Union at Chattanooga. Longstreet wanted to attack
20020-404: Was impressed by the town's modern frame buildings, the town had "seven taverns" and no church. Knoxville initially thrived as a way station for travelers and migrants heading west. Its location at the confluence of three major rivers in the Tennessee Valley brought flatboat and later steamboat traffic to its waterfront in the first half of the 19th century, and Knoxville quickly developed into
20163-415: Was one of the earliest prototypical rock-and-roll songs . Cover versions were recorded by Wynonie Harris , Lionel Hampton , Big John Greer , Johnny Burnette , Jerry Lee Lewis , and Mike Bloomfield 's Electric Flag (as "Wine"). The song lent its name to the alcoholic fruit drink spodi . In 1946 Granville and Brownie McGhee wrote a version of the song that didn't use profanity. Harlem Records released
20306-403: Was one of the region's leading anti-secessionists (although he strongly defended the practice of slavery). Blount County, just south of Knoxville, had developed into a center of abolitionist activity, due in part to its relatively large Quaker faction and the anti-slavery president of Maryville College , Isaac Anderson. The Greater Warner Tabernacle AME Zion Church was reportedly a station on
20449-467: Was selected because Knoxville was home to TVA's headquarters and for its proximity to Oak Ridge National Laboratory . The Sunsphere , a 266-foot (81 m) steel truss structure topped with a gold-colored glass sphere, was built for the fair and remains one of Knoxville's most prominent structures, along with the adjacent Tennessee Amphitheater . During the 1980s and into the 1990s, the city would see one of its largest expansions of its city limits, with
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