Lungs Cancer

WHAT IS IT?

LUNG CANCER

IS THE MALIGNANCY

IN THE EPITHELIUM OF

THE RESPIRATORY TRACT

(Luckmann & Sorennsen 1993)

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HOW TO CLASSIFY?

Clinically, grouped into 2 divisions

SMALL CELL LUNG CANCER (Oat Cell)

NON SMALL CELL LUNG CANCERSquamous Cell Epidermoid

Adenocarcinoma

Large Cell


SMALL CELL LUNG CARCINOMA

20-25% of lung cancer

Rapid growth

Metastasis to mediastinum,thoracic and extra thoracic structures

May narrow bronchi (compression)

Causes hoarseness (paralysis of laryngeal nerve)


NON SMALL CELL LUNG CARCINOMA

SQUAMOUS CELL/ EPIDERMOID


Arise from bronchial epithelium

Cavitation may also occur

Slow growth, metastasis not common

Secondary infections distal to obstructive tumor in bronchioles frequently occur



ADENOCARCINOMA25-30% of lung cancerArise from bronchiole mucus glandSlow growth, may metastasizeRarely cavityStrongly linked to cigarette smokingBronchiolo alveolar cell carcinoma is a subtype



LARGE CELL CARCINOMA


Cavitation common

Slow, metastasis may occur to kidney, liver and adrenals

May be located centrally, mid lung or peripherally


HOW DOES THE CANCER SPREAD/ METASTATIZE?




CAUSES AND RISK FACTOR

Smoking (heavy smoking?)

Exposure to secondhand smoke

Family history of lung cancer

Exposure to asbestos and other chemicals

Air pollution (urban vs rural)


SIGN AND SYMPTOMS

Chronic persistent cough( obstructs airflow)

Coughing up blood, sputum streaked with blood

Any change in respiratory pattern

Weight loss and loss of appetite.

Difficulty swallowing.

Swelling in the neck and face.

Pericardial effusion and temponade04/11/23 www.health-nurses-doctors.blogspot.com

SIGN AND SYMPTOMS

Chest pain ,shoulder, or back pain that does not go away and often gets worse with deep breathing SOB, dyspnea and wheezing Repeated bouts of pneumonia or bronchitis Hoarseness that lasts more than two weeks Increasing fatigue and weakness. Clubbing of the fingers and toes


SIGN AND SYMPTOMS

Horner’s Syndrome (miosis pupil contraction, partial eyelid ptosis, anhidrosis absence of sweating)

Tumor rib involvementbone pain sympathetic nerve ganglia


Diagnosis

Chest X-RaySputum cytologyCT scanMRI scanBronchoscopyLung biopsy /percutaneous needle biopsy/ mediastinoscopy


Treatment

General health

Type of lung cancer (small cell or non-small cell)

Size and position of the tumour

Stage

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SURGICAL MANAGEMENT

Wedge Resection: Involves the removal of a small localized area of diseased tissue near the surface of the lung. Pulmonary functions & structures remain unchanged.Segmental Resection: involves the removal of one or more lung segments (a bronchiole and its alveoli) the remaining lung tissue over expands to fill the space.Lobectomy: lobectomy involves removing an entire lobe of one lung.


SURGICAL MANAGEMENT

Pneumonectomy: an entire lung is removed.

HOW WOULD THE

PATIENT BREATHE

THEN??


Once the lung is removed, the involved side of the thoracic cavity is an empty space.In order to reduce the size of this cavity, the phrenic nerve is severed on the affected side to paralyze the diaphragm in an elevated positionThoracoplasty may also be performed to further reduce the thoracic space


MEDICAL MANAGEMENT

Radiation therapy

Chemotherapy


NURSING MANAGEMENT:

Assessment: Respiratory assessmentLab investigations and other diagnostic

tests Patient’s knowledge and understanding of

diagnosis and treatment,Patient’s anxiety level and support system, Exposure to carcinogen


NURSING DIAGNOSIS:

Ineffective airway clearance related to increased tracheobroncheal secretion

Anxiety related to lack of knowledge Pain related to the pressure of the tumorAltered nutrition less then body

requirement related increased metabolic demand and decreased food intake

Ineffective breathing pattern related to decreased lung capacity


NURSING INTERVENTION

Monitor S/S of respiratory failure Monitor results of chest X-ray examinations, lab

values and other investigations Administer chemotherapy and other desired

medications Educate patient with their disease and its progression Provide opportunity to the client to ventilate his

feelings Identify their support system Post surgery care Care of patients with chest drainage

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Health promotions/teaching:Abstinence from smoking:

Determine the cause /factors of smoking and help client abstinence from smoking

Nicotine therapy or Non nicotine therapyUse of nicotine patch, gum, nasal spray, inhaler

Dealing with urge to smokingCounseling/ support groupDiscussion with any Ex smokerAvoid RelapseChange environment

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Prevention

Stop smoking.

Avoid secondhand smoke

Avoid carcinogens at work. Take precautions to protect yourself from exposure to toxic chemicals at work.

Eat a diet full of fruits and vegetables. Choose a healthy diet with a variety of fruits and vegetables. Food sources of vitamins and nutrients are best.

Exercise


CONCLUSION

WHAT U R IS

HOW DO U

PERCIEVE

URSELF


Lungs Cancer

Health & Medicine