Lung cancer


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Lung cancer

  1. 1. PRESENTINGLUNG CANCER BY Denmark Guillermo, RN
  2. 2. Lung CancerUncontrolled growth of malignant cells in one or both lungs and tracheo-bronchial tree A result of repeated carcinogenic irritation causing increased rates of cell replicationProliferation of abnormal cells leads to hyperplasia, dysplasia or carcinoma
  3. 3. Picture of the Lungs
  4. 4. What is the Function of the Lungs?  The lungs consist of five lobes, three in the right lung and two in the left lung  Most cells in the lung are epithelial cells, which line the breathing passages and produce mucus, which lubricates and protects the lungs  The main function of the lungs is to allow oxygen from the air to enter the bloodstream for delivery to the rest of the body
  5. 5. Normal Cell Division
  6. 6. Two types of cell Cycle MechanismsCDK cycle mechanism- Ensures well delineated transition bet. Cell cycle stagesCheck- point control mechanism- sense flaws in DNA replication and chromosome segregation
  7. 7. Risk factors of Lung CancerRadiation ExposureSmokingEnvironmental/ Occupational Exposure Asbestos Radon Passive smoke
  8. 8. Smoking Facts Tobacco use is the leading cause of lung cancer 87% of lung cancers are related to smoking Risk related to:  age of smoking onset  amount smoked  gender  product smoked  depth of inhalation
  9. 9. Pathophysiology of Lung Cancer
  10. 10. Smoking – Chronic(Carcinogens)
  11. 11. Injury toInhalation of Pulmonary and Smoke Alveolar Epithelium Destruction of Walls Between the Alveoli
  12. 12. Inhalation of Smoke Defense Mechanism of the Lung Lose Effectiveness
  13. 13. Carcinogen Penetrate the lower Airways Lower Airways Inflammations
  14. 14. Carcinogens are Lodged in the LungsNarrowAirways Increase Sputum Production Dyspnea
  15. 15. INFECTION Pleuritic ChestFEVER Pain SWEATS Chills
  16. 16. Injury to Pulmonary and Alveolar Epithelium Localized lesion in the lung area
  17. 17. Bleeding willoccur(hemoptysis)
  18. 18. Destruction of Walls Between the Alveoli Increase “DEAD SPACE” (Areas That Do Not Participate in Gas or Blood Exchange)
  19. 19. Decrease o2 Increase supply to the Respiratory blood Rate(Compensatory Mechanism) fatigue
  20. 20. Cell cyclemechanism alteration
  21. 21. Undetected flaws in DNAreplication and chromosome segregation
  22. 22. uncontrolleddefective cell proliferation
  23. 23. Tumorformation(cancer cells formation)
  24. 24. TUMOR(Cancer Cells)
  25. 25. METASTASI S
  26. 26. 1 Obstruction of the Regional Lymph Node
  27. 27. 2 Direct Extension to larynx
  28. 28. 3 Compression of Esophagus
  29. 29. 4 Compression of Superior Vena Cava
  30. 30. 5 Obstruction of Venous Blood Flow
  31. 31. Obstruction of the Regional Lymph Impaired Node lymph Drainage ex.(Mediastinal Lymph)
  32. 32. Diaphragm Paralysis (Phrenic NerveVocal Cord Compression) Paralysis
  33. 33. Direct Extension to the larynx Laryngeal Nerve HoarsenessCompression
  34. 34. Compression of EsophagusDysphagia
  35. 35. Compression of Superior Vena Cava Superior Vena Cava Syndrome
  36. 36. Obstruction ofVenous Blood Flow
  37. 37. 1 2 Shortness of Swelling Breath (Facial Arm and Truck)3 Distension of 4 Chest Thoracic Vein Pain
  38. 38. Syndromes/Symptoms secondary toregional metastases: 1.Esophageal compression dysphagia 2.Laryngeal nerve paralysis hoarseness 3.Symptomatic nerve paralysis Horner’s syndrome 4.Cervical/thoracic nerve invasion 5.Pancoast syndrome 6.Lymphatic obstruction pleural effusion 7.Vascular obstruction SVC syndrome 8.Pericardial/cardiac extension effusion, tamponade
  39. 39. Where does it travel?Lymph Nodes, Brain, Liver, Adrenal, Gland, Bones40% of metastasis occurs in the Adrenal Gland
  40. 40. How is Lung Cancer Treated?1.Treatment depends on the stage and type of lung cancer2.Surgery3.Radiation therapy4.Chemotherapy (options include a combination of drugs)5.Targeted therapy6.Lung cancer is usually treated with a combination of therapies
  41. 41. Cancer Treatment: Surgery1.The tumor and the nearby lymph nodes in the chest are typically removed to offer the best chance for cure2.For non-small cell lung cancer, a lobectomy (removal of the entire lobe where the tumor is located), has shown to be most effective3.Surgery may not be possible in some patients
  42. 42. Cancer Treatment: Chemotherapy1.Drugs used to kill cancer cells2.A combination of medications is often used3.May be prescribed before or after surgery, or before, during, or after radiation therapy4.Can improve survival and lessen lung cancer symptoms in all patients, even those with widespread lung cancer
  43. 43. Cancer Treatment: RadiationTherapy1.The use of high-energy x-rays or other particles to destroy cancer cells2.Side effects include fatigue, malaise (feeling unwell), loss of appetite, and skin irritation at the treatment site3.Radiation pneumonitis is the irritation and inflammation of the lung; occurs in 15% of patients4.It is important that the radiation treatments avoid the healthy parts of the lung
  44. 44. Lung Cancer Staging1.Staging is a way of describing a cancer, such as the size of the tumor and where it has spread2.Staging is the most important tool doctors have to determine a patient’s prognosis3.The type of treatment a person receives depends on the stage of the cancer4.Staging is different for non-small cell lung cancer and small cell lung cancer
  45. 45. Stage I Non-Small Cell Lung Cancer 1.Cancer is found only in the lung 2.Surgical removal recommended 3.Radiation therapy and/or chemotherapy may also be used
  46. 46. Stage II Non-Small Cell Lung Cancer 1.The cancer has spread to lymph nodes in the lung 2.Treatment is surgery to remove the tumor and nearby lymph nodes 3.Chemotherapy recommended; radiation therapy sometimes given after chemotherapy
  47. 47. Stage III Non-Small Cell LungCancer 1.The cancer has spread to the lymph nodes located in the center of the chest, outside the lung 2.Stage IIIA cancer has spread to lymph nodes in the chest, on the same side where the cancer originated 3. Stage IIIB cancer has spread to lymph nodes on the opposite side of the chest, under the collarbone, or the pleura (lining of the chest cavity) 4.Surgery or radiation therapy with chemotherapy recommended for stage IIIA 5.Chemotherapy and sometimes radiation therapy recommended for stage IIIB
  48. 48. Stage IV Non-Small Cell Lung Cancer 1.The cancer has spread to different lobes of the lung or to other organs, such as the brain, bones, and liver 2.Stage IV non-small cell lung cancer is treated with chemotherapy
  49. 49. Small Cell Lung Cancer–All Stages1.Patients with limited stage (confined to one area of the chest) small cell lung cancer are treated with simultaneous radiation therapy and chemotherapy2.Patients with extensive stage (not confined to one area of the chest) small cell lung cancer are treated with chemotherapy only3.Because small cell lung cancer can spread to the brain, preventative radiation therapy to the brain is routinely recommended to all patients whose tumors disappear following chemotherapy and radiation therapy
  50. 50. Nursing responsibilitiesNursing Management during Diagnostic Phase 1. Obtain nursing history(cough , dyspnea , pain or recurrent infection) 2. focus on emotional aspect of assessment 3. Educate the client with the required physical care and scheduled examinations 4. Assist to cope with anxiety
  51. 51. Nursing management duringTreatment Phase1. Put great emphasis on assessment of respiratory system to determine ability of the client to cope up with surgical intervention2. Clients with impaired pulmonary function may be treated with antibiotics, bronchodilating medications, and supervised breathing exercise
  52. 52. 3. Encouraged patient to avoid smoking during preoperative because smoking will increase pulmonary secretions and decrease blood oxygen saturation.4.Assess the clients understanding and further information as needed5.Explain the procedure to be done and the expected outcome6. Explain and demonstrate post – op exercises such as leg exercise and correct posture
  53. 53. Postoperative assessments1.Monitor for signs and symptoms of respiratory failure2. Monitor for signs of tension pneumothorax3. Observe for subcutaneous emphysema around incision and in chest and neck4.Monitor for signs of pulmonary embolism5. Assess dressing6. Assess drainage
  54. 54. 7. Assess breath sound before and after coughing8. Administer pain medication as ordered9. Allow adequate rest periods10. Provide client opportunity to ventilate feelings
  55. 55. Nursing Interventions duringTerminal Phase1. Physical support such as giving of pain medication should be given great emphasis.2.Help the client to ventilate thoughts and feelings3. Assist significant others to cope with the situation
  56. 56. QuitSmoking!!!!!!