This document discusses lung cancer, including its main types, risk factors, clinical findings, symptoms, and methods of investigation. It notes that the main types of lung cancer are bronchogenic carcinoma arising from bronchial epithelium and pulmonary carcinoma arising from alveolar epithelium. The biggest risk factors are smoking, environmental exposures, and certain occupations. Clinical findings may include cough, breathlessness, chest pain, weight loss, and metastatic spread. Diagnosis involves imaging like x-ray and CT, as well as procedures like bronchoscopy and biopsy.
7. Earliest and permanent symptom.
Beginning: dry,wheezing,
nocturnal
Later: nauseating,painful,
suffocation attack accompanies
“Three week cough” is
highlighted as symptom that
merits a chest X-ray.
7COUGH
8. 8
First vitreous,then mucopurulent
and rust colored purulent;
odorless sputum.
Haemoptysis in the form of small
blood clots or veins added to
sputum – tumor bleeding into
airway.
Rupture of larger vessel –
pulmonary hemorrhage.
9. BREATHLESSNESS 9
Central tumours occlude large airways
resulting in lung collapse and
breathlessness on exertion.
Many patients with lung cancer have co-
existent COPD which is also a cause of
breathlessness.
10. Appears in later stages.
Character of pain:
» aching
» drilling or stabbing
» less pressing
» compressing
Increases with deep breathing,
coughing or moving the shoulder girdle
and tilting the trunk to the right or left.
10CHEST PAIN
11. CHEST PAIN
Site of the pain depends on the location of pathological
process.
» Peripheral tumor or metastasis to pleura – in the affected
half of the chest as in pleurits
» Metastases to ribs – localized to the site of metastasis
» Tumor at the apex of lungs – in the humeral girdle and
arm due to a pressure on the brachial plexus
11
12. FEVER
At the beginning stage, it is
noted in 35% patients.
» At first it is subfebrile and
unstable
» Can be high and remitting
» May turn into hectic
12
13. EXAMINATION
» At beginning stage symptoms may be absent
» At a later stage skin turns pale yellowish,
mucosa becomes cyanotic
» In superior vena cava compression – edema of
the neck
» Reduced subcutaneous fat is reduced (weight
loss)
13
14. EXAMINATION
» Nerve compression: brachial plexus compression –
C8/T1 palsy, small muscle weakness in the hand, pain
radiating to the arm; due to sympatic chain compression
– Horner’s syndrome, miosis, ptosis, anhidrosis.
» Bronchial carcinoma – can invade phrenic nerve causing
ipsilateral hemidiaphragm paralysis; esophagus
producing dysphagia; pericardium pericardial effusion
and malignant dysrhythmias.
14
15. PALPATION
» Cervical, supraclavicular or axillary nodes can
be palpated
» More severe occlusion of supraclavicular fossa,
smaller size of the affected lung, lag of
movement of one shoulder – upper major
bronchus tumor
15
16. PERCUSSION
» Tympanic sound – over the tumor
» Dull sound - in case of obstruction of the
bronchus lumen and the formation of
atelectasis
16
17. AUSCULTATION
» Narrowing of main bronchus
– stenotic breathing
» Complete obstruction –
atelectasis
» With recurrent infections –
characteristic symptoms of
these diseases
17
18. METASTATIC SPREAD
Bronchial carcinoma commonly spreads to mediastinal,
cervical and even axillary or intra-abdominal nodes.
Metastatic sites:
» Liver
» Bone
» Adrenal gland
» Brain
» Malignant pleural effusion
18
