Lung cancer

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Lung cancer

  1. 1. LUNG CANCER
  2. 2. INCIDENCE • Usually occur in males • Also in smoking females • After 50 yrs • Metastasis from other areas [non smokers]
  3. 3. ETIOLOGY • Cigarette smoking risk of lung cancer= exposure to cigarettes measured by, – total number of cigarettes smoked in a lifetime, – Earlier age of smoking onset – Depth of inhalation – Tar and nicotine content – Use of unfiltered cigarettes
  4. 4. Passive smoking/ side stream smoke Usage of pipes and cigars. Employees in mining, chemical/ petroleum manufacturing Inhalation of carcinogens  Asbetos  Nickel  Radon  Uranium  Arsenic  hydrocarbons
  5. 5. PATHOPHYSIOLOGY Bronchogenic growths Hyper secretion of mucus Desquamation of cells Reactive hyperplasia of the basal cells Metaplasia of normal respiratory epithelium to stratified squamous cells metastasis
  6. 6. CLASSIFICATION • NON SMALL CELL LUNG CANCER [NSCLC] • SMALL CELL LUNG CANCER [SCLC]
  7. 7. NSCLC TYPES FEATURES Squamous cell carcinoma Always associated with cigarette smoking and exposure to environment carcinogens Adenocarcinoma Associated with lung scarring and chronic interstitial fibrosis, not related with cigarette smoking. Large cell undifferentiated carcinoma High correlation with cigarette smoking and exposure to carcinogens
  8. 8. SCLC TYPES CRITERIA SMALL CELL ANAPLASTIC UNDIFFERENTIATE D [OAT CELL] Associated with cigarette smoking, exposure to environmental carcinogens Very poor prognosis
  9. 9. CLINICAL MANIFESTATIONSMostly clinically silent Metastasis occurs before s/s persists Persistent pneumonitis- fever, chills, and cough Persistent and productive cough Blood tinged sputum Chest pain Dyspnea Auscultatory wheeze
  10. 10. • Anorexia • Fatigue • Weight loss • Nausea & vomiting • Hoarseness • Unilateral paralysis of diaphragm • Dysphagia
  11. 11. DIAGNOSTICS  History & Physical Examination  Chest X-ray  Ssputum for cytologic study  Bronchoscopy  CT scan  MRI  Positron Emission tomography  Spirometry  Mediastinoscopy  Video Assisted Thoracoscopy  Pulmonary angiography  Lung Scan  Fine needle aspiration
  12. 12. MANAGEMENT • Surgery • Radiation therapy • Chemotherapy • Biologic therapy • Bronchoscopic laser therapy • Phototherapy • Airway stenting
  13. 13. Types of Lung Resections Lobectomy: a single lobe of lung is removed Bilobectomy: two lobes of the lung are removed Sleeve resection: cancerous lobe(s) is removed and a segment of the main bronchus is resected Pneumonectomy: removal of entire lung Segmentectomy: a segment of the lung is removed Wedge resection: removal of a small, pie-shaped area of the segment Chest wall resection with removal of cancerous lung tissue: for cancers that have invaded the chest wall
  14. 14. NURSING MANAGEMENT Ineffective airway clearance r/t increased tracheobronchial secretions and presence of tumor. Acute pain r/t pressure of tumor on sorrounding structures and erosion of tissues Imbalanced nutrition, less than body requirement r/t increased metabolic demands, increased secretions, weakness and anorexia.
  15. 15. • Anxiety r/t lack of knowledge of diagnosis and unknown treatments • Ineffective health maintenance r/t lack of knowledge about the disease process and therapeutic regimen • Ineffective breathing pattern r/t decreased lung capacity
  16. 16. GOALS • Effecting breathing pattern • Adequate airway clearance • Adequate oxygenation of tissues • Minimal or no pain • A realistic attitude toward treatment and prognosis.

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