This document summarizes information about lung cancer, including its causes, types, symptoms, investigations, and treatment protocols. It notes that lung cancer is one of the leading causes of cancer deaths worldwide each year. The major causes are tobacco, occupational exposures like asbestos, and air pollution. There are four main types - small cell lung cancer, non-small cell lung cancer (adenocarcinoma, squamous cell carcinoma, large cell carcinoma), with squamous cell carcinoma being the most common type. Symptoms may include cough, blood in sputum, breathing difficulties, weight loss, and pain. Investigations include chest x-rays, CT scans, bronchoscopy, and biopsy. Treatment involves surgery, chemotherapy, radiation therapy

1. CANCER
LUNG
TUMOURTumours may be benign or malignant. The majority are malignant growth
which may be primary or secondary.
- FLORENCE MACWAN

2. INTRODUCTION
Tumours arising within the lung (bronchial carcinoma) usually
originate within the bronchi, whilst those that spread from
other primary sites (e.g. Breast, gastrointestinal tract) tend to
develop in the lung tissue or the pleura.

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EPIDEM IOLOGY
28%NORTH AMERICA
1,35,720 deaths occur yearly.
Men = Women.
Peak incidence – 70 years old.
7.0%LATIN AMERICA
35,600 deaths occur yearly.
Men > Women
Peak incidence – 75 years old.
48% EUROPE
2,67,000 deaths occur yearly.
Men > Women.
Peak incidence – 65 years old.
3.0% AUSTRALIA
8,410 deaths occur yearly.
Men < Women.
Peak incidence – 85 years old.
40% 60%

4. 4
LUNG
CANCER
4/19/2020
TOBACCO:
The risk depends upon number of cigarettes smoked,
the age of starting to smoke and the time span of
smoking.
OCCUPATION:
Working with radioactive materials, nickel, uranium,
chromates or industrial asbestos.
AIR POLLUTION:
Repeated exposure to diesel fumes, smog, smoke and
low quality air.
MAJOR
CAUSE
S

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PATHO LOGY
Majority of tumours
originate in the large
bronchi.
The tumour grows to
occlude the lumen of
bronchus.
Atelactasis distal to
growth occurs.
Post – operative
pneumonia develops
in advanced and
progressive tumours.
As a result of this lung
abscess may also
occur.
It spreads by direct
invasion of lung, chest
wall and mediastenal.

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TYPES LUNG CANCER
Slowly growing,
metastasize late,
often peripheral
tumours.
Locally invasive,
cavitations
sometimes occur.
Intermediate
between sqamous
and oat/small cells.
Small lung primary,
rapidly dividing,
metastasize early.
For example,
alveolar oat cell,
carcinoma.
O A LS
Oat/Small Cell Large Cells
Sqamous Cell Adenocarcinoma Miscellaneous
M

7. 7
TYPE STATISTICS
O
S
L
A
50%
12%
25%
13%
It is clear from the statistics that sqamous cell carcinoma is
much more common compared to adenocarcinoma and
large cell carcinoma.

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CLINICAL
FEATURES
HAEMOPTYSIS
Recurrent small spots of
blood in the sputum.
COUGH
Initially dry and irritating but
may become productive if
infection occurs.
DYSPNOEA
Highly variable and may be
severe with pulmonary
collapse or pleural effusion.
PAIN
Dull, deep – sated and
pleuritic in nature.
WEIGHT LOSS
Associated with late stages of
the disease.
SECONDARY DISEASE
Pneumonia or lung abscess
may arise.
FACIAL SWELLING
Superior vena cava
obstruction.
STRIDOR
Due to narrowing of the
trachea or the main bronchus.
HOARSENESS
Recurrent laryngeal nerve
involvement of the left hilum.

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METAS TASIS
CEREBRAL
METASTASIS
BONE METASTASIS
LIVER METASTASIS
May cause stroke, headaches and epilepsy.
May present with spinal cord
compression, pathological fractures and
bone pain.
May present with jaundice and
hepatomegaly.

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INVEST IGATIONS
R
CHEST RADIOGRAPH – Essential for any patient
presenting with haemoptysis and will demonstrate over
90% of lung tumours.
S
CT SCANNING – Used to indentify smaller lesions. May
also be used to assess suitability for surgery by
demonstrating metastatic spread.
H
HISTOPATHOLOGY – Sputum culture may have evidence
of tumour cells. Three early morning samples should be
obtained.
B
BRONCHOSCOPY – Used to obtain tissue samples. Also
used to assess operability.

11. SURGERY
CHEMO
THERAPY
RADIO
THERAPY
IMMUNO
THERAPY
TREATMENT
PROTOCOLS60%

12. SURGERY RADICAL EXCISIONS
PNEUMONECTOMY:
Only the diseased tissue from
the affected lung is removed
invasively.
OPEN LOBECTOMY:
A lobe of affected lung is
removed through a chest
incision.
VATS LOBECTOMY:
A lobe of lung is removed
with the assistance of
instruments and a camera.
RATS LOBECTOMY:
A lobe of affected lung is
removed with the assistance
of robots.
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CHEMO THERAPY
The current treatment protocols of small cell carcinoma include
cyclophosphamide, doxorubicin and vincristin.
Adriamycin is also a good potent addition and recently VP-16 has
become an important chemotherapeutic agent.
When these drugs are administered in conjunction with a course
of radiation (3000 rads), this combination has achieved
considerable remission.

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PRE – OPERATIVE IRRADIATION:
Has only been successful in carcinoma of the superior
pulmonary sulcus (Pan coast tumour).
POST – OPERATIVE IRRADIATION:
A dose of 5000 rads is given over a period of 5 weeks to the
left out primary tumour and involved lymph nodes.
PALLIATIVE RADIATION THERAPY:
Useful in improving the quality of life by improving chest
pain, haemoptysis and paroxysmal coughing.
RADIO THERAPY

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IMMUNO THERAPY
T – CELL THERAPY
MONOCLONAL ANTIBODIES
IMMUNE CHECKPOINT
INHIBITORS
CANCER VACCINES
THALIDOMIDE DRUGS
GENERAL
IMMUNOTHERAPIES
01
02
03
04
05
06

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PHYSIOTHERAPY TREATMENTS
PRE - OP POST - OP FOLLOW- UP TERMINAL
• DEEP
BREATHING
EXERCISE
•HUFFING
TECHNIQUES.
•DIAPHRAGMATIC
BREATHING
•UNILATERAL
COSTAL
BREATHING
•HUFFING
•BREATHING
CONTROL
•THORACIC
EXPANSION
EXERCISE
•FET
•BREATHING
EXERCISE
•POSTURAL
DRAINAGE
•VIBRATIONS

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