WELCOME

TO
OUR
PRESENTATION

• PRESENTED BY • PREPARED BY
• Sonu magar,usha yadav Kalpana basnet
• Kalpana basnet, Priti shah PCL Nursing 3rd year
• PCL Nursing 3rd year C.E.A, Rajbiraj
• CEA, Rabiraj
LUNGS
CANCER
 CONTENT
• Introduction
• Definition
• Types
• Causes & risk factor
• Signs & symptoms
• Stages
• Diagnostic investigation
• Management
• Nursing management
• Preventive measures
 INTRODUCTION
➢Lungs cancer is the leading cause of cancer incidence and
cancer death for both men and women.
➢In approximately 70% of patients with lungs cancer disease has
spread to regional lymphatic and others sites by the time of
diagnosis.
➢According to the latest WHO data published in 2020 Lung
Cancers Deaths in Nepal reached 3,586 or 2.23% of total
deaths. The age adjusted Death Rate is 18.16 per 100,000 of
population ranks Nepal #65 in the world.
 DEFINITION
➢Lung cancer, also known as lung carcinoma (since
about 98-99% of all lung cancers are carcinomas), is a
malignant lung tumor characterized by uncontrolled
cell growth in tissues of the lung.
 TYPES OF LUNGS CANCER
LUNGS
CANCER

SMALL CELLS NON-SMALL CELLS

LUNGS LUNGS
CANCER (SCLC) CANCER(NSCLC)

SQUAMAUS
LARGE CELL
ADENOCARCINOMA CELL
CARCENOMA
CARCENOMA
 SMALL CELL CARCINOMA :
• It generally starts in one of the larger breathing tubes,
grows fairly rapidly, and is likely to be large by the
time of diagnosis.
• Spreads more quickly and aggressively
• Accounts for 15% of cases
• • Found mostly in heavy smokers
NON-SMALL CELL LUNGS CANCER
• Most common type
• About 80-85% are NSCLC
Grows more slowly
Its is further classified into the following :-

❑ Epidermoid carcinoma or Squamous cell carcinoma:

• 30-35% of lung cancer
• Arise from bronchial epithelium
• Cavitation may also occur
• Slow growth, metastasis not common
Cont.......
❑ADENOCARCINOMA:
• 25-30% of lung cancer
• Arise from bronchiole mucus gland .
• Slow growth, .
• Rarely cavity
• Strongly linked to cigarette smoking
❑ LARGE CELL CARACINOMA:
• 10-20% of lung cancer
• Cavitation common
• Slow, metastasis may occur to kidney, liver and adrenals
• May be located centrally, mid lung or peripherally
 CAUSES&RISK FACTORS
• Gender
• Smoking history
✓ Active smoking=85-87%
✓ Passive smoking=3-5% .
• Older age
• Pollution and occupational exposure
• Industry work due to asbestos(heat
resistant fibrous).
• Lung Disease like T.B
• family History Diet (low in fruits and
vegetables)
• Genetic predisposition.
 SIGNS & SYMPTOMS
Usually occur late and are related to size and location
of tumor, extent of spread, and involvement of other
structures.
1. Pulmonary manifestations;
• Cough
• Dyspnoea
• Wheezing
• hoaresness suggest partial bronchial obstruction
• Recurring pneumonia
• Chest pain poorly localized
Cont....
Local manifestations (related to the growth of tumor and
compression of adjacent structures).
• Shoulder pain, arm pain,
• superior vena cava syndrome
• Distention of arm and neck veins
• Arm edema
• Suffusion of mucous membranes
Symptoms of metastasis;
•Bone pain
• Abdominal discomfort
•Nausea and vomiting
• Pancytopaenia from bone involvement
• Headache from CNS involvement.
 TNM STAGING OF LUNGS CANCER
▪T (Tumour)
• Tumour describes the size of tumour (area of cancer). The simplified
description of the T stage are :
✓T1: means the cancer contained within the lungs but not more then 3cm
✓T2:the cancer contained 3cm –5cm widest tumour
✓T3: the cancer contained 5cm-7cm widest tumour
✓T4 : the cancer contained bigger than7 cm
▪ N(nodes)
• N1: means cancer cells in lymph nodes (in hilium)
• N2:cancer in lymph nodes (in the centre of chest)
• N3:cancer in lymph nodes (in opposite side of chest of affected lungs)
▪M(metastasis)
• M0:cancer that has not spread to another lobe of lungs
• M1: cancer that spread other areas of body
 DIAGNOSTIC EVALUATION
• History and physical examination (supraclavicular lymph node exam)
• Chest X-ray (PA and lateral view)
• Flexible fiberoptic bronchoscopy (with brush or needle biospy )
• Transthoracic fine needle aspiration biopsy
• Mediastinoscopy
• Thoracoscopy
• thoracotomy
• Scalene node biopsy
• Whole body CT/PET scan
• thoracic computed tomography, MRI
• . Pulmonay function test (PFT)
 MANAGEMENT
The treatment depends on the cell type, stage of disease,
and the physiologic status of the patient.
It includes the multidisciplinary approach that may
be used or in combination including:
• Surgical resection
• Radiation Therapy
• Chemotherapy
• Immunotherapy
 NURSING MANAGEMENT
1. Improve Breathing
• Elevate the head of the bed to promote gravity drainage and
prevent fluid collection in the upper body part(superior venacava
syndrome).
• Give prescribed treatment for productive cough to prevent
thickened or retained secration.
• Administer the oxygen as per necessary.
• Recognize the anxiety associated with dyspnea; teach relaxation
technique
Cont...
2. IMPROVE NUTRITIONAL STATUS

• Suggest eating major meal in the morning if rapidly

becoming satiated and feeling full are problems.
• Ensure adequate protein intake.
• Encourage small amounts of high calorie high protien
foods frequently
 4.PAIN CONTROL

• Administer prescribed drugs for pain management.

• Evaluate the problem of insomnia, depression,
anxiety.
• Initiate the bowel training, because constipation is a
adverse effects of some analgesic.
5. MINIMIZE ANXIETY

• Realize that shock, disbelief, denial, anger, and

depression are normal reactions to the diagnosis of
lung cancer.
• Encourage patient to express his or her concern.
• Encourage the patient to keep active and remain in
the mainstream. Continue with us activities as much
as possible
 6. PATIENTS EDUCATION

• Teach the patient to use pain as prescribed without

being overly concerned about addiction
• Advice patient to remain active and have
positive thinking.
• Educate patient about the high protien diet at home
• Suggest for regular follow up.
 PREVENTIVE MEASURE
• Health education has had some success in reducing tobacco
consumption
• Stopping smoking reduces the risk of developing lung cancer.
• Avoid secondhand smoke.
• Avoid carcinogens at work.
• Choose a healthy diet. Food sources of vitamins and nutrients
are best.
• Regular Health Check Up if any history of lungs cancer
presence in family
 REFERENCE
• Rai. L, Essential text book of medical & Surgical Nursing 1 and 2, 2nd
edition (2076-077), Akshav publication kathmandu page no. 70
• Mandal G.N., Essential text Book of Medical surgical Nursing, Safal
publication Pvt. Ltd. Kathmandu, Nepal. Pageno. 84
• Lewis's, a text book of medical surgical nursing, chintamani, 7th
edition, page no. 585-588
• . Potter.perry, a text book of fundamental of nursing, 7th edition, page
no. 1066, 865
• Gautam. R , essential text book of medical & surgical nursing 1&2 3rd
edition 2077, samikshya publication pvt. Ltd. Kathmandu nepal.
Pageno. 122
Thank
you