BRONCHOGENIC

CARCINOMA
 WHAT IS BRONCHOGENIC
CARCINOMA?
• is a malignant neoplasm of the lung arising from the
epithelium of the bronchus.
• Lung cancer is the leading cancer killer among men and
women in the United States.
• 70% of patients with lung cancer the disease has spread to
regional lymphatics and other sites by the time of diagnosis.
• Long-term survival rate is low
• 5 years survival rate is 13%
 CLASSIFICATION AND STAGING
Two major categories;
• Small cell lung cancer
- It represents 10% to 15% tumors
- There two general cell types include small cell and combined small cell
• Non-small cell lung cancer
- It represents approximately 85% to 90% of tumors
- NSCLC is further classified by cell type
*Squamous cell cancer (25% to 30%) is usually more centrally
located and arises more commonly in the segmental and sub
segmental bronchi

*Adenocarcinoma (40%) is the most prevalent carcinoma of

the lung in both men and women; it occurs peripherally as
peripheral masses or nodules and often metastasizes

*Large cell carcinoma or undifferentiated carcinoma (10% to

15%) is a fast growing tumor that tends to arise peripherally
*Bronchoalveolar cell cancer is found in the terminal bronchai
and alveoli and is usually slower growing compared with other
bronchogenic carcinoma
-NSCLC is staged as I to IV. Stage I is the earliest stage and has
the highest cure rate, whereas stage IV designates metastatic
spread.
 RISK FACTORS

• Environmental factors
*tobacco smoke – smoking is responsible for approximately 78% of lung
cancer in men and 44% in women
• The risk of developing lung cancer is about 23 times higher in male
smokers and 13 times higher in female smokers
• The younger a person is when he or she starts smoking, the greater the
risk of developing lung cancer.
• Smokers who use smokeless products as a supplement source of
nicotine will increase their risk of lung cancer.
• Almost all cases of SCLC are due to cigarette smoking. SCLC is rare in
people who have never smoke. It is the most aggressive form of lung
cancer, grows quickly, and usually starts in the airways in the center of
the chest.

*Secondhand Smoke
- Passive smoking has been identified as a cause of lung cancer in
nonsmokers.
- Each year about 3,400 nonsmoking adults die of lung cancer as a result
of secondhand smoke.
- People in close environment (house, automobile, building) have an
increased risk of lung cancer when compared with unexposed
nonsmokers.
 ENVIRONMENTAL AND OCCUPATIONAL
EXPOSURE

• Various carcinogens have been identified in the atmosphere, including

motor vehicle emissions and pollutants from refineries and
manufacturing plants.
• Radon
- Is colorless, odorless gas found in soil and rocks.
- It has been associated with uranium mines, but its is now known to
seep into homes through ground rock.
• Chronic exposure to industrial carcinogens, such as arsenic,
asbestos, mustard gas, chromates, coke oven fumes, nickel, oil
and radiation, has been associated with the development of
lung cancer.
 CLINICAL MANIFESTATIONS

• Cough or change in a chronic cough

- The most frequent symptom of lung cancer
- It may start as a dry, persistent cough, without sputum production.
• Dyspnea – is prominent in patient early in their disease.
- Causes may include tumor occlusion of the airway or lung parenchyma, pleural
effusion, pneumonia, or complication of treatment.
- Hemoptysis or blood-tinged sputum may be expectorated
- Chest or shoulder pain may indicated chest wall or pleural involvement by a tumor.
• Recurring fever is am early symptoms in response to a persistent infection in an area
of pneumonitis distal to the tumor.
 DIAGNOSTIC FINDINGS
• Chest x-ray – is performed to search for pulmonary density.
• CT scan – used to identify small nodules not easily visualized on the chest x-ray and
also to serially examine areas for lymphadenopathy.
• Sputum cytology – is rarely used to make a diagnosis of lung cancer.
• Fiberoptic bronchoscopy – is commonly used it provides a detailed study of the
tracheobronchial tree and allows for brushing, washing, and biopsies of suspicious
areas.
• A variety of scan may be used to assess for metastasis of the cancer. These may
include bone scan, abdominal scans, PET scan, and liver ultra sound.
• CT scan of the brain MRI and other neurologic diagnostic procedures are used to
detect central nervous system metastases.
 MEDICAL MANAGEMENT
• Surgical Management
- Surgical resection is the preferred method of treating patients with localized non-
small cell tumors, no evidence of metastatic spread, and adequate cardiopulmonary
function.
*Lobectomy – the most common surgical procedure for a small, apparently curable
tumor of the lung.
• Radiation Therapy
- May offer cure in a small percentage of patients.
- It is useful in controlling neoplasms that cannot be surgically resected but are
responsive to radiation.
• Chemotherapy
- Is used to alter tumor growth patterns to treat distant
metastases or small cell cancer of the lungs
- May provide relief, especially of pain, but it does not usually
cure the disease or prolong life to any great degree.
 NURSING MANAGEMENT

• Relieving Breathing Problem

- Airway clearance techniques are kay to maintaining airway patency
through the removal of excess secretion.
- This may be accomplished through deep-breathing exercises, chest
physiotherapy, directed cough, suctioning, and in some instance
bronchoscopy.
• Reducing Fatigue
- Is a devastating symptoms that affects quality of life in patient with cancer.
• Providing Psychological Support
• THANK YOU !!