LUNG CANCER

PRESENTED BY:
MS. SAYALI SHETE
CLINICAL INSTRUCTOR
BVCON
DEFINITION

 A malignant tumor of the lung arising within the wall

or epithelium of the bronchous.
 STAGES OF LUNG CANCER

 Stage 0
1. No evidence of primary tumor.
2. Presence of distant metastasis cannot assess.
 Stage I
1. Carcinoma in situ.
2. No regional lymph node metastasis.
3. No distant metastasis.
4. <3 cm diameter tumor/invades visceral pleura
 Stage II
1. Tumor >3 cms/associated pneumonia/atelectasis.
Stage III
2. Tumor extension into adjacent structure/associated pleural
effusion/atelectasis/pneumonia of entire lung.
 Stage IV
1. Tumor invading mediastinum/involves heart, great
vessels, trachea, esophagus presence of malignant
pleural effusion.
2. Distant metastasis present.
 ETIOLOGY
The exact etiology of lung cancer is unknown.
 Risk Factors
1. Cigarette smoking
2. Tobacco use
3. Occupational carcinogens
4. Nutritional deficiencies: People who eat a diet low in fluid
and vegetable, have an increase risk of developing lung cancer.
Diet poor in vitamin A, C and E.
5. Non-neoplastic diseases such as tuberculosis, chronic
bronchitis and emphysema.
6. Environmental or occupational exposure: Exposure to
pollutants, industrial waste, gases, mustard gas, asbestos,
radon, arsenic, diesel exhaust, etc. increase the risk for lung
cancer.
7. Genetic predisposition: Genetics may predispose
people to lung cancer.
 Pathophysiology

1. Chronic smoking, tobbaco use, exposure to carcinogens

causes cell damage and brings changes in cell
morphology.
2. Carcinogens bind to damaged cell DNA. As a result,
gene mutation occurs.
3. Decreased immunity and gene mutation and
proliferation of abnormal cells occurs which increase
formation of abnormal lung cells. Hence, lung cancer
develops.
 Clinical Manifestations

1. Cough
2. Dyspnea
3. Excessive sputum production.
4. Hemoptysis
5. Wheezing or stridor when obstructed by tumor
6. Chest pain-localized
1. Weight loss
2. Fatigue and anorexia.
3. Persistent respiratory infection
4. Repeated pneumonitis.
5. Fever, nausea, vomiting and headache,.
 Diagnostic Evaluation

 Patient history and physical examination.

 Chest X-ray provides the first evidence of lung cancer.
 Cytology examination of sputum/chest fluids for
malignant cells.
 Computed Tomography (CT) and MRI SCAN helps
to determine size and location of lung cancer.
 Positron-Emission Tomography (PET) helps to identify
metastasis.
 Bronchoscopy to assess lung condition and any
abnormality.
 Biopsy of lesion and of lymph nodes confirms tumor.
 Pulmonary Function Test (PFT) determines lung
volume, capacity, rates of flow, and gas exchange.
 CBC, liver function studies serum electrolytes to detect
any metastasis.
 MANAGEMENT
MEDICAL MANAGEMENT
1. Radiation therapy: Radiation is used to reduce the
size of tumor but it is toxic to normal tissue.
2. Chemotherapy: It is used to change tumor growth
pattern and to supplement surgery or radiation therapy.
3.Palliative therapy: It includes few
radiations to shrink the tumor just to provide pain
relief, bronchoscopy to open airway and pain
management and other comfort measures.
 SURGICAL
MANAGEMENT
 SurgicalManagement For localized tumor and adequate
cardiopulmonary function, surgical resection is done.
 Different types of lung resection is practice namely.
WEDGE RESECTION: Removal of a small
localized area of diseased tissue near the surface of
lung.
2.Segmentectomy -Removal of a segment of
lung.
3.Lobectomy -Removal of a lobe of lung.
4.Pneumonectomy-Removal of entire lung, i.e. a
bronchiole and its alveoli.
 NURSING ASSESSMENT

1. Monitor respiratory rate, breath sounds, chest symmetry, B/L air

entry.
2. Enquire from patient about cough characteristics.
3. Enquire about breathing difficulties: Dyspnea, orthopnea.
4. Assess the activity level of patient whether he/she is lying all the
time.
5. Assess the dietary habits and eating pattern of patient.
6. Monitor vital signs.
7. Assess urine output.
8. Assess pain level of patient.
 NURSING
DIAGNOSIS
1. Ineffective airway clearance related to productive cough.
2. Impaired breathing pattern related to compromised
respiration.
3. Impaired nutritional pattern: Less than body requirement
related to anorexia.
4. Risk for infection: Hyperthermia related to decreased
immunity.
5. Anxiety, fear related to therapeutic regimen and
prognosis.
6. Activity intolerance related to disease and treatment.
7. Altered sleeping pattern related to cough and dyspnea.
8. Knowledge deficit related to disease and therapeutic
regimen.