Lung Cancer (Bronchogenic Carcinoma) : Topic Outline

Lung Cancer (Bronchogenic Carcinoma)
LOWER RESPIRATORY TRACT DISORDERS
TOPIC OUTLINE Malignant transformation of the pulmonary

(1) Definition epithelium
(2) Pathophysiology
(3) Risk Factors
(4) Signs & Symptoms
(5) Assessment & Diagnosis
(6) Medical Management
(7) Nsg Management
DEFINITION
→ Lung cancer is a type of cancer that begins in
the lungs. It occurs when cells divide in the lungs
uncontrollably. This causes tumors to grow.
These can reduce a person’s ability to breathe and
spread to other parts of the body.
→ Lung cancers usually are grouped into two
main types called small cell and non-small cell.
Cancer is a disease in which cells in

the body grow out of control.
PATHOPHYSIOLOGY
Tobacco, frequent exposure to secondhand smoke,

air pollution
Inhaled carcinogens
Carcinogens bind to the DNA of the epithelial

cells
Cellular changes
Abnormal cell growth
Malignant cell RISK FACTORS

 Tobacco Smoke
- 23 x higher in male smokers and 13 x higher
Passing of damaged DNA to daughter cell in female smokers
- Determined by pack-year history, age of
initiation of smoking, the depth of inhalation,
DNA changes resulting to unstable DNA and the tar and nicotine levels in the
cigarettes smoked.
1
- The younger a person is when he or she

starts smoking, the greater the risk of
developing lung cancer.
 Electronic Cigarettes
- electronic nicotine delivery system.
 Secondhand Smoke
- cause of lung cancer in nonsmokers.
 Environmental and Occupational Exposure
- motor vehicle emissions and pollutants from
refineries and manufacturing plants.
- radon (colorless, odorless gas found in soil
and rocks)
- chronic exposure to carcinogens: arsenic,
asbestos, mustard gas, chromates, coke oven
fumes, nickel, oil, and radiation.
 Genetic Mutations
- can cause certain changes in DNA of lung
cells which can lead to abnormal cell growth
and cancer. ASSESSMENT & DIAGNOSIS
- inherited gene changes and acquired gene  Chest X-Ray
changes.  CT Scans
 Other risk factors  Sputum Cytology
- Dietary deficits and underlying respiratory  Fiberoptic Bronchoscopy
diseases, such as COPD and TB.  Transthoracic Fine-Needle Aspiration
SIGNS & SYMPTOMS MEDICAL MANAGEMENT

 Cough (most frequent symptom)  Surgical Resection
 Dyspnea  Radiation Therapy
 Hemoptysis or blood-tinged sputum  Chemotherapy
 Radiation Therapy
 Chest or shoulder pain
 Chemotherapy
 Recurring fever
 Palliative Therapy
If the tumor spreads to adjacent structures and
regional lymph nodes:
TYPES OF LUNG RESECTION
 Hoarseness a single lobe of the lung is
 Chest pain & tightness  Lobectomy removed
 Dysphagia (difficulty swallowing)  Bilobectomy 2 lobes of the lung are removed
 Head & neck edema cancerous lobe(s) is removed and
 Symptoms of pleural or pericardial effusion  Sleeve resection segment of the main bronchus is
resected
 Weakness  Pneumonectomy removal of entire lung
 Anorexia  Segmentectomy a segment of the lung is removed
 Weight loss removal of a small, ple-shaped
 Wedge resection are of the segment
COMMON SITES OF METASTASIS  Chest wall
resection with for cancers that have invaded the
removal of chest wall
cancerous lung
tissue
NSG MANAGEMENT
2
Managing Symptoms
 Educate the pt and family about the potential
side effects of the specific treatment and
strategies to manage them.
Relieving Breathing Problems

 Airway clearance technique (removal of
excess secretions): deep-breathing exercises,
chest physiotherapy, directed cough,
suctioning, bronchoscopy.
 Bronchodilator medications
 Supplemental oxygen
 Pt assume positions that promote lung
expansion and to perform breathing exercises
 Pt education about energy conservation and
airway clearance technique
 Referral to pulmonary rehabilitation program
Reducing Fatigue
Providing Psychological Support

The nurse must help the pt and family deal with
the ff:
 The poor prognosis and relatively rapid
progression of this disease
 Informed decision making regarding the
possible treatment options
 Methods to maintain the pt’s quality of life
during the course of this disease
 End-of-life treatment options

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Lung Cancer (Bronchogenic Carcinoma)

LOWER RESPIRATORY TRACT DISORDERS

TOPIC OUTLINE Malignant transformation of the pulmonary

Cancer is a disease in which cells in

Tobacco, frequent exposure to secondhand smoke,

Carcinogens bind to the DNA of the epithelial

Abnormal cell growth

Malignant cell RISK FACTORS

- The younger a person is when he or she

SIGNS & SYMPTOMS MEDICAL MANAGEMENT

Relieving Breathing Problems

Providing Psychological Support

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