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1. PRESENTING
LUNG CANCER
BY
Denmark Guillermo, RN

2. Lung Cancer
Uncontrolled growth of malignant cells in
one or both lungs and tracheo-bronchial
tree
 A result of repeated carcinogenic irritation
causing increased rates of cell replication
Proliferation of abnormal cells leads to
hyperplasia, dysplasia or carcinoma

3. Picture of the Lungs

4. What is the Function of the Lungs?
 The lungs consist of five lobes,
three in the right lung and two in
the left lung
 Most cells in the lung are epithelial
cells, which line the breathing
passages and produce mucus,
which lubricates and protects the
lungs
 The main function of the lungs is
to allow oxygen from the air to
enter the bloodstream for delivery
to the rest of the body

5. Normal Cell
Division

7. Two types of cell Cycle Mechanisms
CDK cycle mechanism-
Ensures well delineated transition bet.
Cell cycle stages
Check- point control mechanism-
sense flaws in DNA replication and
chromosome segregation

8. Risk factors of Lung Cancer
Radiation Exposure
Smoking
Environmental/ Occupational
Exposure
Asbestos
Radon
Passive smoke

9. Smoking Facts
 Tobacco use is the
leading cause of lung
cancer
 87% of lung cancers
are related to smoking
 Risk related to:
 age of smoking onset
 amount smoked
 gender
 product smoked
 depth of inhalation

10. Pathophysiology of
Lung Cancer

11. Smoking –
Chronic
(Carcinogens)

12. Injury to
Inhalation of
Pulmonary and
Smoke Alveolar
Epithelium
Destruction of
Walls Between
the Alveoli

13. Inhalation of
Smoke
Defense
Mechanism of the
Lung Lose
Effectiveness

14. Carcinogen
Penetrate
the lower
Airways
Lower Airways
Inflammations

15. Carcinogens
are Lodged in
the Lungs
Narrow
Airways
Increase
Sputum
Production
Dyspnea

16. INFECTION
Pleuritic Chest
FEVER Pain
SWEATS Chills

17. Injury to Pulmonary and Alveolar
Epithelium
Localized
lesion in the
lung area

18. Bleeding will
occur(hemoptysis)

19. Destruction of Walls Between
the Alveoli
Increase
“DEAD SPACE”
(Areas That Do Not
Participate in Gas or
Blood Exchange)

20. Decrease o2
Increase supply to the
Respiratory blood
Rate
(Compensatory
Mechanism)
fatigue

21. Cell cycle
mechanism
alteration

22. Undetected
flaws in DNA
replication and
chromosome
segregation

23. uncontrolled
defective cell
proliferation

24. Tumor
formation(cancer
cells formation)

25. TUMOR
(Cancer Cells)

26. METASTASI
S

27. 1
Obstruction
of the
Regional
Lymph Node

28. 2
Direct
Extension
to larynx

29. 3
Compression
of
Esophagus

30. 4
Compression
of Superior
Vena Cava

31. 5
Obstruction
of Venous
Blood Flow

32. Obstruction
of the
Regional
Lymph Impaired
Node lymph
Drainage
ex.(Mediastinal
Lymph)

33. Diaphragm Paralysis
(Phrenic Nerve
Vocal Cord Compression)
Paralysis

34. Direct
Extension to
the larynx
Laryngeal
Nerve Hoarseness
Compression

35. Compression
of Esophagus
Dysphagia

36. Compression
of Superior
Vena Cava
Superior Vena Cava
Syndrome

37. Obstruction of
Venous Blood
Flow

38. 1 2
Shortness of Swelling
Breath (Facial Arm
and Truck)
3 Distension of 4 Chest
Thoracic
Vein Pain

39. Syndromes/Symptoms secondary to
regional metastases:
1.Esophageal compression dysphagia
2.Laryngeal nerve paralysis hoarseness
3.Symptomatic nerve paralysis Horner’s
syndrome
4.Cervical/thoracic nerve invasion
5.Pancoast syndrome
6.Lymphatic obstruction pleural effusion
7.Vascular obstruction SVC syndrome
8.Pericardial/cardiac extension effusion,
tamponade

40. Where does it travel?
Lymph Nodes, Brain, Liver, Adrenal,
Gland, Bones
40% of metastasis occurs in the
Adrenal Gland

41. How is Lung Cancer Treated?
1.Treatment depends on the stage and type
of lung cancer
2.Surgery
3.Radiation therapy
4.Chemotherapy (options include a
combination of drugs)
5.Targeted therapy
6.Lung cancer is usually treated with a
combination of therapies

42. Cancer Treatment: Surgery
1.The tumor and the nearby lymph nodes in
the chest are typically removed to offer the
best chance for cure
2.For non-small cell lung cancer, a
lobectomy (removal of the entire lobe
where the tumor is located), has shown to
be most effective
3.Surgery may not be possible in some
patients

43. Cancer Treatment: Chemotherapy
1.Drugs used to kill cancer cells
2.A combination of medications is often
used
3.May be prescribed before or after surgery,
or before, during, or after radiation therapy
4.Can improve survival and lessen lung
cancer symptoms in all patients, even
those with widespread lung cancer

44. Cancer Treatment: Radiation
Therapy
1.The use of high-energy x-rays or other
particles to destroy cancer cells
2.Side effects include fatigue, malaise
(feeling unwell), loss of appetite, and skin
irritation at the treatment site
3.Radiation pneumonitis is the irritation and
inflammation of the lung; occurs in 15% of
patients
4.It is important that the radiation treatments
avoid the healthy parts of the lung

45. Lung Cancer Staging
1.Staging is a way of describing a cancer,
such as the size of the tumor and where it
has spread
2.Staging is the most important tool doctors
have to determine a patient’s prognosis
3.The type of treatment a person receives
depends on the stage of the cancer
4.Staging is different for non-small cell lung
cancer and small cell lung cancer

46. Stage I Non-Small Cell Lung Cancer
1.Cancer is found
only in the lung
2.Surgical removal
recommended
3.Radiation therapy
and/or
chemotherapy
may also be used

47. Stage II Non-Small Cell Lung Cancer
1.The cancer has spread
to lymph nodes in the
lung
2.Treatment is surgery to
remove the tumor and
nearby lymph nodes
3.Chemotherapy
recommended; radiation
therapy sometimes
given after
chemotherapy

48. Stage III Non-Small Cell Lung
Cancer
1.The cancer has spread to the lymph
nodes located in the center of the chest,
outside the lung
2.Stage IIIA cancer has spread to lymph
nodes in the chest, on the same side
where the cancer originated
3. Stage IIIB cancer has spread to lymph
nodes on the opposite side of the chest,
under the collarbone, or the pleura
(lining of the chest cavity)
4.Surgery or radiation therapy with
chemotherapy recommended for stage
IIIA
5.Chemotherapy and sometimes radiation
therapy recommended for stage IIIB

49. Stage IV Non-Small Cell Lung Cancer
1.The cancer has spread to
different lobes of the lung
or to other organs, such
as the brain, bones, and
liver
2.Stage IV non-small cell
lung cancer is treated with
chemotherapy

50. Small Cell Lung Cancer–All Stages
1.Patients with limited stage (confined to one area
of the chest) small cell lung cancer are treated
with simultaneous radiation therapy and
chemotherapy
2.Patients with extensive stage (not confined to
one area of the chest) small cell lung cancer are
treated with chemotherapy only
3.Because small cell lung cancer can spread to the
brain, preventative radiation therapy to the brain
is routinely recommended to all patients whose
tumors disappear following chemotherapy and
radiation therapy

51. Nursing responsibilities
Nursing Management during Diagnostic
Phase
1. Obtain nursing history(cough ,
dyspnea , pain or recurrent infection)
2. focus on emotional aspect of
assessment
3. Educate the client with the required
physical care and scheduled examinations
4. Assist to cope with anxiety

52. Nursing management during
Treatment Phase
1. Put great emphasis on assessment of
respiratory system to determine ability of
the client to cope up with surgical
intervention
2. Clients with impaired pulmonary function
may be treated with antibiotics,
bronchodilating medications, and
supervised breathing exercise

53. 3. Encouraged patient to avoid smoking
during preoperative because smoking will
increase pulmonary secretions and
decrease blood oxygen saturation.
4.Assess the clients understanding and
further information as needed
5.Explain the procedure to be done and the
expected outcome
6. Explain and demonstrate post – op
exercises such as leg exercise and correct
posture

54. Postoperative assessments
1.Monitor for signs and symptoms of
respiratory failure
2. Monitor for signs of tension
pneumothorax
3. Observe for subcutaneous emphysema
around incision and in chest and neck
4.Monitor for signs of pulmonary embolism
5. Assess dressing
6. Assess drainage

55. 7. Assess breath sound before and after
coughing
8. Administer pain medication as ordered
9. Allow adequate rest periods
10. Provide client opportunity to ventilate
feelings

56. Nursing Interventions during
Terminal Phase
1. Physical support such as giving of pain
medication should be given great
emphasis.
2.Help the client to ventilate thoughts and
feelings
3. Assist significant others to cope with the
situation

57. Quit
Smoking!
!!!!!