1. LUNG CANCER

2. INCIDENCE
• Usually occur in males
• Also in smoking females
• After 50 yrs
• Metastasis from other areas [non
smokers]

3. ETIOLOGY
• Cigarette smoking
risk of lung cancer= exposure to
cigarettes measured by,
– total number of cigarettes smoked in a
lifetime,
– Earlier age of smoking onset
– Depth of inhalation
– Tar and nicotine content
– Use of unfiltered cigarettes

4. Passive smoking/ side stream smoke
Usage of pipes and cigars.
Employees in mining, chemical/ petroleum
manufacturing
Inhalation of carcinogens
 Asbetos
 Nickel
 Radon
 Uranium
 Arsenic
 hydrocarbons

5. PATHOPHYSIOLOGY
Bronchogenic growths
Hyper secretion of mucus
Desquamation of cells
Reactive hyperplasia of the basal cells
Metaplasia of normal respiratory epithelium to stratified squamous
cells metastasis

6. CLASSIFICATION
• NON SMALL CELL LUNG CANCER
[NSCLC]
• SMALL CELL LUNG CANCER
[SCLC]

7. NSCLC
TYPES FEATURES
Squamous cell
carcinoma
Always associated with
cigarette smoking and
exposure to
environment
carcinogens
Adenocarcinoma Associated with lung
scarring and chronic
interstitial fibrosis, not
related with cigarette
smoking.
Large cell
undifferentiated
carcinoma
High correlation with
cigarette smoking and
exposure to
carcinogens

8. SCLC
TYPES CRITERIA
SMALL CELL
ANAPLASTIC
UNDIFFERENTIATE
D [OAT CELL]
Associated with
cigarette smoking,
exposure to
environmental
carcinogens
Very poor prognosis

9. CLINICAL
MANIFESTATIONSMostly clinically silent
Metastasis occurs before s/s persists
Persistent pneumonitis- fever, chills, and cough
Persistent and productive cough
Blood tinged sputum
Chest pain
Dyspnea
Auscultatory wheeze

10. • Anorexia
• Fatigue
• Weight loss
• Nausea & vomiting
• Hoarseness
• Unilateral paralysis of diaphragm
• Dysphagia

11. DIAGNOSTICS
 History & Physical Examination
 Chest X-ray
 Ssputum for cytologic study
 Bronchoscopy
 CT scan
 MRI
 Positron Emission tomography
 Spirometry
 Mediastinoscopy
 Video Assisted Thoracoscopy
 Pulmonary angiography
 Lung Scan
 Fine needle aspiration

12. MANAGEMENT
• Surgery
• Radiation therapy
• Chemotherapy
• Biologic therapy
• Bronchoscopic laser therapy
• Phototherapy
• Airway stenting

13. Types of Lung Resections
Lobectomy: a single lobe of lung is removed
Bilobectomy: two lobes of the lung are removed
Sleeve resection: cancerous lobe(s) is removed and a
segment of the main bronchus is resected
Pneumonectomy: removal of entire lung
Segmentectomy: a segment of the lung is removed
Wedge resection: removal of a small, pie-shaped area of
the segment
Chest wall resection with removal of cancerous lung
tissue: for cancers that have invaded the chest wall

15. NURSING MANAGEMENT
Ineffective airway clearance r/t increased
tracheobronchial secretions and presence of
tumor.
Acute pain r/t pressure of tumor on
sorrounding structures and erosion of
tissues
Imbalanced nutrition, less than body
requirement r/t increased metabolic
demands, increased secretions, weakness
and anorexia.

16. • Anxiety r/t lack of knowledge of
diagnosis and unknown treatments
• Ineffective health maintenance r/t
lack of knowledge about the disease
process and therapeutic regimen
• Ineffective breathing pattern r/t
decreased lung capacity

17. GOALS
• Effecting breathing pattern
• Adequate airway clearance
• Adequate oxygenation of tissues
• Minimal or no pain
• A realistic attitude toward treatment
and prognosis.