LUNG CANCER Flashcards
represents the extent of the primary tumor
T
denotes the lymph node involvement
N
indicates the extent of metastasis
M
No evidence of tumor.
TO
Cannot be assessed or is not apparently radiologically or bronchoscopically
Tx
Cancer in situ.
Tis
<3 cm, in lobar bronchus or distal airways, no local invasion
T1
> 3 cm, tumor in the main bronchus (w/in 2
cm of the carina) or with atelectasis and involves the visceral pleura.
T2
any size, located in the main bronchus or tumor with atelectasis, invades the chest wall, diaphragm, mediastinal pleura, or parietal
pericardium.
T3
- any size
- located as satellite tumor nodule(s) w/in the ipsilateral primary-tumor lobe of the lung
- INVADES:
Mediastinum
Heart
Greatvessels
Trachea
Esophagus
Vertebral body
Carina
T4
Regional lymph nodes cannot be assessed
Nx
Absence of regional lymph node involvement
NO
(+) metastasis to ipsilateral peribronchial or ipsilateral hilar lymphnodes or both
N1
(+) metastasis to ipsilateral mediastinal or subcarinal lymph nodes or both
N2
(+) metastasis to contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene, supraclavicular
N3
Metastasis cannot be assessed
Mx
Absence of distant metastasis
MO
(+) Distant metastasis
M1
- The cancer is limited to the lining of the bronchial airways
- There is no involvement of the lung tissue or distant metastasis
- Usually found during bronchoscopy
- TisN0M0
Stage 0
- Tumor is<3 cm and located in lobar or distal airways
- No lung tissue involvement or distant metastasis
- T1N0M0
Stage 1
- The cancer has invaded neighboring lymph nodes or spread to the chest wall
- No distant metastasis
- T1N1M0
Stage 2
- Tumor is any size, is in the main bronchus, or the tumor is accompanied by atelectasis or
obstructive pneumonitis - Local invasion includes chest wall, diaphragm, mediastinal, pleural, or parietal pericardium
- (+) metastasis to ipsilateral peribronchial or ipsilateral hilar lymph nodes or both
- No distant metastasis
- T3N1M0
Stage IIIa
- Ca has spread locally to mediastinum, heart, great vessels, trachea, esophagus, vertebral body, carina
- (+) malignant pleural or pericardial effusion
- May be involvement of any of the lymph node groups
- No distant metastasis
- T4, any N, M0
Stage IIIb
- Ca is any size
- Involves any of the lymph node groups
- Has spread to other parts of the body(e.g. liver, bones, or brain)
- T any, N any, M1
Stage IV
Two types of small cell lung carcinoma
- limited
- extensive
Ca is confined to only one lung and to its neighboring lymph nodes
Limited
- Cahas spread beyond one lung and nearby lymph nodes
- May have invaded both lungs, more remote lymph nodes, or other organs
Extensive
CARDIOPULMONARY CLINICAL MANIFESTATIONS
Weight loss
Tachycardia
Hypertension
Cyanosis
Cough, sputum production,hemoptysis
Crackles, rhonchi, wheezing
(PFT RESULTS)
- malignancy obstructs
major airways, esp when (+) COPD
Obstructive
(PFT RESULTS)
- large amounts of pulmonary tissue, chest wall, and/or diaphragm are involved
Restrictive
(ABG RESULTS)
- Acute alveolar hyperventilation with hypoxemia (acute respiratory alkalosis)
Localized Lung Ca
(ABG RESULTS)
- Acute ventilatory failure with hypoxemia
(acute respiratory acidosis)
Extensive or Widespread Lung Ca
Surgery for NSCLC limited to only one lung, up to —–
Stage IIIa
partial removal of a lung lobe
Wedge resection
removal of a lung segment or segments
Segmentectomy
removal of one lung lobe
Lobectomy
removal of two lung lobes
Bilobectomy
removal of whole right or left lung
Pneumonectomy
- any treatment involving the use of chemical agents or drugs that are selectively destructive to malignant Ca cells
- S/E: N&V, dizziness, fatigue, increased risk for infection
*Primary tx for SCLC (w/ radiation)
*Cisplatin and etoposide - Carboplatin, gemcitabine, paclitaxel,
vinorelbine, topotecan, irinotecan
Chemotherapy
- often given w/ chemotherapy.
- GOAL: kill Ca cells without hurting normal tissue cells
- S/E: redness, swelling, sloughing of skin,
increased risk for infxn, radiation fibrosis, N&V, change of taste, fatigue, malaise
Radiation therapy
May be used w/ curative intent inpatients
w/ NSCLC who are not eligible for surgery.
- used when the tumor can be visualized w/ bronchoscopy; entails the use of small radioactive rods (seeds) implanted near or directly into the tumor
Brachytherapy
is used in patients w/ limited-stage SCLC;
used to minimize risk of Ca metastasis to
the brain.
Prophylactic cranial irradiation (PCI)
uses special equipment to position the patient
and precisely deliver radiation to a tumor.
Stereotactic radiation therapy
RT MANAGEMENT
Oxygen Therapy
Bronchopulmonary Hygiene Therapy
Lung Expansion Therapy
Aerosolized Medication Therapy
