Test 5 Ch. 26 Cancer of the Lung Flashcards
This is a general term that refers to abnormal new tissue growth characterized by the progressive, uncontrolled multiplication of cells
Cancer
A neoplasm or tumor is defined as an
abnormal growth of new cells
Do not endanger life unless they interfere w/ the normal functions of other organs or affect a vital organ
Benign tumors
Benign tumors grow ________ and push aside _______ tissue but do not ______ it.
slowly;
normal;
invade
Benign tumors are not
invasive or metastatic and are usually encapsulated
These tumors are composed of embryonic, primitive, or poorly differentiated cells
Malignant tumors
Malignant tumors grow in a
disorganized manner and so rapidly
What are associated with malignant tumor (3)
- necrosis
- ulceration
- cavity formation
MT also invade
surrounding tissues and may metasize
MT mostly originate in the epithelium of the
TB tree
A tumor that origanets in the bronchial tree is called
bronchogenic carcinoma
bronchogenic carcinoma is interchangeable with
lung cancer
Pathologic and structural changes associated w/ bronchogenic carcinoma (7)
- Inflammation, swelling, and destruction of the bronchial airways
- Excessive mucous production
- Airway obstruction
- Atelectasis
- Alveolar consolidation
- Cavity formation
- Pleural effusion
Lung cancer is the _________ most common cause of cancer in men and women
second
What is the most common cause of lung cancer?
Cigarette smoking
Lung cancer is the ___________ cause of cancer death
leading
Who gets it more black men or white men?
Black men
Who gets it more often in women?
White women
Heavy smokers are how much likely to develop lung cancer
64 times
About how much % of lung cancer deaths are thought to be caused by smoking?
80%
What is the second leading cause of lung cause
Radon exposure
This is a naturally occurring radioactive gas that is produced from the breakdown of of uranium in the soil and rocks
Radon
________ radon is not likely to be dangerous, however, __________ radon can be more concentrated and therefore risks the chances of lung cancer
Outdoor;
Indoor
Other cancer-causing agents
- Asbestos
- Radioactive ores
- Inhaled chemicals or minerals
- Disease exhaust
- Air pollution
- Arsenic in drinking water
- Radiation therapy to the lungs
- Personal or family history of lung cancer
Bronchogenic carcinomas can be divided into two major categories
- non-small cell lung carcinoma (NSCLC)
- small cell lung carcinoma (SCLC)
The NSCLC can be subdivided into 3 types of lung cancer (SAL)
- squamous cell carcinoma
- adenocarcinoma (including bronchial alveolar cell carcinoma)
- large cell carcinoma
The SCLC category is composed of (3) (SCM)
- small cell carcinoma (oat cell carcinoma)
- combined small cell carcinoma
- a mixture of SCLC and NSCLC
Which cancer group spreads aggressively and responds best to chemo and radiation therapy
SCLC
SCLC occurs almost exclusively in __________ and accounts for ___% to ___% of all lung cancers
smokers;
10% to 20%
This cancer group is more common and accounts for 75% to 85%
NSCLC
How is NSCLC treated?
Removed surgically
This constitutes about 25% to 30% of bronchogenic carcinoma
Squamous cell (epidermoid) carcinoma
Squamous cell carcinoma tumor has a slow growth and
late metazoic tendency
Squamous tends to be __________ and tend not to ___________ until _____ in the disease process
localized;
metastasize;
late
squamous cell carcinoma can be treated w/ ___________ ___________ if it has not metasized
surgical resection
this cancer arises from mucous glands of the TB tree
Adenocarcinoma (bronchial alveolar carcinoma)
Adenocarcinoma accounts for about
40% of all lung cancers
This is not associated w/ smoking and is the most common lung cancel in pts who have never smoked
Adenocarcinoma
Adenocarcinoma growth rate is
moderate and metazoic tendency is early
Adenocarcinoma secondary
cavity formation and pleural effusion are common
If Adenocarcinoma is discovered early then,
surgical resection is possible in a high percentage of cases
This cancer accounts for 10% to 15% of all lung cancers
Large cell carcinoma (undifferentiated)
Large cell carcinoma has a
rapid growth rate and early and widespread metastasis
Small cell (oat cell) carcinoma accounts for __% to ___% of all lung cancers
10% to 20%
oat cell cancer grows
very rapidly becoming very large and metastasizes early
The average survival time for untreated small cell carcinoma is about
1 to 3 months
How much % does pts respond to treatment in small cell carcinoma?
Nearly all relapse in how long?
90%;
24 months
Small cell carcinoma has the strongest correlation w/
cigarette smoking and has the worst prognosis
A type of cancer that starts in the lungs
lung carcinoid tumor (lung carcinoids)
Lung carcinoid cancers are
uncommon and tend to grow slower
Lung carcinoids account for about ___% to ___% of all lung cancers
1% to 2%
How can Carcinoids be also classified?
Based on where they were found in the lungs
Central carcinoids are found in the walls of the large bronchi near the
center of the lungs
Peripheral carcinoids are found in the smaller bronchioles towards the
periphery of the lungs
Cancer that begins in other parts of the body, such as the breast, pancreas, kidney, or skin. can metastasize to the lungs
Cancer that’s spreads to the lungs
Treatment for metastatic cancer of the lungs is based on
where the cancer originated
Unfortunately most lung cancers are not diagnosed until the pt
presents w/ symptoms that suggest lung cancer
What are some symptoms associated w/ lung cancer (8)
- a progressively worsening cough that often includes bloody or rust-colored sputum
- chest pain, especially w/ deep breathing, coughing, or laughing
- hoarse voice
- poor appetite and weight loss
- SOB
- Fatigue
- Frequent bronchial infections or PNA episodes
- the sudden onset of wheezing
When lung cancer spreads to other parts of the body the pt may have symptoms of cancer (4)
- bone pain ( hips or back)
- neurologic problems (headache, arm and leg weakness or numbness, dizziness or balance seizures)
- Jaundice
- enlarged lymph nodes (neck, axillae, mediastinum)
The primary goal of these diagnostic procedures is to (3)
- confirm the presence of a lung carcinoma
- establish the cancer cell type
- confirm the stage of the cancer
Imagining for Lung Cancer (5)
- Chest radiography
- CT scan
- PET scan
- MRI
- Bone scan
Diagnostic tests for Lung cancer (7)
- Sputum cytology
- Bronchoscopy
- Navigational bronchoscopy
- Endobronchial ultrasound (EBUS)
- Endoscopic esophageal ultrasound
- Thoracentesis
- VATS
Analysis Tissue Biopsy Samples (3)
- Immunohistochemistry
- Molecular test
- Complete blood count (CBC)
The most commonly used classification tool to stage NSCLC is the American Joint Committee on Cancer (AJCC) ______ system
TNM system
The staging of cancer is determined by a combination of
T: Represents the size and location of the primary tumor
N: Denotes the regional lymph node involvement
M: The extent of metastasis
There are how many stages of lung cancers?
5;
Stage 0, I, II, III, IV
SCLC is staged differently from non-small cell cancer it is usually classified as a (2)
- limited-stage
- extensive stage
When the cancer is confined to only one lung and its neighboring lymph nodes. What stage is this in SCLC?
Limited stage
The cancer has spread beyond one lung and nearby lymph nodes. What stage is this in SCLC?
Extensive stage
Clinical manifestation for lung cancer (3)
- atelectasis
- alveolar consolidation
- excessive bronchial secretions
Vitals signs (3)
Increased RR
Increased HR
Increased BP
Chest assessment findings (2)
- crackles
- wheezing
Depending on where the malignancy originates the PFT result may show a
restrictive or obstructive values
When the malignancy obstructs the ________ airways the PFTs shows ___________
major;
obstructive
When large amounts of pulmonary tissue, chest wall, and/or diaphragm are involved (extensive adenocarcinoma) PFT may show
restrictive
Chest Xrays (6)
- Small oval coin lesions
- Large irregular mass
- Alveolar consolidation
- Atelectasis
- Pleural effusion
- Involvement of the mediastinum or diaphragm
What scan is used to rule out a possible cancerous area identified on either a chest xray or CT
Positron Emission Tomography (PET) scan
PET scans shows a
“hot spot”
When a small cell carcinoma is protruding the airway what can be done to help hold the airway open?
A wire stent
What are some surgically procedures for NSCLC (5)
- Pneumonectomy
- Lobectomy
- Segmentectomy or wedge resection
- Sleeve resection
- Video-assisted thoracic surgery (VATS)
The entire lung is removed in this surgery
Pneumonectomy
An entire section (lobe) of a lung is removed during surgery
Lobectomy
A part of a lobe is removed in this surgery
Segmentectomy or wedge resection
Entails the removal of some tumors in the large airways. The airway is completely cut above and below the tumor, and the shortened airway is reached
Sleeve resection
May be used to treat early-stage lung cancer that is located in the pleura and peripheral parts of the lungs. They require a smaller incision than a thoracotomy
Video-assisted thoracic surgery (VATS)
This may be used for some small lung tumors near the outer edge of the lungs, uses high-energy radio waves to heat the tumor
Radiofrequency ablation (RFA)
This uses high-intensity rays to kill cancer cells
Radiation Therapy
This treatment uses anticancer agents that can be injected into a vein or taken orally
Chemotherapy
Chemotherapy may be used to (4)
- before surgery (to help shrink a tumor)
- after surgery
- along w/ radiation therapy
- as the primary therapy
SCLC treatment includes (3)
- chemotherapy
- radiation therapy
- surgery (rarely a treatment option for SCLC)
Respiratory Protocols for Lung Cancer (4)
- Oxygen Therapy
- Airway Clearance
- Lung Expansion
- Aerosolized Medication
Questions from the back
Which of the following cancers is commonly located near a central bronchus or hills and projects into the large bronchi?
Squamous cell carcinoma
Which of the following arises from the mucous glands of the TB tree
Adenocarcinoma
Which of the following carcinomas has the strongest correlation w/ cigarette smoking
Small cell carcinoma
Which of the following cancers has the fastest growth (doubling) rate
Small cell carcinoma
Which of the following are associated w/ bronchogenic carcinoma
- Alveolar consolidation
- Pleural effusion
- Atelectasis
Where do most carcinomas tumors originate?
And what % start in the lungs?
Lungs;
30%
Some stages of cancer subdivides into __ and __. This process is called _______ ___________
A and B;
Stage grouping
The lower the stage, the……
Better the prognosis
Inspection for Lung cancer
- cyanosis
- cough, sputum production and hemoptysis
