A lung tumor is an abnormal rate of cell division or cell death in lung tissue or in the airways that lead to the lungs.

1. Lung Tumor
Prepared by
Mr.Abhay Rajpoot
HOD (Dep. of Medical Surgical)
abhayrajpoot5591@gmail.com

2. INTRODUCTION
A lung tumor is an abnormal rate of cell division or cell
death in lung tissue or in the airways that lead to the
lungs.
Lung tumor is a type of cancer that begins in the lungs.
The lungs are two spongy organs in your chest that take
in oxygen when you inhale and release carbon dioxide
when you exhale.

4. DEFINITION
A benign lung tumor is an abnormal growth of tissue that serves no purpose
and is found not to be cancerous.
Benign lung tumor may grow from many different structures in the lung.

5. INCIDENCE
 It is the leading cause of death among all racial groups in
US.
 Accounting for 31% of all ca deaths in men & 27% of
deaths in women.
 In 2005 more than 1,68,000 people died from lung ca in
US; an estimated 1,84000 new cases were diagnosed in
the same year.

6. RISK FACTORS:
• Smoking. The risk of lung cancer increases with the number of
cigarettes you smoke each day and the number of years you have
smoked. Quitting at any age can significantly lower your risk of
developing lung cancer.
• Exposure to secondhand smoke. Even if you don't smoke, your risk
of lung cancer increases if you're exposed to secondhand smoke.
• Previous radiation therapy. If you've undergone radiation therapy to
the chest for another type of cancer, you may have an increased risk of
developing lung cancer.
• Exposure to asbestos and other carcinogens. Workplace exposure to
asbestos and other substances known to cause cancer — such as
arsenic, chromium and nickel — can increase your risk of developing
lung cancer, especially if you're a smoker.
• Family history of lung cancer. People with a parent, sibling or child
with lung cancer have an increased risk of the disease.

7. ETIOLOGY:
 Cigarette smoking which contain 43 known chemical
carcinogens & ca promoters is most significant cause
of ca.
 Genetic abnormality chromosome 3 with loss of genetic
material.
 Alteration of tumor suppressor gene.

8. PATHOPHYSIOLOGY:
Due to etiological factors
Damage of bronchial epithelial cells

Mutation of bronchial epithelial cells
Epithelial cells become neoplastic

9. TYPES OF LUNG CA
 Acc. To cell type tumor can divide into :
s.
no.
Cell type &
prevalence
Presentation & associated
manifestation
spread
1 Small-cell
carcinoma (20-25%)
Central lesion with hilar mass
common, early meditational
involvement,, no cavitations,
SIADH, Cushing syndrome
Aggressive tumor, more than
40% of clients have distant
metastasis at time of
presentation
2 Adenocarcinoma
(20-40%)
Peripheral mass involving; few
local symptoms
Early metastasis to CNS
skeleton, & adrenal glands
3 Squamus cell
carcinoma (30-32%)
Central lesion located in large
bronchi; clients presents with
cough, dyspnea, atelectasis &
wheezing
Spread by local invasion
4 Large cell
carcinoma (10-15%)
Usually peripheral lesion that is
larger than that associated with
adenocarcinoma & tends to
cavitate; gynecomastia
Early metastasis

10. CLINICAL MANIFESTATION:
• A new cough that doesn't go away
• Coughing up blood, even a small amount
• Shortness of breath
• Chest pain
• Hoarseness
• Losing weight without trying
• Bone pain
• Headache

11. DIAGNOSTIC EVALUATION:
 Chest x-ray: usually provide the Ist evidence of lung cancer. It
may be used as a screening tool for lung ca.
 Sputum specimen: is sent for cytologic examination. The
sputum sample is collected on arising in the morning. If
malignant cells are found in the sputum more invasive
examinations are required.
 Bronchoscopy: done to visualize & obtain tissue for biopsy
from the tumor.
 CT-scan: it is used to evaluate & localize tumors in the lung
parenchyma & pleura. CT scanning can also detect distant
tumor metastasis & evaluate tumor response to treatment.
 Cytologic examination: cells or tissues for cytologic
examination & biopsy may be obtained by aspirating fluid
from a pleural effusion, percutaneous needle biopsy & lymph
node biopsy.

12. CONTI…
 CBC, liver function test & serum electrolytes:
Including ca are obtained to evaluate for evidence of
metastatic disease or paraneoplstic syndromes.
 Tuberculin test is performed to rule out TB as a cause
of symptoms.
 Pulmonary function test: may be performed prior to
the initiation of treatment if the client has
manifestations of respiratory insufficiency (e.g.
dyspnea, low oxygen saturation level).

13. MANAGEMENT:
Chemotherapy:
Used in combination, chemotherapeutic drugs to be attached at
different parts of the cell cycle & in different ways, increasing
the effectiveness of therapy. Chemotherapy drugs that
commonly used are- Vance Alkaloids (Vinblastine),
Doxorubicin, Taxanes (Docetaxel), Plantin analogus
(Cisplantin, & Carboplantin).

14. CONTI…
Radiation therapy: It is used alone or in combination with
surgery & chemotherapy.
Goals-
 Treatment- prior to surgery, R/T may be used to debulk
tumors.
 Palliative- (symptom relief) it may also be used to relieve
manifestation such as cough, hemoptysis & dyspnea
from bronchial obstruction.
 R/T may be delivered by external beam radiation to the
primary tumor site or by intraluminal radiation or
brachytherapy.

15. SURGICAL MANAGEMENT
The goal of surgery is to remove all involved tissue while preserving
as much as functional lung as possible.
s.
no.
procedure description Used for
1 Laser bronchoscopy Bronchoscopy guided laser
used to resect tumor
Tumors localized in a main
bronchus
2 mediastinoscopy Visualization of
mediastinum using an
endoscope passed through a
suprasternal incision
Evaluation & biopsy of a
meditational tumors &
lymph nodes
3 thoracotomy Incision into the chest wall Access the lung & thoracic
cavity for surgery

16. 4 Wedge
resection
Removal of an
individual
bronchovascular
segment of a lobe
Peripheral lung tumor with no
evidence of extension to chest
wall or metastasis
5 Segmental
resection
Resection of a section of
a major bronchus with
reconstruction of
remaining normal
bronchus
Small lesion of major bronchus
6 Sleeve
resection
Resection of a section of
a major bronchus with
reconstruction of
remaining normal
bronchus
Small lesion of a major bronchus
7 lobectomy Removal of a single lung
lobe
Tumor confined to a single lobe
8 pneumonecto
my
Removal of an entire
lung
Tumor widespread throughout the
lung, involving the main bronchus or
fixed to the hilum

17. COMPLICATION
• Shortness of breath. People with lung cancer can
experience shortness of breath if cancer grows to block the
major airways..
• Coughing up blood. Lung cancer can cause bleeding in the
airway, which can cause you to cough up blood
(hemoptysis).
• Pain. Advanced lung cancer that spreads to the lining of a
lung or to another area of the body, such as a bone, can
cause pain.
• Fluid in the chest (pleural effusion). Lung cancer can
cause fluid to accumulate in the space that surrounds the
affected lung in the chest cavity (pleural space). Fluid
accumulating in the chest can cause shortness of breath.
• Cancer that spreads to other parts of the body
(metastasis).

18. Nursing management:
 Ineffective breathing pattern r/t tumor & treatment of
tumor.
 Activity intolerance r/t resectional lung surgery &
inoperable lung ca.
 Acute pain r/t surgical procedure or terminal stage of
ca.
 Anticipatory grieving r/t advanced diagnosis of lung ca.

19. THANK YOU