1. PULMONARY NEOPLASM

2. INTRODUCTION

3. DEFINITION
• Lung cancer is malignancy in the epithelium of
the respiratory tract

4. INCIDENCE
• Lung cancer accounts about 6.8% of all
malignancies in India
• The incidence is estimated to be about
6.6%per one lakh in males1.7per one lakh
among in females

5. RISK FACTORS
• Cigarette smoking
Exposure with
• radioactive isotopes,
• polycyclic hydrocarbons,
• vinyl chloride,
• metallurgical ores
• , and mustard gas.

6. ETIOLOGY
• cigarette smoking
• include inhaled toxins, such as asbestos, and
pollutants. ,radon, nikal ,iron
• iron oxides uranium polycyclic aromatic
hydrocarbons chromates arsenic ,air pollution
Working in mines smelting or chemical or
petroleum manufacturing
Contd…

7. Contd..
• polycyclic aromatic hydrocarbons
chromates,arcenic,air pollution, lung
disease,TB pneumonia diet low in fruit and
vegetables previous radiotherapy to the chest

8. PATHOPHYSIOLOGY

9. Paraneoplastic syndromes
• Remote effects of malignancy occur in 10 to
20 per cent of lung cancer
clients. These usually result from the secretion
of substances (e.g., hormones, enzymes and
antigens) by the tumor itself. These
substances then act on target organs,
producing a variety of symptoms called
paraneoplastic symptoms

10. Classification and Staging
• small cell lung cancer,
• non-small cell lung cancer

11. Staging
• T is the tumors size ,location and degree of
invasion
• N is the regional node involvement
• M is distant metastasis

12. Clinical Manifestations
• Early
• Asymptomatic until late phase
• Persistent Cough
• Dyspnoea
• Chest and shoulder pain
• Recurrent temperature
• Recurrent infection
• Blood tinged sputum
• Wheeze
• Anorexia
• Weight loss
• Vomiting
• Hoarseness of voice
•

13. Late
• Bone pain
• Spinal cord compression
• Chest pain
• Dysphasia
• Blurred vision
• Pleural effusion
• Horseness of voice
• Dysphagia
• Head and neck oedema

14. Signs symptoms depends upon
location of lesion
• Localized
• Cough mostly chronic dry cough
• Breathing symptoms
• -shortness of breath and strider
• Changes in sputum
• -increased amount Hemoptysis
• Pneumonia
• Hoarseness of voice
• chest pain and tightness

15. generalized
• Bone pain
• Head ache
• Mental status changes
• Abdominal pain
• Anorexia
• Idiopathic weight loss
• Pancots syndrome
• Horner's syndrome
• Pleural effusion
• Svenalar syndrome

16. Assessment and Diagnostic Findings
• CXR
• CT
• PET SCAN
• sputum cytology
• biopsy
• thoracoscopy
• bronchoscopy
• CBC-WBC RBC
• BIOPSY
• Contd..

17. Contd..
• MRI
• FNAC
• Pleural aspirate cytology
• Mediastinoscopy
• Lymph node biopsy
• Open lung biopsy (rare)
• esophageal ultrasound (EUS)
• lung scan spirometry, video assisted
thoracoscopy, pulmonary angiography, lung scan

18. Management
• treatment may involve surgery,
• radiation therapy,
• chemotherapy
• combination of these.
• immune system therapy
• (gene therapy, therapy with defined tumor
antigens biological response modifiers)

19. CHEMOTHERAPY
• includingalkylating agents (ifosfamide),
platinum analogues (cisplatin andcarboplatin),
taxanes (paclitaxel, docetaxel), vinca
alkaloids(vinblastine and vindesine),
doxorubicin, gemcitabine,
vinorelbine,irinotecan (CPT-11), and etoposide
(VP-16)

20. RADIATION THERAPY
• Radiation is used to reduce the size of a
tumor,
• to make an inoperable tumor operable,
• relieve the pressure of the tumor on vital
structures.
• control symptoms of spinal cord metastasis
and superior vena caval compression
• Reduce bone and liver pain.

21. Treatment-Related Complications
• diminished cardiopulmonary function
• pulmonary fibrosis,
• Pericarditis,
• myelitis
• cor pulmonale.
• pneumonitis.
• Pulmonary toxicity

22. SURGICAL MANAGEMENT
• lobotomy (removal of a lobe of the lung).
• Entire lung may be
removed(pneumonectomy)

23. Types of surgical approaches
• Wedge Resection.
• Segmental Resection.
• Segmental Resection.
• Pneumonectomy.

24. LASER THERAPY
• laser use is palliative for the relief of
endobronchial obstructions caused by non
resectable lung tumors. Lasers do not produce
systemic or cumulative toxic effects and are
well tolerated.

25. CLOSED CHEST DRAINAGE

26. Metastasis.

27. OTHER TYPES OF LUNG TUMORS
• sarcomas,
• lymphomas,
• bronchial adenomas.

28. Benign tumors.
• Hamartomas
• Chondromas
• Mesotheliomas

29. Nursing Management
•

30. Nursing Diagnoses
• Ineffective airway clearance related to
increased tracheobronchial secretions and
presence of tumor
• Anxiety related to lack of knowledge of
diagnosis or unknown prognosis and
treatments
• Acute pain related to pressure of tumor on
surrounding structures and erosion of tissues

31. Contd..
• Imbalanced nutrition: less than body
requirements related to increased metabolic
demands, increased secretions, weakness, and
anorexia
• Ineffective health maintenance related to lack of
knowledge about the disease process and
therapeutic regimen
• Ineffective breathing pattern related to decreased
lung capacity.

32. Nursing Implementation
• health promotion,
• managing symptoms
• relieving breathing problems
• reducing fatigue
• providing psychological support
• acute intervention.
• ambulatory and home care

33. Evidence based practice

34. CONCLUSION