Lung Cancer: Disease Concept Map PDF

# Disease Name: Lung Cancer ## Epidemiology - Leading cause of cancer related death for males and females throughout the world. - 25% of all cancer deaths are from lung cancer. ## Pathophysiology - **Genetic predisposition plus:** Genetic predisposition exposure to carcinogens from smoking and o...

# Disease Name: Lung Cancer ## Epidemiology - Leading cause of cancer related death for males and females throughout the world. - 25% of all cancer deaths are from lung cancer. ## Pathophysiology - **Genetic predisposition plus:** Genetic predisposition exposure to carcinogens from smoking and other toxins paralyze the cilia of the respiratory tract's epithelium, leading to an accumulation of carcinogens. - **On a molecular level:** A respiratory tract lesion develops and has genetic and structural changes from hyperplasia to dysplasia to an invasive, neoplastic, cancerous mass. There is an activation of oncogenes and a deactivation of tumor suppressor genes, and reduced apoptosis = unchecked cell growth and proliferation of cancer. - **Spread:** via angiogenesis (building of blood vessels) and metastasis, = destructive invasion of nearby tissue. Dysplasia becomes a thickened area of bronchial mucosa. Growing lesion can erode the lining epithelium, grow into the bronchial lumen, or become a mass within the lung tissue. Can extend into the pleural surface and then spread to the tracheal, bronchial, or mediastinal lymph nodes. ## Etiology - Risk Factors - **Cigarette Smoking** - 80-90% cases - **Occupational exposure** - other toxins - **Race** - African American - **Age** - Avg age = 70 years - **Family history** - **Mutations:** in the ras family of oncogenes - **Mutations:** in other oncogenes and tumor Suppressor genes. ## Signs/Symptoms - Cough - Hemoptysis (blood in sputum) - Wheeze - Stridor - Chest pain - Dyspnea - Weight loss - Excessive fatigue - Weakness - Hoarseness (may be a sign if the tumor compresses the recurrent laryngeal nerve) - Fever/productive cough (may lead to a misdiagnosis of pneumonia r/t obstruction of bronchioles causing secretions) - Asymptomatic but present with s/s of a paraneoplastic syndrome: - Syndrome of inappropriate ADH (SIADH) - hyponatremia, confusion - Hypercalcemia - Thrombosis - Tanning r/t ACTH ## Diagnosis - Chest x-ray - CT or MRI scan - Cytological examination of sputum - Bronchoscopy - CT-guided tissue biopsy - Low-dose helical CT scan ## Treatment - **Surgery, Chemotherapy, Radiation combination** - Stages 1 and 2 NSCLC = VATS surgery - Wedge resection - Lobectomy - Pneumonectomy - Stereotactic Radiotherapy - targets cancer cells - **SCLC, Inoperable Stage 3 and metastatic dz - chemotherapy –** several different agents - **Etoposide -** Platinum based compounds - **Cancer immunotherapy using checkpoint inhibitors -** pembrolizumab, nivolumab, or atezolizumab - **Protein tyrosine kinase receptor inhibitors -** Erlotinib (Tarceva) block the stimulus for cancer growth in NSCLC