Lung Cancer Disease Concept Map PDF

# 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 ### On a Molecular Level - Genetic predisposition plus genetic predisposition exposure to carcinogens from smoking and...

# 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 ### On a Molecular Level - 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. - 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 - 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, and 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. - May be 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, and 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