Lung Carcinoma Analysis PDF

Lung Carcinoma: An In-depth analysis Joshy Ogaldez Cardio Pathophysiology 2080 What is it? Lung carcinoma is also known as Bronchogenic carcinoma: Bronchogenic carcinoma is define as a malignant neoplasms that originate in the airways or lungs parenchyma Two different types? Malignan...

Lung Carcinoma: An In-depth analysis Joshy Ogaldez Cardio Pathophysiology 2080 What is it? Lung carcinoma is also known as Bronchogenic carcinoma: Bronchogenic carcinoma is define as a malignant neoplasms that originate in the airways or lungs parenchyma Two different types? Malignant Cancerous Grows aggressively Metastasizes Benign Non-Cancerous Grows non-Aggressively Does not metastasizes Does not invade surrounding tissue Metastasizes: Spread beyond the original or primary tumor lesion History Epidemiology Lung cancer accounts for 1.37 million deaths worldwide each year In the US, it’s the top cause of cancer mortality Risk factors include Smoking most common Environment exposures Occupation exposes Usually present with advanced diseases Highly heterogenous Arises in the bronchial tree in different sites. Pathophysiology? Two major classes Non-small cell lung carcinoma (NCCLC) o Non-squamous o Adenocarcinoma o Large cell carcinoma o Squamous cell Carcinoma Small cell lung carcinoma (SCLC0 o Small Cell carcinoma Etiology- NSCL 90% of all lung cancer is caused from tobacco smoke 1 in 9 smokers eventually will develop lung cancer Occupational and environmental: o Air pollution o Radon o Asbestos o /nickel o Chromium o Silica o Chloromethyl ethers v o Beryllium Genetics Etiology- SCCL Mostly caused due to tobacco use 95% have a pack year history Occupational and environmental: o Radon (high levels) o Chloromethyl ethers v Clinical Signs and Symptoms NCLS Often Asymptomatic until the disease is well advanced Cough (persistent & worsening) Hemoptysis Dyspnea Chest pain Hoarseness Loss of appetite Wheezing SCLS Most are symptomatic at presentation time Bone pain Cough (persistent & worsening) Fatigue/Weakness Dyspnea Wheezing Hoarseness Loss of appetite Unexplained Weight loss Neurological dysfunction Lymph node involvement  Lung Carcinoma Complications Regional spread Metastatic spread NCLS Airway compressions Brain metastases Esophageal compression Bone pain Horner syndrome Hepatomegaly Pancoast syndrome Liver metastases Phrenic nerve palsy Spinal cord compressions Recurrent laryngeal nerve palsy SVC syndrome SCLS Lutron invasion causing left vocal cord paralysis Brain metastases (neurological issues) Phrenic nerve compression causing hemidiohragm Leptpmeningeal carcinomatosis (Carcinoma spread elevation to the meninges) Dysphasia (esophageal compression) Adrenal metastases (adrenal insufficiency) Superior vena cava syndrome Liver metastases (Jaundice, tenderness, Pericardial effusion and tamponade heptaomegaly) Lymph node enlargement (Cervical and super Bone metastases (bone pain, spinal cord clavicle) compression Fatigue Anorexia Cachexla NSLC Assessment & Diagnosis Imaging CT Scan without contrast MRI PET Scan Biopsy Confirm diagnosis Histologic information used for targeted treatment. Sputum cytological studies Bronchoscopy Mediastinosopy Thracososcopy (video -assisted) SCLC Assessment & Diagnosis Imaging Chest X-ray Rarely solitary indulge Unilateral hilar enlargement Increased hilar opacity Perhilar mass Mediastinal mass CT Scan without contrast MRI If suspected metastasis to the brain Assessment & Diagnosis Continued Staging Confirms prognosis Aids in appropriate treatment methods Factors are rated on 0-4 scale (higher # begin more severe) Cancer style stages are built by The size of the tumors anatomically (T) Presence of cancer on lymph nodes (N) If the cancer so found to metastases in the body (M) Stage 1 Stage 2 Stage 3 (A) Stage 3 (B) Stage 3 (C) Stage 4  Histopathology Confirm diagnosis Histologic information used for targeted treatment. Sputum cytological studies Bronchoscopy Mediastinosopy Thracososcopy (video -assisted) Endoscopic Ultrasound  Histopathology Confirm diagnosis Histologic information used for targeted treatment. Sputum cytological studies Bronchoscopy Mediastinosopy Thracososcopy (video -assisted) Endoscopic Ultrasound SCLC Assessment & Diagnosis Continued Staging (NCSCL) Limited Stage (LS-SCLC) Normally only seen on one lung and possibly the regional lymph nodes Primary tumor and regional nodes adequately encompassed within one Radation field Extensive-Stage SCLC (ES-SCLC) Cancer has spread to opposite lung, lymph nodes or to distant organs Includes Malignant pleural Pericardial effusion Hematogenous metastases  NCLS Treatment Surgery Completed resection preferred Chemotherapy Indicated for those with Tate II and stage iB Radiation Alternative for those that don’t qualify for surgery Postoperative treatment for patients with positive surgical margins  NCLS Treatment: Radiation Therapy A cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells from growing. Two types External radiation Use of machine outside the body to send Radation towards the area infected with cancer Internal radiation Uses a radioactive substance sealed in needed, seeds, wires or catheters that are placed directly into or near the cancer  NCLS Treatment: Chemotherapy (NSCL) The use of drugs to stop the growth of cancer cells, wither by killing the cells or stopping their division.. Chemotherapy drugs include: (common) cisplatin docetaxel doxorubicin etoposide gemcitabine paclitaxel pemetrexed Vinorelbine Combination of these drugs maybe used There are other drugs not sited  SCLS Treatment and Management Surgery Completed resection preferred Chemoradation Prevention Smoking Cessation Avoid tobacco Environmental Minimize exposure to carcinogens like asbestos and radon Public Health Measure Awareness Regular screening  Prognosis NCLS Survival rate SCLC Survival rate 4.5% Distal metastasis ES-SCLC About < 10 months 5-year survival 55.6% Localized LS-SCLC 80% 5 year  Mechanical Ventilation Can be lifesaving, carries poor prognosis Non-invasive mechanical ventilation in the ARF settings Supports respiratory muscles Facilitates alveolar ventilation Facilities airway patency In the case of respiratory failure, has a high rate of mortality in Resources Britanni ca, T. Editors of Encyclopaedia (2024, S ep tember 10). lu ng cancer. 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