Lung Cancer (exam 1)

StudyBlue printing of Lung Cancer (exam 1) html, body, div, span, applet, object, iframe, h1, h2, h3, h4, h5, h6, p, blockquote, pre, a, abbr, acronym, address, big, cite, code, del, dfn, em, font, img, ins, kbd, q, s, samp, small, strike, strong, sub, sup, tt, var, b, u, i, center, fieldset, form, label, legend, table, caption, tbody, tfoot, thead, tr, th, td { margin: 0; padding: 0; border: 0; outline: 0; font-size: 100%; background: transparent; } body { line-height: 1; } blockquote, q { quotes: none; } blockquote:before, blockquote:after, q:before, q:after { content: ''; content: none; } /* remember to define focus styles! */ :focus { outline: 0; } /* remember to highlight inserts somehow! */ ins { text-decoration: none; } del { text-decoration: line-through; } /* tables still need 'cellspacing="0"' in the markup */ table { border-collapse: collapse; border-spacing: 0; } /* end RESET */ .header { min-width:800px; } .logo { padding:6px 20px 2px 20px; margin:0; font-size:25px; font-weight:bold; color:#808285; position:relative; border-bottom: 1px solid #c5c5c5; } .logo-blue { color:#70adc4; } .logo-desc { font-weight:normal; font-size:19px; color:#cccccc; margin-top:50px; position:absolute; display: none; } .back-button { position:absolute; top:20px; right:20px; font-size:13px; line-height:25px; color:rgb(0,175,225); font-weight:normal; } .back-button a { color:rgb(0,175,225); } .instructions { padding:0; margin:0; width:100%; position:relative; color:rgb(100,100,100); } .step-holder { border-left:1px solid #ededed; margin-left:20px; } .steps { padding:15px 0; float:left; width:24%; border-right:1px solid #ededed; text-align:center; } .steps-01 { } .steps-02 { } .steps-03 { } .steps-04 { } .label { padding:5px 10px; } .print-button { } .print-button a { background-color:rgb(0,175,225); color:white; line-height: 19px; padding:9px 8px 5px 30px; font-size:14px; text-decoration:none; background-image: url(images/printer.png); background-repeat: no-repeat; background-position: 7px 50%; -moz-border-radius: 5px; -webkit-border-radius: 5px; } .print-button a:hover { background-color:black; } .theNote .content { width: 8.0in !important; margin: 5px auto; padding:20px; background-color:white; } .theNote .header { border-bottom: 1px dashed #C8C8C8; font-size: 17px; padding: 0 0 10px; line-height: 19px; color: #00ADE1; min-width:500px; } .theNote .body { font-size: 14px; line-height: 19px; padding: 10px 0; } .theNote{ padding:6px 0; clear:both; background-color: rgb(200,200,200); } .theNote h3{ color: rgb(100,100,100); } .theNote h1, .theNote h3{ background-color:white; padding:2px 20px; width:8.0in !important; margin: 0 auto; font-size: 15px; } .theNote h1{ padding-top: 10px; font-size: 15px; } .theNote h1:first-child{ font-size: 20px; } .theNote h3 { font-size: 14px; font-weight: normal; } #options { border: 3px double #ccc; padding: 5px 12px; margin: 10px 50px 10px 20px; float: left; } #info { border-top: 1px solid #ccc; padding-top: 5px; font-style: italic; } li { margin: 5px 10px 5px 25px; } ul li { list-style: disc; } ol li { list-style: decimal; } img { border: 0; } table { clear: both; width: 100%; border: 1px solid #c5c5c5; border-width: 1px 0; margin: 0; page-break-after: always; } table#page { page-break-after: auto; } td { text-align: center; font-size: 12px; border-bottom: 1px dashed #c5c5c5; height: 1.75in; width: 50%; padding-left: 15px; } .leftside { border-right: 1px solid #cccccc; padding: 0 15px 0 0; } .bottom td { border-bottom: none; } .clearfix { clear:both; line-height:1px; height:1px; } img { max-width:80%; max-height:150px; margin:20px; } @media print {.header { display: none; } .content .header{ display:inherit; } table { border: 1px dashed #bbb; border-width: 1px 0; } .theNote{ background-color:white; } } LUNG CANCER Primary lung cancers categorized into two subtypes: Non–small cell lung cancer (NSCLC) 85% Small cell lung cancer (SCLC) 15% Small Cell Lung Cancer SCLC behaves differently from other cell types. Its unique ability to spread and be widely disseminated by the time of diagnosis leads to a very poor prognosis, often survival ranging from only 2 to 4 months. Associated with cigarette smoking and exposure to environmental carcinogens Accounts for 15-25% of lung cancers Most malignant form Spreads early via lymph & blood system Poorest prognosis Non Small Cell lung Cancer-Adenocarcinoma Most common type Not related to cigarette smoking Accounts for 30-40% of lung cancers More common in women Often no symptoms until widespread metz Adenocarcinoma is the most common form of lung cancer and the most common cell type in nonsmokers. Cancer cells can be found in the periphery of the lung and are known to present with fewer pulmonary symptoms than those that originate in the central portion of the lung parenchyma. Progression is slow; however, adenocarcinoma invades the lymphatic and blood vessels early in the disease, resulting in a worse prognosis compared to that for SCLCs. Non Small Cell Lung Cancer: Squamous Cell Carcinoma • Associated with cigarette smoking • Second most common type of lung cancer • Accounts for 30-35% of lung cancers • More common in men • Bronchial obstructive characteristics These malignancies have a tendency to be slow growing, such that a visible mass may not be detected for up to 4 years. Non Small Cell Lung Cancer: Large Cell Carcinoma • High correlation to smoking and exposure to environmental carcinogens • Least common • Accounts for 5-15% of lung cancers • Highly metastatic via lymph & blood Found in periphery of the lung, often times spreading to the subsegmental bronchi or larger airways. Because this cell type is poorly differentiated and possesses neuroendocrine features, the prognosis is often times very poor. Common metastatic sites for all types of lung cancer include liver, bone, adrenal glands, and the brain. Clinical Manifestations of Lung cancer Persons with lung cancer access the health care system when they have begun to experience multiple serious symptoms. A comprehensive history and physical includes obtaining an accurate history of risk factors. This information combined with the physical symptoms paints a more complete picture indicative of lung cancer. Respiratory symptoms include cough, dyspnea, sputum production, wheezing, hemoptysis, and chest pain. Additional clinical manifestations include dysphagia, hoarseness, pain, fatigue, weakness, nausea, disturbed sleep, memory impairments, anorexia, and night sweats. Superior Vena Cava Syndrome-Complication of Superior Vena Cava Syndrome Superior vena cava syndrome, partial or complete obstruction of the superior vena cava, is a potential complication of lung cancer. Obstructed venous flow from the head and neck produces the symptoms of this syndrome. Edema of the neck and face, headache, dizziness, vision disturbances, and syncope are all symptoms of this syndrome. Veins of the upper chest and neck are dilated; flushing occurs, followed by cyanosis. Cerebral edema may affect the level of consciousness and laryngeal edema may impair respirations. Paraneoplastic Syndrome-Complication of Lung Cancer: Commonly associated with small-cell lung cancer. It results from a production of active substances such as hormones, enzymes, or antigens either by the tumor itself or in response to the tumor. Systemic manifestations seen are hormonal, dermatologic, neurological, neuromuscular, vascular, hematologic, and connective tissue syndromes. During this syndrome, the client can respond temporarily to symptomatic treatment, but they are impossible to control without successful treatment of the underlying lung cancer. This is considered a metabolic emergency that can disrupt the complete homeostasis of vital body functions. Diagnostics: • Chest x-ray & CT Scan • ECG & Pulmonary Function Tests • Sputum specimen • Bronchoscopy and TTNA • Lung biopsy