Lower Airway Cancer 2

Front 1

The diagnosis of lung cancer is made by examination of cancer cells. Cytologic testing of early-morning sputum specimens may identify tumor cells; however,cancer cells may not be present in the sputum.

Back 1

When pleural effusion is present, fluid is obtained by thoracentesis for cytology. Most commonly, lung lesions are first identified on chest x-rays. CT examinations are then used to identify the lesions more clearly and to guide biopsy procedures.

Front 2

Other diagnostic studies may be needed to determine how widely the cancer has spread. Such tests include needle biopsy of lymph nodes,. MRI and radionuclide scans of the liver, spleen, brain, and bone help determine the location of metastatic tumors.

Back 2

Pulmonary function tests and arterial blood gas analysis help determine the overall respiratory status.. Together, these tests help determine the extent of the cancer and the best methods to treat it.

Front 3

Additional labs include a complete blood count which can show elevated whiteblood cells and a low hemoglobin which can be a sign of anemia of chronic disorders. Serum electrolyte imbalances can show signs of metastasis such as an elevated calcium.

Back 3

One of the highest risk factor for lung cancer is smoking. Smoking is responsible for 80-90% of all lung cancers. It is important to know pack per year history and exposure to second hand smoke. Other environmental carcinogens include asbestos, radon, arsenic, air pollution, and dyes.

Front 4

Lung Cancer; Early warning signs include

Back 4

a chronic cough & repeated episodes of pneumonia or bronchitis. Blood-tinged sputum may occur with bleeding from a tumor. Hemoptysis is a later finding in the course of the disease. If infection or necrosis is present, sputum may be purulent and copious.

Front 5

Late manifestations of lung cancer usually include

Back 5

fatigue, weight loss, anorexia, dysphagia, and nausea and vomiting. Superior vena cava syndrome may result from tumor pressure in or around the vena cava.

Front 6

Bronchogenic carcinomas are the most common lung cancers

Back 6

and arise as a result of the failure of cellular

regulation in the bronchial epithelium.

These cancers are slow growing, taking 8 to 10 years to reach one centimeter in size, which can then be detected on x-ray.

Front 7

Three types of incisions can be made depending on the location of the cancer:The incisions are large and are held open with retractors during surgery,contributing to pain after surgery.

Back 7

Surgery may consist of;

a wedge resection,

segment resection,

lobectomy, or

pneumonectomy.

Front 8

A wedge resection is the

Back 8

removal of the peripheral portion of a small, localized areas of disease.

Front 9

A segmental resection is

Back 9

a lung resection that includes

the bronchus,

pulmonary artery, vein, and tissue of the involved lung segment or segments of a lobe.

Front 10

A lobectomy is

Back 10

the removal of a lobe and

a pneumonectomy is the removal of the entire lung, and can both be accomplished through video-assisted thoracoscopic surgery (VATS) for select patients.

Front 11

This lobectomy procedure involves making three small incisions in the chest for placement of

surgical instruments.

Back 11

These same openings are used

later for placement of drains and chest tubes. The lung section, lobe, or lung is isolated from its airway, which is surgically closed. The lobe or the lung is closed off from the rest of the lung using a double-stapling technique.

Front 12

Chest tubes are placed into the pleural space to allow for lung re-expansion

Back 12

There are special interventions for a pneumonectomy patient. They need to be positioned on their back or operative side to allow for the remaining lung to stay inflated. There is the potential for a bronchial stump leak if pressure on the nonoperative side increases. If a leak occurs you will see a mediastinal shift.

Front 13

There are special interventions for a

pneumonectomy patient.

Back 13

They need to be positioned on their back or

operative side to allow for the remaining lung to stay inflated.

There is the potential for a bronchial stump leak if pressure on the non operative side increases.

If a leak occurs you will see a mediastinal shift.

Front 14

.Care after surgery for patients who have undergone thoracotomy (except for pneumonectomy) requires closed–chest drainage to drain air and blood that collect in the pleural space.

Back 14

A chest tube, a drain placed in the pleural space,allows lung re-expansion. The chest tube also prevents air & fluid from returning to the chest. The drainage system consists of one or more chest tubes or drains, a collection container placed below the chest level, and a water seal to keep air from entering the chest.

Front 15

Radiation therapy can be an effective treatment

Back 15

for advanced lung cancer confined to the chest. It can also be used to shrink the tumor prior

to surgery.

Front 16

Photodynamic therapy may be used to remove small bronchial tumors. The patient is injected with an agent that sensitizes cells to light. After 48 hours, the agent remains highly concentrated in the cancer cells, but non-cancerous cells have expelled the agent.

Back 16

The patient is then taken to surgery. A laser light is focused on the tumor and activates a chemical reaction causing cell destruction. These patients are then monitored in the Intensive Care Unit for airway management.

Front 17

Palliative care includes the use of

Back 17

oxygen therapy when the patient is hypoxic.

Drug therapy with bronchodilators and corticosteroids helps to decrease bronchospasm,

inflammation and edema.

Front 18

Radiation therapy can help

Back 18

relieve bronchial obstructions which can help

relieve swallowing problems.

Front 19

A thoracentesis can be performed if

Back 19

the patient is having breathing difficulties due to increased pleural fluid accumulation.

Front 20

Pain management may be needed to help with localized chest pain and pain at metastatic sites.

Back 20

to help with localized chest pain and pain at metastatic sites. Around the clock analgesics are most effective.

Front 21

Cytologic testing of early-morning sputum specimens

Back 21

may identify tumor cells; however,cancer cells may not be present in the sputum.

Front 22

When pleural effusion is present, fluid is obtained by thoracentesis for cytology.

Back 22

Most commonly, lung lesions are first identified on chest x-rays.

CT examinations are then used to identify the

lesions more clearly and to guide biopsy procedures.