Bacalu Paula-Georgiana "Dunarea De Jos" University of Galati"

Lung Cancer
Lung cancer (or malignant lung tumor) is a maligniant tumor originating from the different cells of the lung !t"s one of the leading causes of mortality of malignancies #oth for men and $omen %he main etiologic factor involved in causing the disease is smo&ing Due to late discovery' often outdated stages thera(eutically' only )*+ of (atients diagnosed get to survive a $hile longer (, years) %he li&elihood of develo(ing lung cancer is relatively lo$ until the age of -. years (for #oth se/es)' #ut then #egins to gro$ as the individuals gets older %he (ea& incidence is around 01 years Lung cancer is a disease that is characteri2ed' li&e other cancers' due the uncontrolled gro$th of cells inside the lungs %hese cells eventually forms a mass that is different from the surrounding healthy (arenchyma %he most common etiologic agent involved in lung cancer is the smo&ing (active #ut sometimes (assive) 3o$ever the lung cancer occurs is nonsmo&ing individuals' in these situations is lin&ed to chronic e/(osure to dusts such as as#estos' e/cessive air (ollution in industrial areas or even genetic factors Lung cancer can #e (rimary or secondary Primary cancer is one that originates in the lung structures' $hile secondary form occurs in metastasis of other malignancies %he lung is one of the most common organ that is locali2ed metastases' $ith #one' liver and #rain

Bacalu Paula-Georgiana "Dunarea De Jos" University of Galati"

Causes Unli&e most other cancers' $hose causes are often un&no$n' the leading cause of lung cancer is re(resented in over .1+ of (atients smo&ing !f a (erson 4uits smo&ing' the ris& of cancer is reduced gradually over time' #ut difficult !t seems that only after ), years of total a#stinence from smo&ing ris&s of cancer are starting to #ecome similar to that of a nonsmo&er' #ut they are reduced to 5+ only after -1 years of smo&ing cessation %he most im(ortant ris& factors that influence the occurrence of this cancer are6 7 8um#er of cigarettes smo&ed 7 %he age at $hich the individual $as started smo&ing9 7 %he (eriod of time that smo&ing (or ho$ long to 4uit smo&ing) 7 8icotine content of cigarettes smo&ed Because not all (atients diagnosed $ith lung cancer are smo&ers' researchers found other factors that may cause this cancer %heir role is relatively $ell esta#lished' #ut there are factors such as genetics' $hose influence remains to #e esta#lished Passive smo&ing (#y a nonsmo&er chronic e/(osure to cigarette smo&e) is incriminated in 5,+ of all lung cancer cases occur in nonsmo&ers : nonsmoler individual $ho lives $ith a (erson $ho smo&es' has a t$ofold increased ris& of develo(ing lung cancer Passive smo&ers are e/(osed mainly to nitrosamines' studies demonstrating that these com(ounds are e/creted in (eo(le nonsmo&er

Symptoms

Bacalu Paula-Georgiana "Dunarea De Jos" University of Galati"

:#out a 4uarter of all (atients do not develo( sym(toms $hen it is diagnosed $ith lung cancer !n these cases' the cancer is diagnosed #y (erforming /-rays or com(uted tomogra(hy (C%) for other health (ro#lems %he remaining (atients have certain sym(toms' even if some are nons(ecific' $hich leads them to see& medical attention ;ym(toms may #e a conse4uence of (rimary lung tumor' $hich can cause local com(ression or e/tend #y metastasis in the rest of the #ody ;ym(toms of lung cancer are classified as (rimary tumor-induced sym(toms' induced #y locoregional invasion' metastasis occurs #y or due to an a#normal ecto(ic hormone (roduction ;ym(toms of (rimary lung cancer include6 7 Cough 7 3emo(tysis (#loody s(utum or fran& hemorrhagic) 7 <hee2ing 7 Chest (ain 7 Dys(noea 7 =e(eated lung infections and u((er res(iratory tract' such as (neumonia or #ronchitis Staging of Lung Cancer Because of the thera(eutic and (rognostic im(lications' staging lung cancer is very im(ortant De(ending on the stage in $hich it is diagnosed' e/(erts can ma&e certain (redictions regarding the evolution and life e/(ectancy of the (atient ;tandard (rocedures that must #e (erformed to #e a#le to accurately determine the stage of cancer include6

Bacalu Paula-Georgiana "Dunarea De Jos" University of Galati"

7 Com(lete history and (hysical e/amination9 7 Com(uted tomogra(hy of the $hole a#domen9 7 Blood count9 7 >valuation of liver function and &idney9 7 Determination of serum electrolytes %he information gained from (erforming these investigations can #e used to guide further testing and analysis Lung cancer can #e staged according to the tumor si2e' its location' lym(h node' involvement and the e/istence of distant metastases %hese criteria are included in the %8? staging system (tumor' lym(h node' metastases) Treatment ?ost lung cancers can not #e cured #y current treatment' #ut this is mainly due to late discovery of neo(lasia' often in a state e/ceeded ;ym(tomatic treatment and the (alliative treatment modalities are among only a((lica#le to (atients $ith advanced lung cancer %reatment is multidisci(linary and (ersonali2ed for each individual #ased on tumor characteristics (gene' histologic)' staging and comor#idities' and de(ending on the (atient@s desire !nternational guidelines recommend the follo$ing treatment o(tions' de(ending on the stage of the cancer6 ) ;tage !6 surgical resection' adAuvant thera(y (chemothera(y and B or radiothera(y) and chemo(revention9 5 ;tage !!6 ;imilar to stage ! (surgical resection and adAuvant thera(y)9 - ;tage !!!:6 chemoradiotera(ie first intention and surgery in selected cases' carefully selected9

Bacalu Paula-Georgiana "Dunarea De Jos" University of Galati"

* ;tage !!! B6 chemothera(y and adAuvant measures to reduce dimensions and to slo$ the develo(ment of the (rimary tumor9 , ;tage !C6 cis(latin-#ased chemothera(y' surgical resection if the malignant lesion is uni4ue and is accessi#le resection Prognostic %he (rognosis of (atients diagnosed $ith lung cancer varies de(ending on the stage of the disease $as discovered %hus' in stage !' life e/(ectancy at , years is 0,+' $hile for stage !!! and !C' it is less than ,+ !n general' it is estimated that less than )*+ of (atients survive a median of , years after diagnosis Complications %he most common com(lications of lung cancer are6 ) ;(inal cord com(ression6 a((eared #y #one metastases9 5 ?eta#olic com(lications6 hy(ercalcaemia' hy(onatremia9 - %hera(eutic com(lications6 neutro(enia' hy(onatremia or hy(omagnesemia' renal failure' ne(hroto/icity' ototo/icity' recurrent #leeding The role of nurses in supporting patients diagnosed with lung cancer. Diagnosis of lung cancer is e/tremely traumatic' #eing related to concerns a#out treatment' shortness future and (ossi#le death Dear of the un&no$n and uncertainty a#out the future can #e very stressful for the (atient 8urse $ill advise the (atient to #anish fear' to discuss feelings that (ress' to re4uest su((ort $henever needed Deelings may #e more intense in intimate moments %he nurse

Bacalu Paula-Georgiana "Dunarea De Jos" University of Galati"

$ill advise the (atient that acce(ting the e/istence of feelings can #e the first ste( in mastering them Lac& of understanding can isolate the (atient and increases sorro$ !t is im(ortant for the (atient to tal& o(enly a#out their feelings and concerns $ith those $ho su((ort him' (rinci(ally $ith the nurse

Eey $ords6 lungs' smo&e' cancer' chemothera(y' nicotine' maligniant tumor

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