Lung Cancer

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Lung Cancer by Mind Map: Lung Cancer

1. Risk factors

1.1. Exposure to carcinogen

1.1.1. Environmental and Occupational Exposure Radon gas Industrial Carcinogens arsenic asbestos mustard gas chromates coke oven fumes nickel oil radiation

1.1.2. Tobacco Smoke

1.1.3. Secondhand Smoke

2. Clinical manifestation

2.1. Physical: depends on location size

2.1.1. Local and regional Bronchus Persistent dry cough / change in chronic cough (65 - 75%) Dyspnea (60%) wheezing Hemoptysis / blood-streaked sputum Pneumonia recurrent fever Pleura pleuritic pain Pleural effusion Supervior vena cava syndrome (edema in face, neck and shoulders) Compression on Superior vena cava Compression of the brachial plexus Pancoast's syndrome (Shoulder or arm pain) Compression on laryngeal nerve hoarseness dysphagia

2.1.2. Metastasis Brain involvement headaches decreased mental capacity seizures encephalopathy Bone involvement Bone Pain (VERY PAINFUL) Liver involvement Abdominal pain Jaundice Ascites Adrenal gland

2.1.3. Non-specific fatigue (weakness) Anorexia Weight loss Cachexia

2.2. Psychological

2.2.1. Grieving

2.2.2. Anxiety

2.2.3. Depression

3. Classification

3.1. Staging

3.1.1. TNM T Tx T0 Tis T1, T2, T3, T4 N Nx N0 N1, N2, N3 M Mx M0 M1

3.2. cytology

3.2.1. Non-small cell lung cancer (NSCLC) (80%) Adenocarcinoma (40%) Large cell carcinoma (15%) Squamous cell carcinoma (20-30%)

3.2.2. Small Cell Lung Cancer (20%)

4. Pathophysiology

4.1. Carcinogenesis

4.1.1. Carcinogen binds to and damages cell's DNA Cellular change and abnormal cell growth malignant cell

5. Diagnosis

5.1. Radiography

5.1.1. Positron Emission Tomography (PET) Scan

5.1.2. Magnetic resonance imaging (MRI)

5.1.3. Computed Tomography (CT) Scan

5.1.4. Chest x ray

5.2. Cytologic Examination

5.2.1. Sputum x cytology

5.2.2. Fine-needle aspiration under CT-guidance

5.2.3. Fiberoptic Bronchscopy

5.3. Blood Test

5.3.1. Tumor Marker Carcinoembyronic Antigen (CEA)

6. Treatment

6.1. Surgical Management (for localized non-small cell)

6.1.1. Types Lobectomy Bilobectomy Sleeve resection Pneumonectomy Segmentectomy Wedge resection Chest wall resection

6.2. Radiation Therapy

6.2.1. Types Internal Brachytherapy External External beam radiation therapy

6.2.2. Side effect Skin Reaction Erythema dry desquamation moist desquamation ulceration

6.3. Chemotherapy

6.3.1. Choice of drug depends on the growth of the tumor cell the specific phase of the cell cycle that the medication affects

6.3.2. Mechanism alter tumor growth patterns

6.3.3. Indication Distant metastases Small cell lung cancer

6.3.4. Can be used as Adjunct therapy with

6.3.5. Common Side effect Hypersensitivity reactions Nausea Vomiting Alopecia hepatotoxicity nephrotoxicity myelosuppression Pancytopenia Heart failure

7. Nursing

7.1. Relieving breathing problems

7.1.1. Breathing Techniques Pursed lip breathing Diaphragmatic Breathing

7.1.2. Positioning Fowler's position Tripod position

7.1.3. Exercise

7.1.4. Energy conversation and work simplification

7.1.5. Environmental adjustment

7.1.6. Nutritional Management Mealtime and food pattern Calories and nutrients

7.1.7. Relaxation Technique

7.2. Reduce fatigue

7.2.1. Exercise Moderate physical exercise (50% - 90% of estimated max. heart rate) Promotes the efficient use of oxygen Lowers resting heart rate & Blood pressure Increases flexibility Increases muscle and bone strength Promote more restful sleep Decrease detrimental stress Increase sense of well being, self-esteem, self-efficacy and sense of being in control and quality of life

7.2.2. Pharmacological approaches Erythropoietin

7.2.3. Adjustment strategies Organization and planning of pleasurable activities and necessary tasks delegation to family members and willing helpers Priorities setting Sleep and rest balanced with activity Improve sleep quality sleep routine better sleep environment managing stress and anxiety avoiding caffeine Balanced diet Restorative activity Activities which result in a person feeling mentally restored

7.3. Psychological support

7.3.1. Facilitating expression of individual experiences

7.3.2. Patient empowerment

8. Prevention

8.1. Smoking prevention

8.2. Smoking cessation

8.3. Reducing tobacco exposure

9. Anatomy and Physiology