Lung Cancer | Mind Map

Reference

Conway, E.M., Pikor, L.A., Hamilton, M.J., Lam, S.,S., Lam, W.L., &amp; Bennewith, K.L. (2016). Macrophases, inflammation, and lungcancer. American Journal of Respiratory and Critical Care Medicine 193(2). doi: 10.1164/rccm.201508-1545CI

American Cancer Society. (2017). Lung cancer. Retrieved from https://www.cancer.org/cancer/lung-cancer.html

McCance, K.L., Heuther, S.E.., Brashers, V.L., and Rote, N.S. (2014). Pathophysiology: The biological basis for disease in adultsand children (7th ed.). St. Louis, MI: Elsevier Inc.

Lung Cancer Concept Map

MSN605 Pathophysiology Across the Lifespan for ANP

Tabitha Agnir

Treatments

Self-care such as eating healthy foods and quitting smoking

Medications including chemotherapy, targeted therapy, andimmunotherapy

Surgery such as Pulmonary lobectomy, Wedge resection,Radiosurgery, Video-Assisted Thoracoscopic Surgery

Thoracotomy and Radiation Therapy

Palliative Care

Physicians include:

Primary Care Provider

Oncologist

Palliative medicine

Radiologist

Pulmonologist

Cardiothoracic surgeonPhysicians

Primary Care Provider

Oncologist

Palliative medicine

Radiologist

Pulmonologist

Cardiothoracic surgeon

Causative Factors

Non-small Cell Lung Cancer -Inherited or acquired gene changes, such as TP53 or p16 tumor suppressor genes, and K–RAS or ALK oncogenes

Small Cell Lung Cancer-Inherited or acquired gene changes, such as TP53 and RB1 tumor suppress genes

Lung Carcinoid TumorNot much is known about the genetic implications of this tumor

Text book, exercises 34,35, 36, 37

Pathophysiologic Etiology

Chronic inflammatory conditions (such as asthma) increase cancer risk.

Lung cancer arises from respiratory epithelium. May be a response to a variety of risk factors thatincrease the potential of lung cancer, such as smoking, second hand smoking, and genetic factors.

Lung cancer tumors alter the immune system and are considered a hallmark of cancer. Lungtumors arise from chronic inflammation sites, filled with leukocytes, cytokines, chemokines, growthfactors, and matrix-degrading enzymes.

Tumor cancer cells are genetically different than the remaining cells.

Tumor-infiltrating leukocytes have tumor suppressing or tumor protecting effects. Thus, theyproliferate without any “stop” signal in their genetics.

CTLA-4 and cell death protein 1 are cytokines and immune checkpoints thought to be used toprotect lung carcinomasCTLA-4 blocking antibody with chemo revealed that squamous LC hadgreat clinical benefits.

Tumor promotes tumor associated macrophages (TAM) prevent immune system from creatinganti-tumoral response.

Common Findings

General

Cough that does not go away or gets worse

Coughing up blood or rust-colored sputum (spit orphlegm)

Chest pain that is often worse with deep breathing,coughing, or laughing

Hoarseness

Weight loss and loss of appetite

Shortness of breath

Feeling tired or weak

Infections such as bronchitis and pneumonia that donot go away or keep coming back

New onset of wheezing

Metastasized Lung Cancer Findings

Bone pain

Nervous system changes (headache, weakness,numbness of an extremity, dizziness, seizures)

Yellowing of skin and/or eyes

Lumps near the surface of the bodyBone pain

Nervous system changes (headache, weakness,numbness of an extremity, dizziness, seizures)

Yellowing of skin and/or eyes

Lumps near the surface of the body

Syndromes

Horner Syndrome (Typically in NSCLC than SCLC)

Superior Vena Cava Syndrome

Paraneoplastic SyndromesHorner Syndrome (Typicallyin NSCLC than SCLC)

Superior Vena Cava Syndrome

Paraneoplastic Syndromes

Risk Factors

Tobacco smoke

Radon exposure

Asbestos

Uranium, arsenic, beryllium, cadmium, silica, vinylchloride, nickel compounds, chromium compounds,coal products, mustard gas, chloromethyl ethers

Diesel exhaust

Arsenic in drinking water

Radiation therapy

Air pollution

Personal or Family history of lung cancer

Diagnostic Testing

Image Testing

Diagnostic Testing

Lab Tests

Other Examinations

Tests to find Lung Cancer Spread in Chest

Endobronchial ultrasound, endoscopic esophagealultrasound, Mediastinoscopy and Mediastinotomy,Thoracoscopy, Endobronchial ultrasound, endoscopicesophageal ultrasound, Mediastinoscopy andMediastinotomy, Thoracoscopy

Complete Blood Count

Blood Chemistry Tests

Blood tests for chromogranin A (CgA), neuron-specific enolase(NSE), cortisol, and substance P

Lung or Pulmonary Function Tests

Urine samples to test for 5-HIAAComplete Blood Count

Blood Chemistry Tests

Blood tests for chromogranin A (CgA), neuron-specific enolase(NSE), cortisol, and substance P

Lung or Pulmonary Function Tests

Urine samples to test for 5-HIAA

Biopsies sent to a pathology lab todiagnose disease such as cancer andclassify cancer type

Takes approximately one week forpathology report

Microscopic examination of affectedcells. May be taken by sputum cytology,thoracentesis, needle biopsy (fine needle,core biopsy), Transthoracic needlebiopsy, Bronchoscopy

Chest X-Ray, Computed Tomographyscan and/or biopsy, Magnetic ResonanceImaging scan, Positron EmissionTomography scan, and bone scan.

Non-small Cell Lung Cancer (85% of lung cancers)Small Cell Lung Cancer (10-15% of lung cancers)Lung Carcinoid Tumor (Fewer than 5% of lung cancers)