Saturday, January 14, 2006

cancer, lung

Lung cancer has shown a significant increase during the last several decades. This is in part due to more accurate diagnosis, a growing number of older people in the population, an increase of cigarette smoking, and an increase in air pollution. Exposure to asbestos, radioactive dust and gases have also been implicated in lung cancer.
This is the most common fatal malignancy in males and may soon replace breast cancer as the most common malignancy in females. High-risk patients should have periodic screening with yearly chest X-rays and sputum cytology. Early detection will reduce mortality.
Cancer of the lung may be primary or metastatic. Bronchogenic carcinoma is the most common type of primary lung cancer. The tumor initially produces no symptoms. As the tumor enlarges, the patient may experience a productive cough of mucopurulent or blood-streaked sputum. The cough may be slight at first and attributed to smoking. As the disease advances the patient may experience fatigue, weight loss, and anorexia. Dyspnea (shortness of breath) and chest pain occur in the later stages of the disease. Hemoptysis (spitting up blood) is not uncommon.
Metastasis to the lung may be found before the primary lesion is known. The mortality of persons with lung cancer is dependent on the specific type of cancer and size of tumor. Squamous cell carcinoma is the most common. Adenocarcinoma and undifferentiated small cell cancer are the least common.
Early diagnosis is difficult because symptoms do not appear until the disease is well established. X-ray and other diagnostic tests such as bronchoscopy, biopsy, examination of the sputum, and surgical exploration are used for definitive diagnosis.
Surgical removal is the treatment of choice. It is usually successful in the early stages of the disease. Depending on the size and location of the tumor, removal of lung lobe (lobectomy) or excision of entire lung (pneumonectomy) may be performed. Radiation therapy is used as an adjunct to surgery and for palliation. Chemotherapy is used to slow the course of the disease and alleviate symptoms.
Phipps, W. J., et al. Medical Surgical Nursing. St. Louis: C. V. Mosby Co., 1983.
Rossman, I. Clinical Geriatrics. 3rd ed. Philadelphia: J. B. Lippincott Co., 1986.
Scherer, J. C. Introductory Medical-Surgical Nursing. Philadelphia: J. B. Lippincott Co., 1982.

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