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Abnormal new tissue growth characterized by the progressive, uncontrolled multiplication of cells
cancer
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New and abnormal formation of tissue, such as a tumor or growth; Can be benign or malignant
neoplasm
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A tumor that originates in the bronchial mucosa; Term is used interchangeably with lung cancer
Bronchogenic carcinoma
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Agents known to produce cancer
carcinogens
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A new growth or malignant tumor that occurs in epithelial tissue
carcinoma
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Cancer arising from connective tissue such as muscle or bone
sarcoma
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Cancer arising from the lymphoid tissues
lymphoma
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Cancer of the skin
melanoma
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Neoplasm of the central nervous system
Glioblastoma
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Malignant neoplasm of blood-forming tissues
leukemia
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Movement of body cells from one part of the body or organ system to another
metastasis
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most common FATAL cancer in both men and women in the United States
lung cancer
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NEW cases of lung cancer are reported in the United States annually, greater than
215,000
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most common cause of lung cancer
cigarette smoking
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3 causes of lung cancer
- cigarette smoking
- genetic predisposition
- environmental & occupational
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2 types of cancer
- small cell lung cancer
- non small cell lung cancer
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example of a small cell lung cancer
small cell or oat cell carcinoma
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example of a non small cell lung cancer
- squamous (epidermoid) cell carcinoma
- adenocarcinoma aka brochioalveolar cell carcinoma
- large cell carcinoma - undifferentiated
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small cell (oat cell) carcinoma arises from
kulchitsky (k type) cells found in the bronchial epithelium
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small cell (oat cell) carcinoma commonly found near the
hilar region
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small cell (oat cell) carcinoma commonly reffered to as
oat cell carcinoma
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small cell (oat cell) carcinoma has what type of growth rate
very rapid
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small cell (oat cell) carcinoma metastasizes very early to distant tissue such as
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small cell (oat cell) carcinoma strongest correlation with
cigarette smoking
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small cell (oat cell) carcinoma worst ____ of all lung cancers
prognosis
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Squamous (Epidermoid) Cell Carcinoma originates from the
basal cells of the bronchial epithelium and grows through the epithelium before invading the surrounding tissues
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Squamous (Epidermoid) Cell Carcinoma commonly located near the
hilar region, projecting into the large bronchi
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Squamous (Epidermoid) Cell Carcinoma has what type of growth rate
slow tumor growth rate
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when does the Squamous (Epidermoid) Cell Carcinoma metastasizes
late (usually to hilar lymph nodes)
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Squamous (Epidermoid) Cell Carcinoma common secondary complications
- nonproductive cough
- hemoptysis
- pneumonia
- atelectasis
- cavity formation in 10-20% of cases
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Adenocarcinoma arises from the
mucus glands of the tracheobronchial tree
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Adenocarcinoma most commonly found in the
peripheral regions of the lung parenchyma
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Adenocarcinoma most common type of lung cancer in (2)
women and non smokers
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Adenocarcinoma growth rate is
moderate
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when does Adenocarcinoma metastasizes
early
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Adenocarcinoma common secondary complications
- pleural effusion
- cavity formation
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bronchioalveolar cell carcinoma is included in
adenocarcinoma
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tumors arise from the terminal bronchioles and alveoli is termed as
bronchioalveolar cell carcinoma aka adenocarcinoma
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bronchioalveolar cell carcinoma growth rate is
slow
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metastasis of bronchioalveolar is
unpredictable
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large cell carcinoma is commonly arises
peripherally but can also be found centrally, distorting the trachea and large airways
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large cell carcinoma growth rate
rapid
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metastasis of large cell carcinoma
early and widespread
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common secondary complications of large cell carcinoma
- chest wall pain
- pleural effusion
- pneumonia
- hemoptysis
- cavity formation
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history and physical examination
- change in cough or sputum
- hemoptysis
- wheezing or stridor if tumor is obstructing an airway
- dyspnea
- chest pain
- fever
- hoarseness
- facial edema w/ distended veins of the upper chest
- bone pain
- mental, emotional, or coordination status changes
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nonspecific systemic symptoms often associated w/ metastasis
- weight loss
- anorexia
- nausea
- vomiting
- weakness
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imaging techniques
- radiographic imaging
- chest computed tomography (chest ct)
- magnetic resonance imaging (mri)
- positron emission tomography (pet)
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PET uses 5-fluoro-deoxy glucose FDG tagged w/ a radionucliide to assess
metabolic activity
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positron emission tomography is based on the
metabolic function of a tissue rather than its anatomy
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lab studies
- cbc
- liver function studies
- abg
- pft
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non-invasive diagnostic testing
sputum cytology
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sputum cytology is most useful for diagnosing which carcinoma
squamous cell carcinoma
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invasive diagnostic procedures
- flexible fiberoptic bronchoscopy
- transthoracic needle aspiration
- thoracentesis
- pleural biopsy
- mediastinoscopy
- transesophageal ultrasound guided endoscopic fine needle aspiration
- thoracoscopy
- throacotomy
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primarily used to describe non small cell lung cancer
staging
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staging system used describes
- cancer cell type
- size of tumor
- level of lymph node involvement
- extent to which the cancer has spread
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most common system used is the
TNM classification
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T=
extent of primary tumor
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N=
lymph node involvement
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are roman numerals used to identify the stages as used in small cell lung cancer?
no
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small cell lung cancer is classified in 2 ways
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cancer is confined to only one lung and to its neighboring lymph nodes
limited
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cancer has spread beyond one lung and nearby lymph nodes
extensive
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treatment is dependent upon (5)
- pt overall health
- type of cancer (small vs non small)
- surgical resectability
- size of the tumor
- location of tumor
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is surgery usually a option for small cell lung cancer
no, most are spread outside of the lungs by the time they are detected
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use of powerful drugs to destroy cancer cells. destroys healthy cells, leaving the pt very immunocompromised
chemotherapy
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chemo used to (3)
- slow the growth of the tumor
- prevent the tumor from spreading further
- relieve symptoms
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use of x rays to kill the cancer cells
radiation therapy
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surgical resection is the principal form of treatment in which stages
1&2
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stage 3, pt with enlarged lymph nodes good candidates for surgery?
no, combo of radiation theraphy and chemo
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if lymph nodes appear normal, but are cancerous, what type of treatment option
- surgery may be
- radiation n chemo before surgery
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if tumor of any size present all over is surgery an option?
no, radiation therapy and chemo only
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treatment types for pt with stage iv
- chemo
- comfort/palliative care
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4 treatment RT can do for lung cancer pt
- o2 therapy
- bronchopulmonary hygiene
- hyperinflation therapy
- aerosolized medication
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4 types of bronchoscopy
- placement of stents in the airway
- photodynamic therapy
- laser therapy
- brachytherapy
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