Concept and Etiology: Cancer is defined by abnormal cell growth, when this
abnormal cell growth initiates in the lungs, it is classified as lung cancer. Lung
cancer can affect the respiratory system if the tumour grows large enough to
impede the airways, it can also cause bleeding within the airways. Lung
cancer can cause fluid to accumulate in the plural space which would cause a
plural effusion. IF for some reason the lung cancer was not found and
treated early enough, lung cancer could spready (metastasize) to other areas
of the body as well. If a person has lung cancer, they would no longer be in a
state of complete physical health due to effects cancer has on the body,
therefore that person would no longer be considered healthy.
Classification: Lung cancers are broadly classified into two types: small cell
lung cancers (SCLC) and non-small cell lung cancers (NSCLC). This
classification is based upon the microscopic appearance of the tumor cells.
These two types of cancers grow, spread, and are treated in different ways,
so making a distinction between these two types is important. Small cell lung
cancers are known to grow and spread very quickly and are also very
aggressive. Once found, they have often spread to several other parts of the
body. Non- small cell lung cancers can be broken down into 3
subtypes: Adenocarcinoma in situ (previously called bronchioloalveolar
carcinoma) is a subtype of adenocarcinoma that frequently develops at
multiple sites in the lungs and spreads along the pre-existing alveolar walls. It
may also look like pneumonia on a chest X-ray. Squamous cell cancers arise
most frequently in the central chest area in the bronchi. This type of lung
cancer most often stays within the lung, spreads to lymph nodes, and grows
quite large, forming a cavity. Large cell carcinomas, sometimes referred to as
undifferentiated carcinomas, are the least common type of NSCLC,
accounting for 10%-15% of all lung cancers. This type of cancer has a high
tendency to spread to the lymph nodes and distant sites. Additionally, there
is also Bronchial carcinoids. These tumors are generally small (3-4 cm or less)
when diagnosed and occur most commonly in persons under age 40.
Unrelated to cigarette smoking, carcinoid tumors can metastasize, and a
small proportion of these tumors secrete hormone-like substances.
Carcinoids generally grow and spread more slowly than bronchogenic
cancers, and many are detected early enough to be surgically removed
(Robinson, 2020).
Lung cancer is staged on the following information:
T – Tumor size and location
N – Regional lymph node involvement. Lymph nodes are small ball-shaped
immune system organs distributed throughout the body. It is important to
know whether the lung cancer has spread to the lymph nodes around the
lung.
M – Metastasis status. Metastasis status refers to which organs the cancer
has spread.
While non-small cell ranges in stages from 0 to IV, small cell is staged as
either limited or extensive (American Lung Association, 2021).
Signs: persistent cough measured by a healthcare provider, fever, swelling
which is a sign of vena cava syndrome, finger clubbing,
Symptoms: persistent cough that gets worse, recurrent chest infections,
coughing up blood, pain when breathing or coughing, shortness of breath,
fatigue, loss of appetite and unexplained weight loss, dysphagia
Often the disease has progressed extensively before any signs any symptoms
are present of the disease. It should be noted that many of the
signs(objective) and symptoms (subjective) could be the same, the difference
would be dependent upon if the patient reports them or if they have been
observed by clinical staff.
Diagnostic Tests:
A chest X-ray is usually the 1st test used to diagnose lung cancer. Most lung
tumors appear on X-rays as a white-grey mass.
A CT scan is usually the next test you'll have after a chest X-ray. A CT scan
uses X-rays and a computer to create detailed images of the inside of your
body.
A PET-CT scan may be done if the results of a CT scan show you have cancer
at an early stage. The PET-CT scan (which stands for positron emission
tomography-computerized tomography) can show where there are active
cancer cells. This can help with diagnosis and choosing the best treatment.
There are also numerous biopsies that can be done to distinguish if cancer is
present and decide what type of cancer it is and where it is located.
(NHS,2019)
References:
Lung cancer staging. American Lung Association. (2021, October 28).
Retrieved November 7, 2021, from https://www.lung.org/lung-health-
diseases/lung-disease-lookup/lung-cancer/symptoms-diagnosis/lung-cancer-
staging.
NHS. (2019, August 15). Lung Cancer. NHS choices. Retrieved November 7,
2021, from https://www.nhs.uk/conditions/lung-cancer/diagnosis/.
Robinson, J. (2020). Types of lung cancer: small cell and non-small cell lung
cancer types. WebMD. Retrieved November 7, 2021, from
https://www.webmd.com/lung-cancer/lung-cancer-types.
