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Necessary Rules about
Lung CancerMDs and Nurse Practitioners Needto Know
Marcos Nascimento, MDUCF Voluntary Professor
5
BLAH
BLAH
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General Concepts
AboutLung
Cancer
1
General Concepts Lung Cancer
• Leading death cause from cancer• 90% Smoking related• ALL LC are associated w Smoking• Nonsmoker = Adenocarcinoma• Smokers = 10 times higher risk than
Nonsmokers• Smoking Cessation decreases the risk, but
NEVER to a Non Smoker!• No screening tests
N Engl J Med 2008, 359: 1367-1380
Bronchogenic
Lung Types
Cancer
2
Bronchogenic LUNG CANCER TYPES
1. Small Cell ©• Para neoplastic Syndromes SIADH Cushing Syndromes Peripheral neuropathy/ Dementia Eaton - Lambert Syndrome2.Squamous © PTH Like Hormone
Mayo Clin Proc 2008; 83: 584- 594 / J of Clin Oncol 2007; 25: 561-570
Bronchogenic LUNG CANCER TYPES
3. Large Cell (P)
4. Adenocarcinoma (P)
- Bronchoalveolar Carcinoma
*** Pulmonary Solitary Nodule
Mayo Clin Proc 2008; 83: 584- 594 / J of Clin Oncol 2007; 25: 561-570
LEARN
LungPRESENTATIONS
Cancer
& Watch About
3
Bronchoalveolar Carcinoma Presentation
1. Cough ( Most Common)2. Weight Loss/ Dyspnea3. Hemoptysis; 4. Hoarseness 5** Recurrent Pneumonia6. SVC Syndrome7. Pancoast Syndrome8. Horner Syndrome9. Effusion
Mayo Clin Proc 2008; 83: 584- 594
LungCancerHow Diagnosis ?
4
Lung Cancer Diagnosis
• Sputum Cytology• Bronchoscopy for Central “S” Lesions• Needle Biopsy for peripheral Lesions• Mediastenoscopy • Cytology for Pleural Effusions
Necessary
Lung CancerMANAGEMENT AFTER DIAGNOSIS
5
MANAGEMENT QUESTIONS AFTER LC DIAGNOSIS:
• Is the LC Ressectable?1. Thorax CT2. MRI3. PET Scan• If the LC is ressectable, is the patient a surgical
candidate?1. PFTs: FEV1> 50%?• Remember: Many LC are also COPD patients
Lung Cancer screening results: Easily Misunderstaood. Mayo Clin Proc 2007; 82: 14-15 / BTS Guidelines on the selection of patients with Lung Cancer for surgery. Thorax 2001; 56: 89-108
RULES5
In LUNG CANCER
FORCREATINGCHANGING
WORLD
RULES5
RU
LES
GENERAL CONCEPTS LUNG CANCER
LUNG CANCER HISTOLOGIC TYPES
LUNG CANCER PRESENTATIONS
LC DIAGNOSIS
LUNG CANCER MANAGEMENT
prioritize organize mobilize
Annotated Bibliography
Clinical Guidelines:• Alberts WM, American College of Chest Physicians.
Diagnosis and management of lung cancer. ACCP evidence- based guidelines. Chest 2007; 132: 1S- 422S
Screening • Survival of patients with stage I Lung Cancer detected of
CT screening. N Engl J Med 2006, 355: 1763-1771
Smoking• Wilson JF. In the Clinic. Smoking Cessation. Ann
Intern Med 2007; 146:ITC2-1 – ITC2-16
www.pulmaosa.com.br
THANK YOU
Dr. Marcos Nascimento, MdUCF Voluntary Professor