Lung Cancer Treatment

Treatment for lung cancer depends upon a variety of factors. The most important factors are
the histopathologic (diseased tissue) type of lung cancer and the stage of the cancer.

Once the stage of the lung cancer has been determined, the oncology team and the patient
work together to develop a treatment plan. It is important for lung cancer patients to discuss
the value of different forms of therapy with their oncologist. Other factors that affect lung
cancer treatment include the patient's general health, medical conditions that can affect
treatment (such as chemotherapy), and tumor characteristics.

Characteristics of the lung tumor are used to help separate patients into two groups: patients
who are at low risk for cancer recurrence and patients who are at high risk for cancer
recurrence. Specific prognostic—disease-forecasting—factors are used to place patients in
either of these groups. In particular, the histopathologic groupings of small cell lung carcinoma
(SCLC) versus non-small cell lung carcinoma (NSCLC) may be used to better predict a patient's
prognosis and expected response to therapy.

Medical Management

RADIATION THERAPY – is the medical use radiation as part of cancer treatment to control
malignant cells.

CHEMOTHERAPY - it refers toantineoplastic drugs used to treat cancer or the combination of

these drugs into a cytotoxic standardized treatment regimen. 

IMMUNOTHERAPY -  is the use of the immune system to reject cancer. The main premise is
stimulating the patient's immune system to attack the malignant tumor cells that are
responsible for the disease. This can be either through immunization of the patient (eg. by
administering a cancer vaccine, such as Dendreon's Provenge), in which case the patient's own
immune system is trained to recognize tumor cells as targets to be destroyed, or through the
administration of therapeutic antibodies as drugs, in which case the patient's immune system
is recruited to destroy tumor cells by the therapeutic antibodies.
Surgical Management

• LUNG RESECTION - is performed under general anesthesia, meaning the person is put to

sleep with medication. To perform a lung resection, the surgeon makes an incision in the
chest. If necessary, a rib is removed from the chest to gain better access to the diseased
part of the lung. The lung is examined and the area of concern, such as a tumor, is
identified. The blood vessels that supply the area to be removed are sutured, or tied off,
and cut. The tumor or diseased area is then removed. If cancerous tumors are removed, the
lymph nodes near the lung and draining the lung are also removed.

After removal of the diseased area, the muscles are sutured and reconstructed where
necessary. A chest tube is left in place to remove fluid, blood, and air from the lung and
chest wall. The incision is closed with sutures, clips, or staples.

• LOBECTOMY – surgical excision of a lobe.

• PNEUMONECTOMY – is a surgical procedure to remove a lung.

• THORACOTOMY – is an incision into the pleural space of the chest to gain access to the
thoracic organs.

• ELECTROSURGERY – is the applicatio of a high-frequency electric current to biological

tissue as a means to cut, coagulate, desiccate, or fulgurate tissue.

• CRYOSURGERY – is the application of extreme cold to destroy abnormal or diseased

tissue.

• CHEMOSURGERY – the destruction of tissue by chemical agents for therapeutic purposes;

originally applied to chemical fixation of malignant, gangrenous or infected tissue, with use
of frozen sections to facilitate systematic microscopic control of its excision.

• LASER SURGERY – is surgery usiing a laser to cut tissue instead of a scalpel.

Nursing Management

• Relieving breathing problems

- Maintain airway patency; remove secretions

 - Encourage DBE, aerosol therapy, oxygen therapy, mechanical therapy

- Advise use of relaxation and energy-conservation technique

- Refer for pulmonary rehabilitation

• Reducing fatigue

- Assess level of fatigue and identify cause

- Educate patient about energy-conservation tech and appropriate exercise

• Psychological support

- Help the patient and family deal with poor prognosis and progression of the disease

- Assess psychological aspects and assist patient in coping

- Assist patient and family with informed decision in making regarding treatment options

- Support patient and family in the end-of-life decisions

Nursing Diagnosis

- Impaired tissue integrity r/t the effects of tx

- Imbalanced nutrition less than body requirements r/t anorexia, malabsortion and
cachexia (wasting syndrome: eg. Weight loss)

- Pain or chronic pain r/t disease

- Fatigue r/t physical and psychological stressors

- Disturbed body image r/t changes in the appearance and role functions.