The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Lung cancer may include:
Research quality ratings and patient incidents/safety measures
for hospitals and medical facilities in specialties related to Lung cancer:
Treatment depends on a number of factors, including the
type of lung cancer (non-small or small cell lung cancer), the
size, location, and extent of the tumor, and the general
health of the patient. Many different treatments and
combinations of treatments may be used to control lung cancer,
and/or to improve quality of life by reducing symptoms.
Patients with non-small cell lung cancer may be treated in
several ways. The choice of treatment depends mainly on the
size, location, and extent of the tumor. Surgery is the most
common way to treat this type of lung cancer. Cryosurgery ,
a treatment that freezes and destroys cancer tissue, may be
used to control symptoms in the later stages of non-small cell
lung cancer. Radiation therapy and chemotherapy may also be
used to slow the progress of the disease and to manage
symptoms. (Source: excerpt from What You Need To Know About Lung Cancer: NCI)
Small cell lung cancer spreads quickly. In many cases,
cancer cells have already spread to other parts of the body
when the disease is diagnosed. In order to reach cancer cells
throughout the body, doctors almost always use chemotherapy.
Treatment may also include radiation therapy aimed at the
tumor in the lung or tumors in other parts of the body (such
as in the brain). Some patients have radiation therapy to the
brain even though no cancer is found there. This treatment,
called prophylactic
cranial irradiation (PCI), is given to prevent tumors
from forming in the brain. Surgery is part of the treatment
plan for a small number of patients with small cell lung
cancer. (Source: excerpt from What You Need To Know About Lung Cancer: NCI)
Minor hemoptysis: Treat the specific etiology
- Massive hemoptysis is a medical emergency
–Attention to airway, breathing, and circulation
–Administer supplemental O2 –Stabilize hemodynamics
–Cough suppression (e.g., guafenesin, codeine)
–Place bleeding side in dependent position to prevent blood from draining into the opposite lung
–Intubation as needed for airway control (a double-lumen tube will preserve oxygenation if bleeding is persistent)
–Control bleeding by bronchoscopic balloon tamponade, arteriography and embolization in persistent bleeding, or emergent thoracic surgery if embolization is not available and bleeding persists
-
Treat underlying etiology as necessary
-
Consider IV estrogen for massive hemoptysis
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hemoptysis:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
The patient may need blood, packed red cells, or blood products emergently
-
Diagnosis-specific therapy (e.g., FB removal)
-
Therapy for bronchiectasis is aimed at treatment of underlying endobronchial infection
-
Cauterization of bleeding vessels is more useful in the upper airway
-
Digestive tract: Antacids, reduce portal hypertension, surgically repair source of bleeding
-
It is a life-threatening surgical emergency if a large blood vessel bleeds into the trachea from tracheotomy tube-related erosions
-
Consider gel-foam or metal coil injection into the bronchial circulation for chronic bleeding caused by bronchiectasis
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Hemoptysis:
Emergency interventions
(Handbook of Signs & Symptoms (Third Edition))
If the patient coughs up copious amounts of blood, endotracheal intubation may be required. Suction frequently to remove blood. Lavage may be necessary to loosen tenacious secretions or clots. Massive hemoptysiscan cause airway obstruction and asphyxiation. Insert an I
V. line to allow fluid replacement, drug administration, and blood transfusions, if needed. An emergency bronchoscopy should be performed to identify the bleeding site. Monitor the patient’s blood pressure and pulse to detect hypotension and tachycardia, and draw an arterial blood sample for laboratory analysis to monitor respiratory status.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Lung cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Recent treatment, which consists of combinations of surgery, radiation, and chemo-therapy, may improve the prognosis and prolong survival. Nevertheless, because treatment usually begins at an advanced stage, it's largely palliative.
Surgery is the primary treatment for stage I, stage II, or selected stage III squamous cell cancer; adenocarcinoma; and large cell carcinoma, unless the tumor is nonresectable or other conditions rule out surgery.
Surgery may include partial removal of a lung (wedge resection, segmental resection, lobectomy, or radical lobectomy) or total removal (pneumonectomy or radical pneumonectomy).
Preoperative radiation therapy may reduce tumor bulk to allow for surgical resection. Preradiation chemotherapy helps improve response rates. Radiation therapy is ordinarily recommended for stage I and stage II lesions, if surgery is contraindicated, and for stage III lesions when the disease is confined to the involved hemithorax and the ipsilateral supraclavicular lymph nodes.
Generally, radiation therapy is delayed until one month after surgery, to allow the wound to heal, and is then directed to the part of the chest most likely to develop metastasis. High-dose radiation therapy or radiation implants may also be used.
Research has shown that chemotherapy combinations of paclitaxel, gemcitabine, docetaxel, irinotecan, and vinorelbine are more active and better tolerated when combined with cisplatin or carboplatin. Many of these drugs are also being utilized as single agents for the treatment of small-cell and non–small-cell lung cancers.
In laser therapy, laser energy is directed through a bronchoscope to destroy local tumors.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Malignant spinal neoplasms:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of spinal cord tumors generally includes decompression or radiation. Laminectomy is indicated for primary tumors that produce spinal cord or cauda equina compression; it isn't usually indicated for metastatic tumors. If the tumor is slowly progressive or if it's treated before the cord degenerates from compression, symptoms are likely to disappear, and complete restoration of function is possible. In a patient with metastatic carcinoma or lymphoma who suddenly experiences complete transverse myelitis with spinal shock, functional improvement is unlikely, even with treatment, and his outlook is ominous. If the patient has incomplete paraplegia of rapid onset, emergency surgical decompression may save cord function. Steroid therapy with dexamethasone minimizes cord edema and temporarily relieves symptoms until surgery can be performed. Partial removal of intramedullary gliomas, followed by radiation, may alleviate symptoms for a short time. Metastatic extradural tumors can be controlled with radiation, analgesics and, in the case of hormone-mediated tumors (breast and prostate), appropriate hormone therapy. Transcutaneous electrical nerve stimulation (TENS) may control radicular pain from spinal cord tumors and is a useful alternative to opioid analgesics. In TENS, an electrical charge is applied to the skin to stimulate large-diameter nerve fibers and thereby inhibit transmission of pain impulses through small-diameter nerve fibers. Chemotherapy generally hasn't proven effective against most spinal tumors, but may be recommended in some cases.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hemoptysis:
Emergency interventions
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient coughs up copious amounts of blood, endotracheal intubation may be required. Suction frequently to remove blood. Lavage may be necessary to loosen tenacious secretions or clots. Massive hemoptysis can cause airway obstruction and asphyxiation. Insert an I.V. line to allow fluid replacement, drug administration, and blood transfusions if needed. An emergency bronchoscopy should be performed to identify the bleeding site. Monitor blood pressure and pulse to detect hypotension and tachycardia, and draw an arterial blood sample for laboratory analysis to monitor respiratory status.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Lung cancer:
Treatment
(Handbook of Diseases)
Various combinations of surgery, radiation, and chemotherapy may improve the prognosis and prolong survival. Nevertheless, because treatment usually begins at an advanced stage, it’s largely palliative.
Surgery
Unless the tumor is nonresectable or other conditions rule out surgery, excision is the primary treatment for stage I, stage II, or selected stage III squamous cell carcinoma, adenocarcinoma, and large cell carcinoma. Surgery may include partial removal of a lung (wedge resection, segmental resection, lobectomy, radical lobectomy) or total removal (pneumonectomy, radical pneumonectomy).
Radiation
Preoperative radiation therapy may reduce tumor bulk to allow for surgical resection. Preradiation chemotherapy helps improve response rates. Radiation therapy is ordinarily recommended for stage I and stage II lesions, if surgery is contraindicated, and for stage III lesions when the disease is confined to the involved hemithorax and the ipsilateral supraclavicular lymph nodes.
Generally, radiation therapy is delayed until 1 month after surgery, to allow the wound to heal, and is then directed to the part of the chest most likely to develop metastasis. High-dose radiation therapy or radiation implants may also be used.
Chemotherapy
Another treatment is chemotherapy, including combinations of drugs, which produce a response rate of about 40%, but have a minimal effect on overall survival. Promising combinations for treating small cell carcinomas include cyclophosphamide with doxorubicin and vincristine; cyclophosphamide with doxorubicin, vincristine, and etoposide; and etoposide with cisplatin, cyclophosphamide, and doxorubicin.
Laser therapy
Some patients may undergo laser therapy, which involves direction of laser energy through a bronchoscope to destroy local tumors.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Hemoptysis:
Nursing considerations
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
Comfort and reassure the patient, who may react to this alarming sign with anxiety and apprehension. If necessary, to protect the nonbleeding lung, place him in the lateral decubitus position, with the suspected bleeding lung facing down. Perform this maneuver with caution because hypoxemia may worsen with the healthy lung facing up.
Prepare the patient for diagnostic tests to determine the cause of bleeding. These may include a complete blood count, a sputum culture and smear, chest X-rays, coagulation studies, bronchoscopy, lung biopsy, pulmonary arteriography, and a lung scan.
Patient teaching
Explain that hemoptysis generally ceases (but not abruptly) during treatment of the causative disorder. Many chronic disorders, however, cause recurrent hemoptysis. Instruct the patient to report recurring episodes and to bring a sputum specimen containing blood if he returns for treatment or reevaluation.
» READ BOOK EXCERPT ONLINE »
Source: Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series, 2007
Hemoptysis:
Emergency Actions
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
If the patient coughs up copious amounts of blood, endotracheal intubation may be required. Suction frequently to remove blood. Lavage may be necessary to loosen tenacious secretions or clots. Massive hemoptysis can cause airway obstruction and asphyxiation. Insert an I.V. line to allow fluid replacement, drug administration, and blood transfusions, if needed. An emergency bronchoscopy should be performed to identify the bleeding site. Monitor blood pressure and pulse to detect hypotension and tachycardia, and draw an arterial blood sample for laboratory analysis to monitor respiratory status.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Hemoptysis:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ If necessary, to protect the nonbleeding lung, place the patient in the lateral decubitus position, with the suspected bleeding lung facing down.
▪ Perform this maneuver with caution because hypoxemia may worsen with the healthy lung facing up.
▪ Prepare the patient for diagnostic tests to determine the cause of bleeding, such as a complete blood count, a sputum culture and smear, chest X-rays, coagulation studies, bronchoscopy, lung biopsy, pulmonary arteriography, and a lung scan.
Patient teaching
▪ Give the patient instructions for providing sputum specimens.
▪ Explain the underlying cause of hemoptysis and its treatment.
▪ Explain the importance of reporting recurrent episodes.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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