Bronchogenic Lung Cancer: A Case Study
Neoplasia Case Study
You have met a 67 y.o. female patient who presents with c/o dyspnea and a chronic cough for weeks. She is a smoker since she was a teenager. This is a fo9llow-up visit after testing has been completed. Testing completed included:
Pulmonary Function Testing which show a definite blockage in her airflow;
A Chest X-Ray which shows a lesion
Bronchoscopy washings which showed malignant cells.
Histology is a squamous cell carcinoma
Her diagnosis is bronchogenic lung cancer.
1. Why did this patient have a blockage in her airflow?
2. Did her lung cancer metastasize from cancer in another location in her body, or did it arise in her lungs?
3. Why did she develop dyspnea?
4. The lining of the bronchi are normally pseudostratified columnar epithelium, not squamous cell. Why did this patients cancer develop from squamous cells?
This patient is scheduled for surgery, followed by radiation therapy and chemotherapy. Surgery will remove the bulk of the tumor, and the radiotherapy is expected to shrink the remaining tumor cells. The chemotherapy is aimed at mnetastatic liver tumors that were discovered. The patient has stopped smoking.
5. Why did the APN order a liver scan when it was discovered that the patient had bronchogenic carcinoma?
6. Why did the cancer metastasize before she had enough signs and symptoms to see out her physician?
7. Have survival rates for patients with this type of cancer improved or not in recent years with treatment? If so what are the latest survival rates published?
8. What educational information should be shared with this patient?
Title: Bronchogenic Lung Cancer: A Case Study
Introduction: In this case study, a 67-year-old female patient presents with dyspnea and chronic cough. After undergoing various tests, including pulmonary function testing, chest x-ray, and bronchoscopy washings, she is diagnosed with bronchogenic lung cancer. The histology reveals squamous cell carcinoma. This essay aims to address several key questions related to the patient’s condition and treatment plan.
Why did this patient have a blockage in her airflow?
The blockage in airflow is a result of the tumor growth in the patient’s bronchi. As a squamous cell carcinoma develops, it can obstruct the airway passage, leading to symptoms such as dyspnea and chronic cough.
Did her lung cancer metastasize from cancer in another location in her body, or did it arise in her lungs?
The patient’s lung cancer originated in her lungs rather than metastasizing from another location. The presence of malignant cells in the bronchoscopy washings confirms that the cancer cells originated within the bronchi.
Why did she develop dyspnea?
Dyspnea, or shortness of breath, is a common symptom of bronchogenic lung cancer. The tumor growth within the bronchi causes airway obstruction, reducing the flow of air into and out of the lungs. This restricted airflow leads to difficulty breathing and dyspnea.
Why did this patient’s cancer develop from squamous cells, while the lining of the bronchi is normally pseudostratified columnar epithelium?
The development of squamous cell carcinoma in the patient’s bronchi is due to a process called metaplasia. Chronic exposure to tobacco smoke, as in this patient’s case, can lead to cellular changes known as metaplasia. Pseudostratified columnar epithelial cells can transform into squamous cells as an adaptive response to chronic irritation and inflammation caused by smoking.
Why did the APN order a liver scan when it was discovered that the patient had bronchogenic carcinoma?
The APN ordered a liver scan to assess whether the cancer has metastasized beyond the lungs. Lung cancers, including bronchogenic carcinoma, have a propensity to spread to distant sites, and the liver is a common site for metastasis.
Why did the cancer metastasize before she had enough signs and symptoms to seek out her physician?
Cancer metastasis refers to the spread of cancer cells from the primary site to other parts of the body. Metastasis can occur even before noticeable signs and symptoms develop. In this case, the patient’s chronic cough and dyspnea were likely attributed to the primary tumor in the lungs. However, cancer cells may have already disseminated to the liver, leading to metastatic lesions without causing notable symptoms.
Have survival rates for patients with this type of cancer improved or not in recent years with treatment? If so, what are the latest survival rates published?
Survival rates for patients with bronchogenic lung cancer have shown modest improvements over recent years due to advancements in treatment options. However, it is essential to consult current research and medical literature for up-to-date survival rates specific to squamous cell carcinoma.
What educational information should be shared with this patient?
The patient should receive comprehensive education regarding her diagnosis, treatment plan, and lifestyle modifications. Key points to address include:
Explanation of the diagnosis, stage, and prognosis of bronchogenic lung cancer.
Detailed information about surgery, radiation therapy, and chemotherapy procedures.
Side effects and potential complications associated with each treatment modality.
Importance of smoking cessation and support resources available.
Nutritional guidance to maintain strength during treatment.
Emotional support resources for coping with the diagnosis and treatment journey.
Conclusion: This case study highlights various aspects of bronchogenic lung cancer, including airflow blockage, metastasis, dyspnea, histological changes, treatment modalities, and patient education. Understanding these elements is crucial for healthcare professionals involved in managing and supporting patients diagnosed with this condition. By addressing these questions, healthcare providers can better inform patients and improve their overall care and outcomes.