Kuliah kanker paru bronchogenic carcinoma

(1)

• _{A focus of metastatic}

(2)

• _{The dense white encircling tumor mass is}

arising from the visceral pleura and is a mesothelioma. These are big bulky tumors that can fill the chest cavity.The risk factor for mesothelioma is asbestos exposure. However, mesothelioma is rare even in persons with asbestos exposure.

(3)

• _{Mesotheliomas have}

either spindle cells or

plump rounded cells

forming gland-like

configurations, as seen

here at high power

microscopically. They

are very difficult to

(4)

TNM staging

T: Tumor (size, extension

to surrounding organsim)

N: lymph node (hilar,

mediastinal, supraclavicular)

M: distant metastasis

(multiple organ,

(5)

(6)

(7)

Treatment modalities for lung cancer

• _{Scalpel: surgery}

• _{Beam: radiotherapy}

• _{Drugs: chemotherapy,}

new targeted therapy

(8)

General approach NSCLC

(9)

(10)

0.00

(11)

Survival of lung cancer after surgery

(12)

New targeted therapy

for lung cancer

(13)

The role clinical laboratory examination

• _{As support to treatment: hematology,}

organ function (especially liver, blood,

kidney)

• _{Tumor markers: CEA, SCC, Cyfra 21.1,}

NSE may indicate treatment failure,

recurrent or metastasis

(14)



Mangunnegoro:

43%

of lung cancer patients were

previously diagnosed as pulmonary

Tb



Taufik:

38% of lung cancer patients have

been treated as pulmonary

Tb when

the diagnosis of lung cancer was

established.

(15)

(16)

What We Need to Be Aware of

Not responding to an

adequate treatment

within 1-2 weeks

A male smoker patient in

cancer age,

diagnosed as

pneumonia or smear

negat-ive pulmonary TB,

(17)

What We Need to Be Aware of

•

The esponse to treatment in a smer negative Tb ptnt must be assessed

clinically

in the 1st 2 weeks

Anamnesis

is very important to detect improvement *is the patient feeling better? * is

fever subsiding* *is appetite reappearing? Is cough decreasing?

Adequate verbal contact is mandatory, just drug prescribingdrugs is not enough

(18)

What We Need to Be Aware of frequently neglected symptoms & signs

Beware!

persistent pain

in the shoulder and/or arm

plus a lesion

(19)

23/5/2008

After chemothrp I & radiotherapy 10x

110608

After chemothrp II & radiotherapy 20x Male, 44 yrs

Persistent pain

on rgt shoulder, treated as

tb

for >2 months,

(20)

(21)

What We Need to Be Aware of frequently neglected symptoms & signs

Beware!

persisten pain in the shoulder

and/arm plus a lesion on the apex

of the lung

Look for signs:

paresthesia, paresis

myosis, ptosis,

enophtalmos

(brachial plexsus syndrome.

Pancoast syndrome)

(22)

(23)

What We Need to Be Aware of

frequently neglected symptoms &

signs

• _Severe

headache or signs of stroke

may indicate

cerebral metastasis from lung cancer

• Chest x-ray film must be made

before brain surgery.

• Lung cancer is often found after extirpat-ion of brain lesion

(24)

Prevention: risk factors for lung cancer

(25)