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
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
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?