Case Study of Non-Small Cell Lung Cancer: Adenocarcinoma in a Non-Smoking Patient

OBJECTIVES: The aim of this case study reviews the disease proces of Non-Small confined apartment Lung Cancer (NSCLC), specifically a case with adenocarcinoma in a 46 year-old woman non-smoker. It has been nearly sum of two units years since the diagnosis and has now disentangleed advanced disease. METHODS: Case inquiry methods were utilized to provide the historical progression of the disease proces and to exemplify the rapid move of adenocarcinoma in the lung RESULTS: Adenocarcinoma in NSCLC replicates rapidly and bring outs advanced disease in a short period of time. CONCLUSIONS: Despite attempts to intervene with chemotherapy, radiation, monoclonal antibodies and anti-angiogenic interventions, and epidermal growing factors, this disease remains difficult to treat with a poor prognosis at the start Palliative measures must be engrossed to increase quality of life.

KEY WORDS: Non Small small room Lung Cancer; Adenocarcinoma; Metastasis, Non-Smoking Patients

Lung cancer continues to remain individual of the leading causes of death from cancer in the United States and Canada (Houlihan, 2005; Lobchuk Degner Chateau, & Hewitt, 2006) According to Williams-Brown & Singh (2005) cancer in general continues to challenge the health of the American public with an estimated 13 million novel cases in 2004 with above five hundred thousand cases of death from cancer alone. According to Jemal, et al (2004) above 174,00 new cases of lung cancer will be diagnosed in 2004 with 160000 dying from the disease where 80% of the cases are non-small confined apartment lung cancer.

This is an alarming number of deaths with a true poor prognosis for the patients involved, as nearly seventy percent of lung cancer patients continue upon to advanced disease (Houlihan, 2005) This cancer emblem appears to occur at a higher incidence rate in African Americans (Jemal, et al, 2004) The cases of female lung cancer continue to be augmented faster than any other emblem of cancer with a larger incidence of death. above 85% of women diagnosed with lung cancer die each year and the incidence of lung cancer in women has exponentially grown each decade. The main cause of death is smoking or second-hand sooty vapor (NCCN, 2005). This has occurr in one as well as the other developed and developing countries, and varies according to age, race, ethnicity, socio-economic status, and geographical location (Williams-Brown & Singh, 2005)

PRESENTING SYMPTOMS

This patient is a 46-year-old Caucasian female presenting with flu like symptoms to the Family Practice Physician in March 2004 Patient stated that she felt fatigued from her replete time job as a billing and audit secretary for a construction company and newly had a cough that was persistent. She lives with her husband, a traveling salesman and has sum of two units teenage children. The patient's mother and brother (only other sibling) are deceased from a fatal gunshot hurt by an estranged boyfriend and the father (divorced couple) is positive for leukemia and heart disease. The patient's husband continues to use tobacco and has history of ETOH abuse with rehabilitation failed times individual Their home was tested for radon horizontals several times over the course of several years without a positive finding, as it is geographically located in a high-risk area. The patient had no history of exposing to asbestos or work experience near similar carcinogens.

Further testing surrounding the initial physician visit revealed a urinary tract infection, which was treated with Cipro orally and a chest film to be complet upon an outpatient basis. The history and physical are positive for a Bell's palsy (following infection with the Beijing flu) in 1987 while pregnant with her next to the first child. This diagnosis was confirmed by means of the consultation of a neurologist's exam in 1988 In addition, the patient experienced an ectopic pregnancy with fracture and subsequent total hysterectomy and bladder suspension performed in 1989 In 1994 the patient lay opened a benign tumor within the left ear and an acoustic neuroma was remov prosperously without re-occurrence. This required intricate surgery to carry the neuroma, which had grown across several of the cranial powers on the left cheek and organ of vision This may have been secondary to the initial Bell's palsy or possibly preced it. That remains unclear.

DIAGNOSIS

Once the film of the chest was complet a nodule in the right middle lobe of the lung was identified. The patient was informed and biopsy of the site was scheduled with a comput tomography scan (CT scan), which revealed a 2 cm nodular mass in the center of the right middle lobe of the right lung Within individual week, the biopsy revealed the diagnosis of non-small confined apartment lung cancer in the right lung and surgery was scheduled a month later to displace the nodular mass and the entire right middle lobe of the right lung The patient was assured that this was routine and no ne to drive surgery. With her particular insurance provider there was no other choice. on scheduled surgery in late July 2004 the patient was told post-operatively that the cancer in the right lung was worse than they reflection and she was diagnosed with Stage II-B adenocarcinoma. In May 2005 additional nodules appeared in the mediastinal area and a biopsy and mediastinoscopy revealed mucin- producing adenocarcinoma with signet ring features in the right upper lobe and right paratracheal lymph node. Re-staging of the cancer was complet at a stage III-B (T2 N2 MO) upon May 4,2006, the patient was seen for a bronchoscopy to displace small nodes evident on Positron Emission Tomography (PET) As the patient was intubated beneath anesthesia, an obstruction was discovered revealing a 2 x 2 cm mass undetect by dint of the PET scan. Resection of the mass was complet and post-operatively the patient experienced more [i]or[/i] less gastrointestinal symptoms and abdominal pain in the right upper quadrant (RUQ) The patient was seen in the pressing necessity department and symptoms subsided. A repeat fondling scan was completed on May 19 2006 which revealed liver and right pleural space metastasis.