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Small cell lung cancer: pathophysiologic mechanisms and nursing implications
1Kaiser Permanente Infusion Center, San Francisco, CA.
Purpose/Objectives:
To review current incidence and treatment perspectives for small cell lung cancer (SCLC).
Data Sources:
Published articles, book chapters, American Cancer Society materials.
Data Synthesis:
SCLC constitutes 20%-30% of lung cancer cases and accounts for 40,000 deaths annually. Characterized by rapid cell division, SCLC is very sensitive to radiation and chemotherapy; however, long-term survival rates are very low. A number of paraneoplastic syndromes are associated with this disease, thereby increasing the medical and nursing management challenges.
Conclusions:
Because SCLC usually is diagnosed late in the disease process and survival rates are poor, quality of life and palliation of metastatic symptoms (e.g., pain, breathing difficulties) are important focuses of care. Smoking deterrence and cessation programs, as well as early detection of lesions, are key to reducing incidence and mortality.
Implications For Nursing Practice:
Nursing care focuses on promoting comfort and preventing and managing disease and treatment complications. Nursing diagnoses include ineffective airway clearance, impaired gas exchange, pain, altered nutrition, activity intolerance, and ineffective coping. A patient care standard is presented.