1. Pulmonary Medicine Department Ain Shams University http://telemed.shams.edu.eg/moodle5

2. Investigation : Cytology (sputum, pleural effusion) CXR Percutaneous fine needle aspiration Bronchoscope CAT Radionuclide bone scan PFT

3. CXR :

4. CAT

7. Fiber-optic Bronchoscope (Olympus ) is used to view the air ways and check for any abnormalities

8. Large tumor mass obstructing the main right bronchus

9. Chest multi-functional Spirometer HI-801

10. Treatment NSCLC NSCLC Excision Curative radiotherapy

11. Treatmen t SCLC SCLC Chemotherapy

12. Treatment Palliation radiotherapy: Palliation radiotherapy: Bronchial obstruction SVC (stent &radiotherapy&dexamethasone) Haemoptysis

13. Treatment End bronchial therapy; End bronchial therapy; Tracheal stenting Cryotherapy Laser Brachytherapy Pleural drainage/ pleurodesis

14. Treatment Drug therapy: Drug therapy: Analgesia Corticosteroids Antiemetic Cough suppressants Bronchodilators Antidepressants

15. Prognosis: NSCLC (50% two years survival without spread) NSCLC (10% two years survival with spread) SCLC (median survival is 3 months without treatment) SCLC (median survival is 1-1.5 years with treatment)

16. Prevention : Actively discourage smoking Occupational exposure to carcinogens

17. TNM staging for lung cancer: Primary tumour(T) Primary tumour(T) TX malignant cells in bronchial secretions Tis Carcinoma in situ TO none evident T1 ≤ 3 cmand > 2 cm distal to carina

18. TNM staging for lung cancer: T2> 3cm and > 2 cm distal to carina T3 involves the chest wall, diaphragm, medistinal pleurae, pericardiam, or <2 cm from, but not at, carina T4 involves the mediastinum and heart, greate vessels, trachea,oesohgaus,vertebral body, carina, or amalignant effusion is present

19. TNM staging for lung cancer: Regional nodes (N) Regional nodes (N) NO none involved (after mediastinoscopy) N1 peribronchial and/or ipsilateral hilum N2 ipsilateral medistinum or subcarinal N3 contralateral medistinum or hilum, scalene, or supraclavicular

20. TNM staging for lung cancer: Distant metastasis: Distant metastasis: MO none M1 distant metastases present

21. TNM staging for lung cancer:MetastasesLNTumorStage MONOTxOccult MONOTis, T1, T2Stage I MONIT1, T2Stage II MONOT3 MON1T3Stage III a MON2T1-T3 MON3T1-4Stage III b MONO-N2T4 M1NO-3T1-4Stage IV

22. Thank you Dr. Aya Abdel Dayem