Lung Cancer

 

 

Considerations

 

  • Potentially compromised respiratory function with risk of perioperative respiratory complications

  • 4M’s:

    • ass effects: obstructive pneumonia, lung abscess, SVC syndrome, tracheobronchial distortion, Pancoast’s syndrome, recurrent laryngeal nerve or phrenic nerve paresis, chest wall or mediastinal extension

    • etabolic effects: Lambert–Eaton syndrome, hypercalcemia, hyponatremia, Cushing’s syndrome

    • etastases: particularly to brain, bone, liver, & adrenal 

    • edications: chemotherapy agents, pulmonary toxicity (bleomycin, mitomycin), cardiac toxicity (doxorubicin), renal toxicity (cisplatin)

  • Need for lung resection, mediastinoscopy/bronchoscopy, non-thoracic surgery

  • Comorbidities including smoking, chronic obstructive lung disease, coronary artery disease, hypertension

  • Management of cancer pain with multimodal approach

  • Goals of care & DNR status

 

 

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