Understanding the Pathophysiology of Lung Cancer

NURSING ASSIGNMENT 1
Nursing Assignment
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NURSING ASSIGNMENT 2
Q. 1
Pathophysiology is the study of the operational changes which accompany a particular
disorder. The pathophysiology of lung cancer is complicated and still not entirely clear;
nonetheless, the comprehension of lung cancer pathophysiology has advanced over time. As with
other epithelial tumours, lung cancers are believed to develop from precursor lesions or
preneoplastic in the respiratory mucosa (Scarlata et al. 2017, p.2619).
In the lungs, the tumor cells move into the close tissue via the walls of the close lymph
vessels along with the blood vessels and reach the liver tissue (Popper 2016, p.77). The tumor
cells develop at a distant site creating minor tumours known as micrometastases that stimulates
the production of new blood vessels that supply oxygen along with the nutrients required for the
development of tumours. This results in the growth of cancer cells in the liver, which is known
as liver metastases.
Since the lungs are not getting enough oxygen as the tumour cells use the oxygen
available for their growth, the trouble in moving air in and out of the lungs causes shortness of
breath or dyspnea. The shortness of breath due to lung cancer is as a result of lung tumours
which block the airways in the lungs. Furthermore, it is as a consequence of blood clots and
tumor cells blocking blood vessel in the lungs along with tumor that spreads and obstructs a
nerve leading to paralysis of all or part of the diaphragm hindering the role of the diaphragm of
creating a vacuum effect which pulls air into the lungs causing dyspnea (Grapatsas et al. 2017,
p.15).
Q. 2
Secondary liver cancer is a tumour which began in another part of the body like the lungs
as with Nigel but has now metastasized to the liver, which means it is advanced cancer. This
means that advanced cancer will influence the pharmacokinetics of chemotherapy drugs taken
(Bocci and Kerbel 2016, p. 659). Pharmacokinetics is described as the movement of medications
into, through and out of the body. Since the existence of tumours influences many parameters in
the body, the chemotherapy pharmacokinetics cannot be inferred from healthy persons to persons
affected by cancer. Therefore, when drugs are administered, the tumour cells develop resistance
in medications through changes in the transportation of medicines leading to declined
intracellular accumulation of drugs.

NURSING ASSIGNMENT 3
The advanced liver cancer can alter the absorption together with the distribution of anti-
cancer drugs in the body resulting in bizarre bioavailability (Pathania et al. 2018, p.55).
Moreover, when the binding of plasma protein is declined, the penetration along with medication
distribution into body tissues is affected. Also, due to secondary cancer in the liver, the bile acids
in the intestines are reduced, decreasing the absorption rate of the anti-tumour drugs. In case of
increases of bilirubin and bile acids in concentrations of plasma, the binding of the protein of
drugs is impacted, which influences the distribution along with metabolism of those drugs
(Wahlström et. 2016, p.41).
The clearance of most chemotherapy medications is profoundly affected by the
metabolism of the drugs, and therefore, it is possible to impact a person’s negative and positive
reactions at a prescribed dose. Reduction in the blood flow and the diversion of blood via
collateral varices reduces the clearance of high clearance drugs. There is capillarization of the
sinusoid in advanced liver cancer which lines the hepatic microcirculation mislays their fenestrae
and generates a basement membrane (Yokomori, Ando and Oda 2019, p.114). The
capillarization creates a barrier to diffusion of oxygen that leads to a critical decrease in hepatic
adenosine triphosphate together with oxidative metabolism.
In drug metabolism, serum albumin might decrease hence changing the disposition of
drugs which are substantially bound to albumin (Yousefpour et al. 2018, p.7784). Cationic anti-
cancer drugs may be preferably linked to alpha1-acid glycoprotein, which is frequently escalated
in individuals with cancer rather than it is to albumin. The considerable replacement of liver
tissue might result in a decrease in metabolic capacity. Furthermore, when the bile flow is
disrupted by the obstruction of extrahepatic biliary or through tumour invasion of intrahepatic
bile ductules, it minimizes the elimination of drugs which are principally excreted into the bile.
Q. 3
The effectiveness of chemotherapy is based on the cancer type along with the phase. The
complete efficiency ranges from being therapeutic for few cancers like leukemia’s to being
ineffectual to some like brain tumour, to being needless in others such as most non-melanoma
skin cancers. The potentiality of anti-cancer medications to destroy cancer cells is based on its
capability to interrupt cell division (Farkona, Diamandis and Blasutig 2016, P. 73). If the cells
are not able to divide, they die, and the quicker the cells are splitting, the more probable it is that
medications will destroy the cells causing the malignancy to shrink. The leading cause of deaths