A patient has symptoms of persistent cough, wheezing, weight loss, shortness of breath, hemoptysis, and lymphadenopathy of the neck. On examination of the patient, the nurse observes a large nodule on the thyroid and firm non-movable infraclavicular lymph nodes. Which one of the following best explains this patients current situation?

Lung cancer Tx, N1, M1


•This patient presents with several symptoms of lung cancer (coughing, wheezing, dyspnea, hemoptysis, and weight loss) and shows clinical evidence of lymph node involvement and metastasis to the thyroid. The size of the tumor is unknown based on clinical presentation.

Cancer Staging
T: Size
•Tx - Tumor cannot be evaluated
•Tis - Carcinoma in situ
•T0 - No signs of tumor
•T1,T2,T3,T4 - size and/or extension of primary tumor

N: Degree of regional lymph node involvement
•Nx - Lymph nodes cannot be evaluated
•N0 - Tumor cells absent from regional lymph nodes
•N1 - Regional lymph mets present
•N2 - Tumor spread to an extent, between N1 & N3
•N3 - Tumor spread to more distant or numerous regional lymph nodes

M: Presence of metastasis
•Mx - Distant metastasis cannot be evaluated
•M0 - No distant metastasis
•M1 - Metastasis to distant organs (beyond regional lymph nodes)

G1-G4: The grade of the cancer cells. Low grade are well differentiated, high grade are poorly differentiated.

Visit our website for other NCLEX topics now!