Bronchial carcinoma

Question 1

Background on bronchial carcinoma

Answer 1

Most common lethal cancer in AUstralia
Usually occuring in smokers
Poor prognosis

Question 2

Clinical features

Answer 2

Mostly present at 50-70yo
Only 10-25% are asymptomatic at diagnosis
If symptomatic, the cancer is usually advanced and not resectable

Question 3

Key sx of bronchial carcinoma

Answer 3

Cough
Chest pain
Wheeze
Haemoptysis
SOB

Constitutional:
Anorexia, malaise, fatigue, unexplained weight loss, night sweats

Question 4

Investigations for bronchial carcinoma

Answer 4

CXR
CT Scanning
Bronchoscopy
PET scanning
Fluorescence bronchoscopy (helps early detection)
Tissue diagnosis where possible

Question 5

What are the more common causes of a solitary pulmonary nodule on CXR?

Answer 5

Bronchial carcinoma
Solitary metastasis
Granuloma (TB)
Hamartoma

Question 6

Management of bronchial carcinoma

Answer 6

Refer to respiratory physician to determine type of cancer

Main aim of management - achieve curative resection of NSCLC (non small cell lung cancer) in those who can benefit from it

Resection not an option in SCLC because it metastasises so rapidly –> 80% will have by time of diagnosis

Chemotherapy has important place in treating NSCLC, but only extends life expectancy by 3-20 months in SCLC

Main role of radiotherapy is palliative