Flashcards in Lung Cancer Deck (14):
What is the lifetime risk of lung cancer in men?
1 in 11
Lung cancer shows a male preponderance
What are the risk factors of lung cancer?
Age- especially over 40
Occupation- asbestos, mining, ship building, petroleum refining
What are the most common histlogical types of lung cancer?
Small cell- 18%- assoc. w/ ADH/ACTH
Non small cell - 82%
Non small cell includes:
Squamous cell- 32%
Large cell - 10%
NSCLC not otherwise specified
What presentations are associated with squamous, bronchioalveolar and small cell lung cancers?
Clubbing- squamous cell
Sputum production - bronchioalveolar
Neuroendocrine - small cell
investigations for lung cancer?
CXR- 90% visible
Sputum cytology- 80%
Bronchoscopy - allows biopsy and washings
Transthoracic biopsy for peripheral tumours under radiological guidance
Mediastinoscopy for biopsy of abnormal lymph nodes
Which tumour markers may be positive in lung cancer?
Neuron specific enolase, LDH
Where does lung cancer typically metastasise to?
What paraneoplastic syndromes can occur in lung cancer?
SIADH- dehydration, low plasma sodium
Ectopic adrenocorticotrophic syndrome- cushings
Non metastatic hypercalcaemia
Atrial natriuretic peptide- dehydration
Eaton lambert myasthenia
Paraneoplastic cerebellar degeneration
What is the TNM staging for lung cancer?
T1- less than 3cm
T2- 3 to7 cm, invading bronchus
T3- greater than 7cm, invades local structures
T4- organ invasion
N1- ipsilateral bronchopulmonary and hilar nodes
N2-ipsilateral mediastinal/subcarinal nodes
N3- contra lateral/supraclavicular nodes
How does the TNM staging correspond to the stages of lung cancer?
Stage 3- N3
Stage 4- M1
How is small cell lung cancer managed?
Mostly systemic at presentation
-90% respond, 50% completely
- relapse common within 12 months
-adjunct to treat primary tumour
- prophylactic cranial irradiation
What is the prognosis of small cell lung cancer?
With treatment, 11 months median survival
What is the management of non small cell lung cancer?
for stage 1/2 - good prognosis
Lobectomy preferred with chemo
Part of concurrent chemo-rad
Palliative for brain mets, SVCO
30% short lived response rate
First line if eGFR mutation