Flashcards in Lung Cancer Deck (26)
Smoking is responsible for what percentage of primary lung cancers?
90% (heavy smokers are 40 times more likely to get it than a non smoker)
What other risk factors?
Exposure to radon gas, asbestos, industrial/chemical occupation, passive smoking,air pollution I.e. Living in urban areas
Where can a bronchial carcinoma originate from?
Bronchial epithelium or mucus glands
What percentage originate from squamous cells?
35% most common
How likely is it to be an Adenocarcinoma?
30 second most common
Small cell bronchial carcinoma make up what percentage of bronchial carcinoma?
Large cell bronchial carcinoma make up what percentage of bronchial carcinoma?
15% least common form of bronchial carcinoma
Is It better for it to occur in the large or small bronchi?
Large as it causes symptoms earlier and therefore is noticed and treated earlier
Which type of bronchial carcinoma undergo cavitation and look like a look like a lung abscess on a CXR?
Squamous cell carcinoma
What other areas may become involved?
The chest wall, lymphatics, pleura and intercostal nerves (this causes pain)
Where do bronchial carcinoma metastases occur?
Liver, blood, bone, adrenals and skin
Which cancer exhibits the most likelihood to form metastases?
Small cell bronchial carcinoma
Name 4 clinical signs of lung cancer?
Clubbing, anaemia, cachexia (wasting), superclavicular or axillary lymph nodes, HPOA causing wrist pain, bronchus obstruction, pleural effusion
Clinical features of metastasis? Name 5
Bone pain/tenderness, hepatomegaly, jaundice, confusion, fits, seizures, proximal myopathy, hyper calcaemia, pathogical fracture,
Complications include? Name 5
Local: recurrent laryngeal+phrenic nerve palsy, SVC obstruction, rib erosion, pericarditis, horner's syndrome, AF
Metastatic: addisons, anaemia, hypercalcaemia etc the signs are the complications etc
Radiological findings that may present on CXR include?
Unilateral hilar enlargement, peripheral pulmonary opacity, lung or lobe collapse, pleural effusion, rib destruction, broadening of mediastinum
What investigation would you do?
Cytology, CXR, fine needle aspiration and biopsy, CT bronchoscopy, bloods and lung function tests and LFTs
Contraindications to surgical resection include?
Distant metastasis, invasion of mediastinum, malignant pleural effusion, contra lateral mediastinal nodes, FEV
What is the optimal treatment?
What would be an alternative for those who can't have surgery but still have a non metastatic T1/2 tumour?
What is the treatment for more advanced disease?
Radiotherapy and chemotherapy
Small cell cancers are often what on presentation and what problems does this raise?
Often disseminated and cannot be operated on, while they may respond to chemo, they usually relapse
What is done for palliation?
Stunting to open up airway, pleural drainage, analgesia, steroids, antiemetics, laser ablation
Name the common chemotherapy agents used?
IV cyclophosphamide, doxorubicin, vincristine, cisplatin
Very poor only 5% can be cured, 70% die in the first year and only 6-8% survive 5 years post diagnosis