What is the most common cancer in males?
What is the lung cancer mortality rate for males?
Around 100 per 100,000
What is happening to the incidence of lung cancer in males?
It is slowly falling
Why is the incidence rate of lung cancer in males falling?
Due to reduction in smoking
What causes more deaths in women, lung or breast cancer?
What is the lung cancer mortality rate in females?
Around 40 per 100,000
What is happening to the incidence of lung cancer in females?
It is steadily rising
How much does lung cancer incidence vary between socio-economic groups?
Wide variation- rate three times higher in lowest compared with highest
What is lung cancer overwhelmingly related to?
What is the risk of lung cancer proportional to?
- The duration of the habit
- The number of cigarettes smoked
What % of lung cancers are caused by smoking?
- 90% in men
- 80% in women
Apart from smoking, what are the aetiological factors for lung cancer?
- Asbestos exposure
- Radon exposure
- Genetic factors
- Dietary factors
What is the problem with the signs and symptoms of lung cancer?
They are relatively non-specific, and overlap with those of many respiratory diseases
When do many lung cancer patients first come to medical attention?
When they have advanced disease
What are the signs and symptoms of a primary lung tumour?
- Chest pain
- Post-obstructive pneumonia
- Weight loss
- Lethargy / malaise
What are the signs and symptoms of regional metastases of lung cancer?
- Superior vena cava obstruction
What courses hoarseness in regional metastases of lung cancer?
Left recurrent laryngeal nerve palsy
What causes dyspnoea in regional metastases of lung cancer?
Phrenic nerve palsy
What are the signs and symptoms of distant metastases of lung cancer?
- Bone pain / fractures
- CNS symptoms
What are the CNS symptoms of distant metastases of lung cancer?
- Double vision
What is paraneoplastic syndrome?
The presence of symptoms or disease due to the presence of cancer in the body, but not due to the local presence of cancer cells
What are paraneoplastic syndromes mediated by?
Humoral factors secreted by tumour cells, or the immune response against tumour cells
What humoral factors can cause paraneoplastic syndrome?
What are the types of paraneoplastic syndrome?
Give two examples of endocrine paraneoplastic syndromes
- Cushing's syndrome
Give two examples of neurological paraneoplastic syndromes
- Peripheral neuropathy
Give an example of a skeletal paraneoplastic syndrome
Give 3 examples of haematological paraneoplastic syndromes
- Disseminated intravascular coagulation (DIC)
Give 3 examples of other paraneoplastic syndromes
- Nephrotic syndrome
What is the importance of imaging investigations of various types in lung cancer?
They are central to both diagnosis and assessment of the disease