lung cancer

Question 1

Non-small cell lung cancer:

treatment for stage I and II

Answer 1

(tumor > 2 cm from carina, node negative for stage 1 and node positive for stage 2)
TX = surgery + chemotherapy

Question 2

Non-small cell lung cancer:

treatment for Stage IIIa

Answer 2

(tumor < 2 cm from carina, or invading resectable structure or IPSILATERAL hilar or mediastinal LN +
TX = surgery + chemotherapy + RADIOTHERAPY

Question 3

Non-small cell lung cancer:

treatment for stage IIIB

Answer 3

(tumor invading unresectable structure CONTRALATERAL mediastinal LN+)
chemotherapy –> followed by radiotherapy

Question 4

Non-small cell lung cancer:

treatment for stage IV

Answer 4

(supraclavicular LN + or pleural effusion with malignant cells +)
EGFR mutations: erlotinib/gefitinib
ALK translocation or ROS1 mutation: crizotinib
PDL1 inhibitor: pembrolizumab, nivolumab (BOTH increase autoimmune disorders)

Question 5

Typical imaging findings in patients with small cell lung cancer (SCLC):

Answer 5

• a large mediastinal mass
• hyponatremia due to ectopic production of antidiuretic hormone is most often due to SCLC and is rarely seen with other lung tumors

Question 6

Lung cancer screening recs

Answer 6

low dose CT in 55 to 74-80 YO; > 30-pack-year history of tobacco use within the previous 15 years, and without signs or symptoms suggestive of lung cancer