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Flashcards in Lung cancer Deck (22)
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1
Q

What are the two main types lung cancer and which is the most common? What are its subtypes and which is the most common?

A
1. Non-small cell (80%)
Subtypes:
i. Squamous (35%)
ii. Adenocarcinoma
iii. Large cell 
iv. Alveolar cell 
v. bronchial adenoma
2. Small cell (20%)
2
Q

What type of cancer commonly spreads locally?

A

squamous non small cell

3
Q

What type of cancer is most associated with asbestos?

A

adenocarcinoma (non small cell)

4
Q

What types of cancer metastasise early?

A

Small cell and large cell

5
Q

What type of cancer is unrelated to smoking?

A

alveolar

6
Q

what cancer secretes polypeptide hormones?

A

small cell

7
Q

What are the main causes of lung cancer?

A

smoking

asbestos

8
Q

What are the clinical features associated with local cancer w/in the bronchi?

A

cough
chest pain
haemoptysis
SOB

9
Q

What clinical features are associated w cancer spread w/in the chest?(include specific areas)

A
  • pain, bone fractures
  • pain in shoulder and arm if affecting brachial plexus
  • Horners syndrome
  • L recurrent laryngeal nerve - hoarseness and bovine cough
  • Pressure on oesophagus, heart, SVC
10
Q

Where does lung cancer commonly metastasise to?

A

Brain
Bone
Liver
Adrenals

11
Q

What are non-specific signs and sx of lung cancer?

A

finger clubbing
malaise, lethargy
weight loss

12
Q

What are Chest signs of lung cancer?

A

lymphadenopathy
pleural effusion
lobar collapse
unresolved pneumonia

13
Q

What tests would you do to confirm a diagnosis of lung cancer?

A
  1. CXR
  2. CT
  3. Cytology - sputum + pleural fluid
  4. Fine needle aspiration or biopsy (peripheral lesions/LNs)
  5. Bronchoscopy aided by endobronchial US - histology + assess operability
14
Q

What are the main sx which would make you suspicious of lung cancer?

A
Cough 
Haemoptysis 
Dyspnoea
Chest pain 
Recurrent/slowly resolving pneumonia
Lethargy 
Anorexia/WL
15
Q

What may you see on CXR in a patient w lung cancer?

A
peripheral nodule 
hilar enlargement 
consolidation
lung collapse
pleural effusion
bony secondaries
16
Q

What tests may help with staging lung cancer?how doe it work?

A

PET scan - 18 flurodeoxygenase preferentially taken up by neoplastic tissue

17
Q

What test can be done to help assess suitability for lobectomy?

A

Lung function tests

18
Q

What is the treatment of non small cell carcinoma?

A

Surgery - lobectomy
Radical radiotherapy for stages I, II, III
Chemotherapy +/- radiotherapy for more advanced disease

19
Q

What is the treatment of small cell carcinoma?

A

If v early stage - surgery
Most have combination of chemo +/- radio if fit enough
If extensive - palliative care

20
Q

What does palliation of small cell carcinoma involve, what are the indications for each aspect of treatment?

A

Radiotherapy - bronchial obstruction, SVCO, haemoptysis, bone pain and cerebral metastases
Endobrachial therapy - tracheal stenting, cryotherapy, last, brachytherapy
Pleural drainage - for symptomatic pleural effusions

21
Q

What drugs are used in palliative therapy of SCC

A
Analgesia
steroids
anti-emetics
cough linctus
bronchodilators
anti-depressants
22
Q

What is SCC usually associated w?

A

Ectopic ADH, ACTH secretion
ADH -> hyponatraemia
ACTH -> Cushings