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Flashcards in Lung Cancer Deck (23):
1

Where in the lung do tumours most commonly arise from?

From the epithelium of large & medium-sized bronchi (rarely from lung parenchyma

2

What is the most common kind of lung cancer?

Adenocarcinoma (NSCLC)

3

What is the NSCLC SCLC split?

85% non-small cell lung cancer (adenocarcinoma, SSC, large cell)
15% Small cell

4

ADENOCARCINOMA
1. Where are tumours located?
2. Who is it common in?
3. What mutations may be present?

1. Tumours often peripheral
2. More frequent in women, non-smokers & asbestos exposure
3. EGFR, ALK, Rhos

5

SQUAMOUS CELL CARCINOMA
1. Where are tumours usually located?
2. Who does it most commonly affect?
3. Why may it lead to hypercalcaemia?

1. Close to the bronchi (may present with bronchial obstruction)
2. SMOKERS
3. Can secrete PTH related peptide, causing hypercalcaemia

6

LARGE CELL CARCINOMA
1. How common?
2. Where are tumours located?
3. Why bad?

1. 8% of NSCLC
2. Peripheral tumours
3. Metastasize early

7

SMALL CELL LUNG CANCER
1. Why bad?
2. How chemosensitive?

1. Highly aggressive & rapidly-growing. Usually mets prior to diagnosis
2. Can be v chemosensitive, but high chance of relapse

8

What prophylactic treatment may be considered in people with SCLC?
What is a risk of this?

Prophylactic radiotherapy to the brain
Risk: significant memory impairment

9

What may be associated with SCLC?

Paraneoplastic syndromes: SIADH, Cushing's, Lambert-Eaton

10

What types of lung cancer are most commonly associated with the following presentations?
1. Miosis, anhidrosis, partial ptosis
2. Recurrent laryngeal nerve palsy & SVC obstruction

1. Pancoast tumour (apical), horner's syndrome
2. Mediastinal disease

11

What is SIADH?
What is it characterised by?

syndrome of inappropriate antidiuretic hormone
hypotonic hyponatraemia, concentrated urine, and a euvolaemic state

12

What cancer is most commonly associated with SIADH?

Small cell lung cancer

13

What is EBUS and why is it used?

Endobroncial Ultrasound
Biopsy of lymph nodes in the mediastinum

14

What treatment can reduce haemoptysis?

Radiotherapy

15

Surgery for NSCLC

80% 5 year survival in stage 1 or 2 diseae, but only 30% are suitable for surgery
Mediastinal involvement: CI for surgery

16

What is the most common treatment for people with stage 2 or 3 NSCLC?

Concurrent chemo-radiotherapy

17

SABR can be used to treat which type of tumours?

Peripheral tumours

18

What is the mainstay of treatment for patient with mets/ locally advanced disease?

Chemotherapy

19

When could Pembrolizumab be used for patients with advanced NSCLC?

If there is high PDL expression

20

Why do most patients with SCLC recieve palliative chemo?

Usually a systemic disease at presentation

21

What is PCI?

Prophylactic cranial irradiation, used when there is a chance of brain mets in SCLC

22

How chemosensitive is SCLC?

Very (around 80% will respond) but high chance of relapse

23

Lambert-eaton syndrome is an autoimmune disorder associated with SCLC. How does it present?

involves muscles of the proximal arms and legs

Weakness affects legs > arms