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Flashcards in Lung Cancer Deck (23)
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1
Q

Where in the lung do tumours most commonly arise from?

A

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

2
Q

What is the most common kind of lung cancer?

A

Adenocarcinoma (NSCLC)

3
Q

What is the NSCLC SCLC split?

A

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

4
Q

ADENOCARCINOMA

  1. Where are tumours located?
  2. Who is it common in?
  3. What mutations may be present?
A
  1. Tumours often peripheral
  2. More frequent in women, non-smokers & asbestos exposure
  3. EGFR, ALK, Rhos
5
Q

SQUAMOUS CELL CARCINOMA

  1. Where are tumours usually located?
  2. Who does it most commonly affect?
  3. Why may it lead to hypercalcaemia?
A
  1. Close to the bronchi (may present with bronchial obstruction)
  2. SMOKERS
  3. Can secrete PTH related peptide, causing hypercalcaemia
6
Q

LARGE CELL CARCINOMA

  1. How common?
  2. Where are tumours located?
  3. Why bad?
A
  1. 8% of NSCLC
  2. Peripheral tumours
  3. Metastasize early
7
Q

SMALL CELL LUNG CANCER

  1. Why bad?
  2. How chemosensitive?
A
  1. Highly aggressive & rapidly-growing. Usually mets prior to diagnosis
  2. Can be v chemosensitive, but high chance of relapse
8
Q

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

A

Prophylactic radiotherapy to the brain

Risk: significant memory impairment

9
Q

What may be associated with SCLC?

A

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

10
Q

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
A
  1. Pancoast tumour (apical), horner’s syndrome

2. Mediastinal disease

11
Q

What is SIADH?

What is it characterised by?

A

syndrome of inappropriate antidiuretic hormone

hypotonic hyponatraemia, concentrated urine, and a euvolaemic state

12
Q

What cancer is most commonly associated with SIADH?

A

Small cell lung cancer

13
Q

What is EBUS and why is it used?

A

Endobroncial Ultrasound

Biopsy of lymph nodes in the mediastinum

14
Q

What treatment can reduce haemoptysis?

A

Radiotherapy

15
Q

Surgery for NSCLC

A

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

16
Q

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

A

Concurrent chemo-radiotherapy

17
Q

SABR can be used to treat which type of tumours?

A

Peripheral tumours

18
Q

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

A

Chemotherapy

19
Q

When could Pembrolizumab be used for patients with advanced NSCLC?

A

If there is high PDL expression

20
Q

Why do most patients with SCLC recieve palliative chemo?

A

Usually a systemic disease at presentation

21
Q

What is PCI?

A

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

22
Q

How chemosensitive is SCLC?

A

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

23
Q

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

A

involves muscles of the proximal arms and legs

Weakness affects legs > arms