18 - Lung Cancer Flashcards
How should you follow up a patient that has had pneumonia?
- CXR 6 weeks later to see if there is any underlying pathology, e.g cancer, that was covered by the pneumonia
What features of this CXR are indicative of TB?
- Cavity upper right lobe
- Calcification flecks
- Patchy opacification
What are some underlying causes of bronchiectasis?
What is the incidence of lung cancer and the 5 year survival?
- Commonest male cancer and now overtakes breast cancer in women
- If could at early it is 56%, if not it is 5%
What are the differences in lung cancer incidence between socio-economic groups?
Lower class have a rate three times higher
What are some risk factors for lung cancer?
- Smoking (90% men, 80% women)
- Radon
- Asbestos
- Genetic factors
- Dietary factors
Where does lung cancer commonly spread to?
How do we get the information to stage lung cancer?
- Imaging (CXR, PET, MRI, Bone scan)
- Tissue Sample (needle biopsy of lung/pleura, bronchoscopy)
- Histology (work out cell type)
All used to help work out prognosis and treatment
What are some lung cancer symptoms?
Most commonly have no symptoms
What are some signs are lung cancer?
What are some paraneoplastic syndromes that lung cancer can lead to?
- Small cell: SIADH (ADH) , Cushings (cortisol)
- Squamous and Adeno: Hypercalcaemia (PTHrP)
- Adeno: hypertrophic osteoarthropathy
What are the main types of lung cancer?
What are the main differences between small cell and non-small cell carcinomas of the lung?
- Small cell: aggressive and lots of metastatic growth, treat with chemotherapy
- Non small cell: slower growing, surgical resection and test eGFR if giving nephrotoxic drugs
What are some mutations in genes that can lead to lung cancer?
How is a treatment plan for lung cancer put together?
Taken to an MDT to decide whether chemo, radio, palliative or surgery
What are the different treatment options in general for lung cancer?
What is the histology of small cell lung cancer?
small round / oval cells with high nuclear/cytoplasmic ratio. The nuclei have finely dispersed or salt and pepper chromatin and absent nucleoli. Small cell lung cancer is most often located at the hilum and grows along the bronchi
What is the histology of large cell lung cancer?
sheets and nests of large cells with vesicular nuclei, prominent nucleoli, and moderate or abundant amounts of cytoplasm
