22: Lung Flashcards
What supplementation has been found to increase the risk of lung cancer?
B-carotene
What are the 4 types of lung cancer?
Squamous cell carcinoma
adenocarcinoma
large cell carcinoma
these 3 together make up non-small cell lung cancer (NSCLC) which is 80-85% of cases
small cell carcinoma (SCLC) is 10-15% of cases
Where does Squamous cell carcinoma typically begin? Is it connected to something?
begins in the squamous cells of the bronchi (central part of lungs).
This appears to be the most highly related to smoking and tends to cause early symptoms
Where does adenocarcinoma typically begin? Is it connected to something?
a mucin-producing cell in the peripheral part of the lungs. Its slower growing and is associated with improved outcomes
Where does large cell carcinoma typically begin? Is it connected to something?
in any part of the lung and a tendency to metastasize rapidly. it tends to cause late symptoms
Where does small cell carcinoma typically begin? Is it connected to something?
in multiple parts of the lung and often asymptomatic in the early stages, but it metastasizes rapidly and therefore has poor prognosis
What are the common chemo agents used for SCLC? Why is it usually chemo for treatment?
SCLC usually is found in extensive stage (both sides of lungs)
Cisplatin, carbo, paclitaxel, docetaxel, gemcitabine, etoposide, vinorelbine, pemetrexed
How can chemo be used with NSCLC?
neoadjuvant before surgery
adjuvant to minimize reoccurrence
advanced stage treatment or for those that couldn’t handle surgery/radiation
What targeted therapies are commonly used with NSCLC?
angiogenesis inhibitors (-umab)
epidermal growth father receptor inhibitors (-nib)
anaplastic lymphoma kinase inhibitors (-nib)
BRAF inhibitors (-nib)
When is radiation used with lung cancer?
NSCLC:
inoperable stage 1 and 2
CCRT for stage 3
palliatively
SCLC:
CCRT or palliatively
What are some radiation side effects when treating lung cancer?
esophagitis
fatigue
anorexia
nausea
CCRT has HIGH rate of sever acute esophagitis–34% of patients compared to 1.3% when sequential chemo and radiation
What immunotherapy is commonly used for NSCLC?
Monoclonal antibodies - nivolumab/opdivo, pembrolizumab/keytruda, atezolizumab/Tecentriq - used for stage IV NSCLC
how common is malnutrition with lung cancer? What about Sarcopenia?
45-69%–modality and disease stage. Often when advanced/metastatic, increased issues with wt loss
47% show with sacropenia before starting chemo, going up to 61% before CCRT
What type of lung cancer patients should get automatic referrals for nutrition assessment?
CCRT
Stage 3 or higher
Esophagitis in radiation treatment field
