22 - Lung Cancer Flashcards
What percentage of smokers will get lung cancer in their life time?
20-30%
How does the risk of lung cancer decrease after smoking cessation?
80-90% reduction in risk after 15 years, but never back to the risk of a non-smoker
Aside from smoking, what are the risk factors for lung cancer?
- second hand smoke
- radon
- ionizing radiation
- pollution
- asbestos
- pulmonary fibrosis
- COPD
- HIV
- nickel
- arsenic
- beryllium
- genetics (60% of patients have a p53 mutation)
What are the 3 ways that someone will present with lung cancer?
- symptomatic
- nodule/mass discovered on screening
- nodule/mass incidental finding
What are the symptoms of lung cancer? What does the presence of symptoms suggest?
- cough
- hemoptysis
- chest pain
- dyspnea
Suggests the disease is progressed past the point of being curable my surgery
What type of lung cancer has a good prognosis?
Adenocarcinoma in-situ
Adenocarcinoma is [slow/fast] growing.
slow
Small cell lung cancer is [slow/fast] growing.
fast
What types of lung cancer are associated with early metastases?
- adenocarcinoma
- large cell lung cancer
Large cell lung cancer is [central/peripheral].
Peripheral
Which type of lung cancer is most commonly associated with paraneoplastic syndromes?
Small cell lung cancer
What are the common sites of metastases from lung cancer?
- bone
- brain
- liver
- lymph nodes
- adrenal glands
What type of lung cancer causes SIADH?
small cell lung cancer
What type of lung cancer causes ACTH?
small cell lung cancer
What type of lung cancer causes Lambert-Eaton Syndrome?
small cell lung cancer
What type of lung cancer causes neurologic syndromes?
small cell lung cancer
What key radiographic features suggest malignancy?
- increased size (> 2.5 cm)
- ragged/speculated margins
- doubling time (< 2 years)
- absence of calcification
In cancer staging, what does T indicate?
- size
- location
- invasion
In cancer staging, what does N indicate?
level of lymph node involvement
In cancer staging, what does M indicate?
if distant metastases
What is the best treatment for non-small cell cancer?
lobectomy (but only possible in early stages)
When is surgery indicated for lung cancer treatment?
- low stage
- cardiac and lung function are suitable to handle anesthesia
Who should be screened for lung cancer? How is it done?
- ages 55-74
- > 30 pack years
Done with low dose CT
A pancoast tumor is usually what type of cancer?
Non-small cell, usually squamous cell
