4) Lung Cancer Flashcards
Risk Factors for lung cancer?
- SMOKING
- HIV, Pulmonary fibrosis and prev radiotherapy can predispose
- Asbestos, chromium, arsenic exposure all risk
Red Flag symptoms for CXR in lung cancer?
Haemoptysis Persistent or unexplained (>3 weeks) -cough -chest/shoulder pain -hoarseness -dyspnoea -Wt loss
Suspicious signs on examination of lung cancer?
Features suggesting mets eg cerebral/bone mets
Clubbing
Lymphadenopathy
SVCO warrants urgent referral to physicians
Symptoms of lung cancer?
COugh Haemoptysis dyspnoea chest pain recurrent pneumonia lethargy wt loss
Signs of lung cancer?
cachexia anaemia clubbing Hypertrophic pulmonary osteoarthropathy (wrsit pain) nodes consolidation/collapse pleural effusion bone tenderness, hepatomegaly, focal cns, myopathy
Local complications of lung cancer?
Recurrent laryngeal nerve palsy Phrenic nerve palsy horners syndrome svco rib erosion pericarditis af
Metastatic sites of lung ca?
Brain
Bone
Adrenals
Liver
Endocrine complications of lung cancer?
Ectopic hormone secretion by small cell tumours:
- ACTH
- SIADH
PTH- Squamous cell
Non metastatic cerebral complications of lung cancer?
Proximal myopathy Confusion fits lambert eaton syndrome cerebellar syndrome
Other complications of lung cancer?
Acanthosis nigricans clubbing HPOA dermatomyositis Thrombophlebitis migrans
How should patients be Ix?
CXR -> CT Staging -> Bronchoscopy or alternative biopsy-> PET Scan- Lung fx (for surgery)
Types of NSCLC?
Adenocarcinoma
Squamous
Large cell
other
DD of nodule on Xray?
Malignancy (1/2) Abscess Granuloma AV malformation Cyst Foriegn body Skin tumour Carcinoid tumour Pulmonary hamartoma
Important things to ask in Hx?
Smoking Asbestos? DHX? Blood thinners? Previous imaging and where? WHO performance status
How is survival affected by staging in NSCLC?
1a= 60mo median survival IV = 6mo median survival
