Bronchial Carcinoma

Question 1

Epidemiology

Answer 1

Most common malignant tumour worldwide
3rd most common cause of death in the UK
1.4M deaths annually

Question 2

Risk factors

Answer 2

SMOKING
Asbestos
Radiation
Pre-existing health conditions

Question 3

Local tumour effects

Answer 3

Cough (80%)
Breathlessness (60%)
Haemoptysis (70%)
Chest pain
Wheeze
Hoarse voice
Recurrent infections
C8/T1 palsy

Question 4

Common sites for mets

Answer 4

Mediastinal, cervical and axillary nodes

Liver, bone, adrenal glands and brain

Question 5

Signs of metaststaic spread

Answer 5

Liver: anorexia, nausea and weight loss
Brain: increased ICP
Arenal glands: Usually asymptomatic but sometimes Addisons
Bone: Bony pain + pathological fractures

Question 6

Clinical signs of bronchial carcinoma

Answer 6

Cachexia
Anaemia
Clubbing
Hypertrophic pulmonary osteoarthropy

Question 7

Local tumour complications

Answer 7

Recurrent laryngeal nerve palsy
SVC obstruction
Horners
Rib erosion
Pericarditis

Question 8

Why investigate?

Answer 8

Stage and classify
Assess potential treatments
Tissue diagnosis

Question 9

Methods used to stage and diagnose

Answer 9

CXR: to show obvious evidence of lung cancer
CT: indicates the extent of the disease (TNM)
PET/CT: Characterises the extent of mediastinal/nodal involvement
MRI: pan coast tumours mainly

Question 10

Treatment methods for cure in NSCLC

Answer 10

Surgery

Radiation: pt must have adequate lung function

Question 11

Treatment methods for palliative care

Answer 11

Radiation

Chemotherapy

Question 12

Prognosis of NSCLC and SCLC

Answer 12

NSCLC: 50% 2yr survival w/o spread
SCLC: 3 months if untreated. 1-5yrs w/ treatment