Bronchial carcinoma

Question 1

How common is a bronchial carcinoma?

Answer 1

95% of primary lung tumours
Most common malignant tumour in the Western World
3rd most common cause of death in the UK

Question 2

What is the pathology of bronchial carcinoma?

Answer 2

• Divided into small cell and non small cell cancer
• Non small cell:
• Squamous
• Large cell
• Poorly differentiated
• Metastasize easily
• Adenocarcinoma
• Asbestos exposure
• More common in non smokers
• Small cell:
• Arises from endocrine cells and secretes hormones
• Poor prognosis
• Metastasis most commonly spreads to bone and brain

Question 3

What are the risk factors/aetiology of bronchial carcinoma?

Answer 3

• Male
• Smoking – inc. passive smoking
• Exposure to asbestos
• Contact with arsenic, chromium, iron oxides and products of coal combustion

Question 4

What are the signs/symptoms of bronchial carcinoma?

Answer 4

• Cough
• Chest pain
• Haemoptysis
• Breathlessness
• Pleuritic pain
• Pain in the shoulder and inner arm (Pancoast’s tumour)
• Bone fractures
• Horner’s syndrome – spread to the sympathetic ganglion
• Hoarseness of voice
• Bovine cough (sounds like you’re breathing out air really fast)
• Finger clubbing
• Malaise
• Lethargy
• Weight loss

Question 5

What investigations are conduced for suspected bronchial carcinoma?

Answer 5

• CXR
• Round shadow who’s edge shows a fluffy/spiked appearance
• Sputum cytology
• Bronchoscopy
• Transthoracic fine needle aspiration biopsy
• CT
• PET scan

Question 6

What are the surgical treatments for bronchial carcinoma?

Answer 6

• Lobectomy
• Endoscopic laser therapy
• Transbronchial stenting
• Aspiration of pleural effusions

Question 7

What are the pharmacological treatments for bronchial carcinoma?

Answer 7

• Chemotherapy
• Radiotherapy – can be for palliative care also
• Analgesia
• Prednisolone – improves appetite

Question 8

What are the non pharmacological treatments for bronchial carcinoma?

Answer 8

Counselling