Bronchial Carcinoma Flashcards
What types of Bronchial Carcinoma are there?
- Non small cell
2. Small Cell
What types of Non-small cell cancer are there? (3)
- Squamous Cell (42%)
- Adenocarcinoma (39%)
- Others: Large cell, Carcinoid, Bronchoalveolar
What types of Small cell are there? (1)
Oat Cell (from Kulchitsky cells) part of the APUD endocrine system
Which type of cancer is worst?
Small Cell Oat Cell, it is rapid and highly malignant
Is it common?
Bronchial carcinoma accounts for 19% of all cancers and causes 27% of all cancer deaths
Who does it affect?
Mainly people who smoke but there is an increasing incidence in women
Risk factors (11)
Active or passive cigarette smoking, age, COPD, previous cancer, industrial dusts, asbestos, chromium, arsenic, iron oxides, radiation, EGFR TK mutation
Symptoms (8)
Cough, haemoptysis, dyspnoea, chest pain, recurrent pneumonia, lethargy, anorexia, weight loss
Signs (10)
Cachexia, anaemia, clubbing, chest consolidation, lung collapse, pleural effusion, bone tenderness, SVC obstruction, dysphagia, wheeze
Differentials (6)
A secondary malignancy, Pulmonary Hamartoma (rare benign), Bronchial Adenoma, Abscess, Granuloma, Arteriovenous Malformation
Investigations (8)
Urgent Chest x-ray, CT, PET scan, Bronchoscopy, Biospy, Lung function tests, Radionuclide bone scan, cytology of sputum
Treatment (10)
Excision, radiotherapy, chemotherapy, tracheal stenting, analgesia, steroids, anti-emetics, morphine, cough linctus, bronchodilators, anti-depressants, palliative care
Complications (6)
SVC obstruction, Horner’s Syndrome, Rib erosion, recurrent laryngeal nerve palsy, Metastatic spread, Neoplastic Endocrine Syndromes
Is there a good prognosis?
Not really, 10 year survival rate is 5.5%, Small cell has a much poorer prognosis, smoking cessation improves prognosis
Prevention
Discourage smoking, reduce occupational exposure to carcinogens, lung cancer screening programmes
