Cancer Flashcards
What is the main symptom of primary lung tumour?
Haemoptysis
What can happen to lung volume as a cancer grows?
Lung volume can decrease
Why do lungs shrink as tumours grow?
The tumours obstruct parts of the bronchial tree, all the air beyond an obstruction becomes absorbed and the lung tissue shrinks down causing a reduction iN size.
What are the main presentations of primary lung cancer?
Haemoptysis, recurrent pneumonia and stridor.
Which surrounding structure can primary lung tumours invade?
Recurrent lanyrgeal nerve Pericardium Oesophagus Brachial plexus Pleural cavity Superior vena cava
What is a symptom of recurrent layrngeal nerve palsy?
Hoarse voice
Paralysis of vocal cords
What can local invasion of the pericardium cause?
Atrial fibrillation
Pericardial effusion
Dyspnoea
What can local invasion of the oesophagus cause?
Dysphagia for solids.
What is a Pancoast tumour?
A tumour in the lung apex.
Where can Pancoast tumours invade?
The brachial plexus (muscle wastage in hand and arm) Brachiocephalic vein Subclavian artery Phrenic nerve Recurrent laryngeal nerve Sympathetic Ganglion (Horner's Syndrome)
What can local invasion of the pleural space cause?
Accumulation of excess pleural fluid. Often litres.
Presenting symptom breathlessness
What can local invasion of the superior vena cava cause?
Obstructs drainage of blood from arms and head.
-Puffy eyelids and a headache
Anastomoses with the IVC
Where can lung cancer metastasise to?
Liver Brain Bone Adrenal glands Skin Lung
What would be the clinical presentation for a lung tumour that invades the chest wall?
Localised chest wall pain, worse on movement.
When there’s bone erosion the patient will describe paroxysmal pain.
How would you treat a cerebral metastases?
High dose corticosteroid therapy e.g Dexomethasone.
Temporary relief of symptoms (few weeks) by removing oedema
What do you see on the LFT’s in cases of liver metastases?
Abnormal results particularly Alkaline Phosphate
What are the common presentations of bone metastases?
Localised pain which is worse at night
Bone fracture with no obvious trauma/injury
Name as many paraneoplastic symptoms as you can
Finger clubbing Hypertrophic pulmonary osteoarthropathy Weight loss Thrombophlebitis Hypocalcaemia Hyponatraemia Weakness e.g eaton-lambert syndrome
What is Eaton Lambert syndrome?
Mimics myasthenia gravis
What is thrombophlebitis?
Increased coagulability of the blood. Not confined to just lung cancer, can be caused by gastric and pancreatic
What are the investigations for lung cancer?
CXR CT scan of the thorax PET scan Bronchoscopy Endobronchial Ultrasound FBC LFT's U&E's Spirometry FEV1
What is the gold standard for making a diagnosis of lung cancer?
Tissue test e.g biopsy/lymph node aspiration/pleural fluid.
What sort of cancers can smokers suffer from?
Lung Laryngeal Cervical Bladder Mouth Oesophageal Colon cancer
What are the risk factors for lung cancer?
Smoking Asbestos Nickel Chromates Radiation Atmospheric pollution Genetics
