Cancers of the Lung, Heart & Vasculature Flashcards
How common are cardiovascular cancers?
Very are
What are some reasons cardiovascular cancers are rare?
Low exposure to carcinogens
Cardiac myocytes divide very rarely
Cardiac myocytes have a strong selective advantage against anything that compromises function
Who is more likely to get lung cancer?
Smokers
Men
Older people present (75-90 years)
Those of lower socioeconomic status
What are some etiological factors in the development of lung cancer?
Asbestos, radon gas, indoor cooking fumes, COPD, immunodeficiency
Where does squamous cell carcinoma originate?
Bronchial epithelium
Where are squamous cell carcinomas located?
Centrally located
Where does adenocarcinoma originate?
Mucus producing glandular tissue
Where are adenocarcinomas located?
Peripherally
Where does small cell lung cancer originate?
Pulmonary neuroendocrine cells
What are the 4 pathophysiologies of lung cancer?
Squamous cell carcinoma
Adenocarcinoma
Large cell lung cancer
Small cell lung cancer
What are the non-small lung cancers (NSCLC)?
Squamous cell carcinoma
Adenocarcinoma
Large cell lung cancer
Which pathophysiology of lung cancer is most aggressive?
Small cell lung cancer
Define metaplasia
Reversible change where one adult cell type is replaced by another, this is an adaptive change
Define dysplasia
An abnormal pattern of growth in which some of the cellular and architectural features of malignancy are present (pre-invasive stage where basement membrane is intact)
What are some common symptoms of lung cancer?
Fatigue Chest pain Breathlessness Unexplained weight loss Repeated respiratory infection
What are some features of advanced lung cancer metastases?
Neurological effects include focal weakness, seizures
Bone pain
What are some signs of lung cancer and mets?
Clubbing
Horner’s syndrome
Pemberton’s sign
Cachexia
When is PET useful for imaging in diagnosis?
To exclude occult metasteses
What imaging is primarily used in diagnosis of lung cancer?
Chest xray
What imaging is primarily used in staging of lung cancer?
CT
What are the 3 main biopsy methods used for lung cancers?
Bronchoscopy
Endobronchial ultrasound and transbronchial-needle aspiration of mediastinal lymph nodes (EBUS [TBNA]
CT guided lung biopsy
How are lung cancers staged?
TNM (tumor 1-4, nodes 0-3, mets 0-x)
What are some things that determine treatment?
Patient fitness Cancer histology Cancer stage Patient preference Health service factors
How is patient fitness assesed?
WHO performance status
What is standard treatment for early lung cancer?
Surgery that involves resection (lobectomy and lymphadenectomy)
When is radical radiotherapy used?
As an alternative to surgery for early stage disease, used if there are comorbidities involved with surgery
When may sublobar resection be used?
If stage 1 and tumor is smaller than 3 cm
What method is used for radical radiotherapy?
Stereotactic ablative body radiotherapy (SABR)
