Cancers of the Lung, Heart & Vasculature

Question 1

How common are cardiovascular cancers?

Answer 1

Very are

Question 2

What are some reasons cardiovascular cancers are rare?

Answer 2

Low exposure to carcinogens
Cardiac myocytes divide very rarely
Cardiac myocytes have a strong selective advantage against anything that compromises function

Question 3

Who is more likely to get lung cancer?

Answer 3

Smokers
Men
Older people present (75-90 years)
Those of lower socioeconomic status

Question 4

What are some etiological factors in the development of lung cancer?

Answer 4

Asbestos, radon gas, indoor cooking fumes, COPD, immunodeficiency

Question 5

Where does squamous cell carcinoma originate?

Answer 5

Bronchial epithelium

Question 6

Where are squamous cell carcinomas located?

Answer 6

Centrally located

Question 7

Where does adenocarcinoma originate?

Answer 7

Mucus producing glandular tissue

Question 8

Where are adenocarcinomas located?

Answer 8

Peripherally

Question 9

Where does small cell lung cancer originate?

Answer 9

Pulmonary neuroendocrine cells

Question 10

What are the 4 pathophysiologies of lung cancer?

Answer 10

Squamous cell carcinoma
Adenocarcinoma
Large cell lung cancer
Small cell lung cancer

Question 11

What are the non-small lung cancers (NSCLC)?

Answer 11

Squamous cell carcinoma
Adenocarcinoma
Large cell lung cancer

Question 12

Which pathophysiology of lung cancer is most aggressive?

Answer 12

Small cell lung cancer

Question 13

Define metaplasia

Answer 13

Reversible change where one adult cell type is replaced by another, this is an adaptive change

Question 14

Define dysplasia

Answer 14

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)

Question 15

What are some common symptoms of lung cancer?

Answer 15

Fatigue
Chest pain
Breathlessness
Unexplained weight loss
Repeated respiratory infection

Question 16

What are some features of advanced lung cancer metastases?

Answer 16

Neurological effects include focal weakness, seizures

Bone pain

Question 17

What are some signs of lung cancer and mets?

Answer 17

Clubbing
Horner’s syndrome
Pemberton’s sign
Cachexia

Question 18

When is PET useful for imaging in diagnosis?

Answer 18

To exclude occult metasteses

Question 19

What imaging is primarily used in diagnosis of lung cancer?

Answer 19

Chest xray

Question 20

What imaging is primarily used in staging of lung cancer?

Answer 20

CT

Question 21

What are the 3 main biopsy methods used for lung cancers?

Answer 21

Bronchoscopy
Endobronchial ultrasound and transbronchial-needle aspiration of mediastinal lymph nodes (EBUS [TBNA]
CT guided lung biopsy

Question 22

How are lung cancers staged?

Answer 22

TNM (tumor 1-4, nodes 0-3, mets 0-x)

Question 23

What are some things that determine treatment?

Answer 23

Patient fitness
Cancer histology
Cancer stage
Patient preference
Health service factors

Question 24

How is patient fitness assesed?

Answer 24

WHO performance status

Question 25

What is standard treatment for early lung cancer?

Answer 25

Surgery that involves resection (lobectomy and lymphadenectomy)

Question 26

When is radical radiotherapy used?

Answer 26

As an alternative to surgery for early stage disease, used if there are comorbidities involved with surgery

Question 27

When may sublobar resection be used?

Answer 27

If stage 1 and tumor is smaller than 3 cm

Question 28

What method is used for radical radiotherapy?

Answer 28

Stereotactic ablative body radiotherapy (SABR)