Carcinoma of the Lung Flashcards
How many people does lung cancer kill in the UK per year
34000
What are most lung cancers caused by
Smoking
Studies by who estabilished the causative link between smoking and lung cancer?
Doll and Hill
What are some other causes of carcinoma of the lung
Passive smoking Genetic factors Ionising radiation (radon gas) Asbestos exposure Diffuse lung fibrosis Lack of dietary fruit and vegetables
Family history of Lung cancer is a risk factor. True or false
True
What are the 2 main groups of lung cancer
Small cell and non small cell
What are 3 types of non small cell carcinomas
Squamous cell carcinoma
Adenocarcinoma
Large cell (undifferentiated) carcinoma
Where do small cell carcinoma usually arise from
Neuro-endocrine cells of the bronchial tree and its endocrine potential is sometime manifest clinically by ectopic hormone production
What is the most common type of lung cancer
Squamous cell carcinoma
What type of lung cancer has the greatest tendency to cavitate
Squamous cell
Define large - cell undifferentiated carcinomas
Lung cancers that do not show squamous or glandular differentiation
What do central lung cancers usually present with
chest symptoms (haemoptysis)
What do peripheral tumours present with
More often general symptoms or effects of metastases
Where do paraneoplastic syndromes arise
At sites distant from the tumour or its metastases
The syndrome of inappropriate anti diuretic hormone secretion is most common with which type of lung cancer
Small cell cancer
What might hypercalcaemia in patients with lung cancer be indicative of
Bone metastases
What might cause paralysis of the phrenic nerve
Direct invasion of the mediastinum
What can cause facial oedema, headache, distended pulseless jugular veins and enlarged collateral veins over the chest and arms
Obstruction of the superior vena cava
What is a pancoast tumour
A carcinoma situated in the superior sulcus of the lung where the subclavian artery forms a groove over the lung apex
How many lung cancers are visible during bronchoscopy
2/3rds
How can samples from a tumour be taken during bronchoscopy
Biopsy forceps or cytology brush can be passed through the channel
Who is bronchoscopy contra-indicated in?
Those with uncontrolled angina or recent MI
What does endobronchial ultrasound allow
Needle aspiration to be performed
What does endobronchial ultrasound allow
Needle aspiration to be performed
Treatment of lung cancer depends on what 3 things
the cell type and stage of the disease and the fitness of the patient
What is the main treatment for small cell carcinoma
Chemotherapy
Are untreated patients with small cell carcinoma usually symptomatic or asymptomatic
Very symptomatic
How long is the chance of survival for untreated small cell carcinoma
3 months
Describe limited disease
When the small cell cancer has spread minimally and radiotherapy can be used
Describe extensive disease
When the small cell ccarcinoma has spread beyond a radiotherapy port (distant metastases)
Where is consolidation radiotherapy usually given
To the site of the tumour and mediastinal nodes
Where is a common place for metastases
Cerebral
What is the best chance of cure in non-small cell carcinoma
Surgical resection
What is the staging system used in lung cancer
TNM
What is the key radiological investigation for staging lung cancer
CT scanning
What can be used to investigate the active disease in mediastinal nodes
PET (positron emission tomography )
What can be used to investigate the active disease in mediastinal nodes
PET (positron emission tomography )
Over expression of what receptor is a feature of non-small cell lung cancer
Epidermal growth factor receptor (EGFR)
Over expression of what receptor is a feature of non-small cell lung cancer
Epidermal growth factor receptor (EGFR)
What does palliative care focus on
Improving the patient’s functioning and psychosocial wellbeing with relief of symptoms
What should opiates be prescribed with
Laxatives and an anti-emetic
What drug might be helpful in bossting the appetite
Prednisolone
Where does alveolar cell carcinoma spread
It arises in the alveoli of the lung and spreads along the alveolar and bronchiolar epithelium
What does alveolar cell carcinoma resemble histologically
Adenocarcinoma
What is required to diagnose alveolar cell carcinoma
A transbronchial biopsy of alveolar tissue
What is the treatment of choice when the tumour in alveolar cell carcinoma is confined to one lobe
Surgical resection
Carcinoid tumours are less likely to metastasis. True or false
True
What age are patients with a carcinoid tumour likely to be affected at?
Young age
Are carcinoid tumours related to smoking
No
What are the two common presentations of carcinoid tumours
Haemoptysis and wheeze
What is the treatment of choice for a carcinoid tumour
Surgical resection
How does a superior vena caval obstruction present?
With headache, distended neck veins that are non-pulsatile, oedema of the face and arms, dilated collateral veins over the chest
What is the most common cause of SVCO
Lung cancer
What is sometimes useful in reducing oedema and inflammation around a tumour
Dexamethasone
