Clinical Features and Radiology of Lung Cancer and Staging Flashcards
What are the risk factors for lung cancer?
Smoking, passive smoking and exposure to asbestos, radon, air pollution and diesel exhaust
What are the symptoms of lung cancer?
Chronic coughing, coughing up blood, wheezing, chest/bone pain, chest infections, difficulty swallowing, raspy/hoarse voice, shortness of breath, weight loss and nail clubbing
What are the clinical signs of lung cancer?
Chest signs, clubbing, lymphadenopathy, Horner’s syndrome, Pancoast tumour, SVCO, hepatomegaly and skin nodules
What are the initial investigations which would be carried out if lung cancer was suspected?
CX-Ray, full blood count, renal/liver functions/calcium, clotting screen and spirometry
What investigations might be used to get a ‘tissue diagnosis’?
Bronchoscopy, EBUS (ultrasound), imaged guided lung/liver biopsy, bone biopsy, mediastinoscopy and surgical excision biopsy
What scans can be used to help stage the cancer?
CT and PET scans
What is the range of the performance status?
From fully active to bed/chair bound
What are the main treatment options for patients with lung cancer?
Surgery, radiotherapy, chemotherapy and best supportive care
When viewing a chest X-Ray what else should be viewed if possible?
Any previous chest X-Ray films
What is a pulmonary nodule?
An opacity in the lung up to 3cm with no mediastinal adenopathy or atelectasis
What is a pulmonary mass?
An opacity in the lung over 3cm with no mediastinal adenopathy or atelectasis
How is lung cancer staged?
Clinical history/examination, performance status, pulmonary function and TNM staging
What does TNM stand for?
T - Tumour
N - Nodes
M - Metastasis
What is FDG PET ?
A PET scan that uses radioactive markers attached to glucose to scan for cancer cells
Name the steps in a systematic review of a CXR
- Name, marker, rotation and penetration
- Lines/metal work
- Heart
- Mediastinum
- Lungs: upper/middle/lower zones
- Bones
- Diaphragm
- Soft tissue
