Clinical Features and Staging of Lung Cancer

Question 1

Give some clinical signs of lung cancer

Answer 1

• finger clubbing
• lymphadenopathy
• Horner’s syndrome
• superior vena cava obstruction (no blood drainage upon lifting of the arms)
• hepatomegaly
• skin nodules (metastasis)

Question 2

Give some of the initial investigations used in the diagnosis of lung cancer

Answer 2

• CXR
• FBC
• renal function (in preparation for a contrast CT)
• spirometry

Question 3

Give some investigations used in the ‘tissue diagnosis’ of lung cancer

Answer 3

• bronchoscopy
• endobronchial ultrasound
• image guided lung biopsy
• fine-needle aspiration of neck node
• bone biopsy

Question 4

In what three ways are lung cancers staged

Answer 4

T = tumour size and proximity to other structures
N = nodal involvement
M = metastasis

Question 5

What investigation may be carried out for further staging of the cancer

Answer 5

CT–PET scan (sugary content injected, makes cancer cells light up - useful to observe liver metastasis)

Question 6

What does treatment of lung cancer usually depend on

Answer 6

• patient performance status
• patient wishes
• type and stage of tumour
• aims of treatment (radical/palliative)