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Respiratory Physiology > Clinical Features and Staging of Lung Cancer > Flashcards

Clinical Features and Staging of Lung Cancer Flashcards

1
Q

What percentage of cancer deaths are lung cancer?

A

20%

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2
Q

What percentage of lung cancers are related to smoking?

A

85%

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3
Q

What other environmental risk factors of lung cancer are there?

A
  • Exposure to carcinogens such as asbestos and radon
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4
Q

What is a “synergistic effect” with reference to lung cancer?

A
  • 1 + 1 = 3

- If you are exposed to 2 antigens you have a far more increased chance of developing lung cancer than just the one

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5
Q

What are some symptoms of advanced metastatic lung cancer?

A
  • Bone pain
  • Spinal compression and parasthesia
  • Cerebral metastasis
  • Thrombosis
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6
Q

What main symptoms will elicit from cerebral metastasis?

A
  • Vomiting

- Ataxia

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7
Q

What are the symptoms of the paraneoplastic form?

A
  • Hyponatraemia
  • Anaemia
  • Hypercalcaemia
  • Dermatomyositis
  • Eaton lambert
  • Cerebellar ataxia
  • Neuropathy
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8
Q

What is hyponatraemia?

A

Low blood sodium

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9
Q

What is eaton lambert?

A

Autoimmune disease that causes muscle weakness in the limbs (similar to myasthenia gravis)

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10
Q

What are some of the general signs of lung cancer?

A
  • Clubbing
  • Chest signs
  • Cervical lymphadenopathy
  • Horner’s syndrome
  • Pancoast tumour
  • Obstruction of the superior vena cava
  • Hepatomegaly
  • Skin nodules
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11
Q

What is Horner’s Syndrome?

A

Damage to the sympathetic trunk

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12
Q

What is a pancoast tumour?

A
  • Tumour of the lung apex

- Can put pressure on vessels around there

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13
Q

When lung cancer is suspected, what are the initial investigations that should be carried out?

A
  • Chest Xray
  • Full blood count
  • Renal and liver function (calcium level)
  • Clotting screen
  • Spirometry
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14
Q

What further investigations could be performed to get a diagnosis of lung cancer?

A
  • Bronchoscopy
  • EBUS
  • Lung and liver biopsy
  • Cervical lymph node sampling
  • Bone biopsy
  • Mediastinoscopy
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15
Q

What is EBUS?

A

Endobronchial Ultrasound Guided Transbronchial Aspiration

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16
Q

When would a lymph node sample or a lung, liver and a bone biopsy be performed?

A

When metastasis is suspected

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17
Q

How many T stages are there in lung cancer?

A

4

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18
Q

What is a T1 tumour?

A
  • Diameter 0-3cm

- No invasion

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19
Q

What is a T2 tumour?

A
  • Diameter 3-7cm
  • > 2cm away from the carina
  • Lobar atelectasis
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20
Q

What is lobar atelectasis?

A

Diminished lung lobe volume

21
Q

What is a T3 tumour?

A
  • Diameter >7cm
  • <2cm away from the carina
  • Atelectasis of the whole lung
  • Invasion of any of chest wall, diaphragm, mediastinum, pleura, pericardium
22
Q

What is a T4 tumour?

A
  • Tumour in carina

- Invasion of heart, great vessels, trachea, oesophagus, spine

23
Q

What is N staging?

A

Staging involving lymph node spread

24
Q

What is the N0 stage?

A

No lymph spread

25
Q

N1?

A

Ipsilateral hilar/peribronchial nodes involved

26
Q

N2?

A

Ipsilateral mediastinal/subcarinal nodes

27
Q

N3?

A
  • Controlateral mediastinal/hilar nodes

- Ipsilateral/controlateral scalene or subclavicular nodes

28
Q

What is M staging?

A

If the cancer has metastasised to distant structures

29
Q

What are M0 and M1?

A
  • M0 means no distant spread

- M1 means distant spread

30
Q

What happens to prognosis as staging increases?

A

Prognosis gets worse

31
Q

What is the treatment pathway used based on?

A
  • Performance
  • Patient wish
  • Histological type due to some cancers being more aggressive
  • The aim of the treatment
32
Q

What are the two aims that treatment can be used for?

A
  • Cure

- Palliative

33
Q

What is meant by performance of a patient?

A
  • How active they are from the illnesses symptoms
34
Q

What is a performance grading score of 0?

A
  • Fully active patient
35
Q

What is a performance grading score of 1?

A
  • Symptoms present but still mostly active
36
Q

What is a performance grading score of 2?

A
  • Up and about more than 50% of the time

- Unable to work

37
Q

What is a performance grading score of 3?

A
  • Up and about less than 50% of the time

- Limited self care

38
Q

What is a performance grading score of 4?

A

Bed or chair bound

39
Q

What are the surgical options for lung cancer?

A
  • Wedge resection
  • Lobectomy
  • Pneumonectomy
40
Q

What is a wedge resection?

A
  • A less invasive technique that resects a small part of the lung
41
Q

What is a lobectomy?

A

Complete removal of a lobe

42
Q

What is a pneumonectomy?

A

Complete removal of a lung

43
Q

What are the three types of radiotherapy that can be administered for lung cancer?

A
  • Radical (cure)
  • Palliative (reduce suffering)
  • Sterotactic (directly at the tumour)
44
Q

When can chemotherapy be used in lung cancer?

A
  • As a direct treatment

- As an adjuvant

45
Q

What specialised monoclonal antibodies are used in lung cancer chemo?

A
  • Erlotinib

- Gefitinib

46
Q

What cancer are cisplatin and pemetrexed used for?

A

Adenocarcinoma

47
Q

What cancer are cisplatin and etoposide used for?

A

Small cell

48
Q

What cancer are cisplatin and gemcitabine used for?

A

Squamous

Respiratory Physiology (16 decks)

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