Clinical Features and Staging of Lung Cancer Flashcards
What percentage of cancer deaths are lung cancer?
20%
What percentage of lung cancers are related to smoking?
85%
What other environmental risk factors of lung cancer are there?
- Exposure to carcinogens such as asbestos and radon
What is a “synergistic effect” with reference to lung cancer?
- 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
What are some symptoms of advanced metastatic lung cancer?
- Bone pain
- Spinal compression and parasthesia
- Cerebral metastasis
- Thrombosis
What main symptoms will elicit from cerebral metastasis?
- Vomiting
- Ataxia
What are the symptoms of the paraneoplastic form?
- Hyponatraemia
- Anaemia
- Hypercalcaemia
- Dermatomyositis
- Eaton lambert
- Cerebellar ataxia
- Neuropathy
What is hyponatraemia?
Low blood sodium
What is eaton lambert?
Autoimmune disease that causes muscle weakness in the limbs (similar to myasthenia gravis)
What are some of the general signs of lung cancer?
- Clubbing
- Chest signs
- Cervical lymphadenopathy
- Horner’s syndrome
- Pancoast tumour
- Obstruction of the superior vena cava
- Hepatomegaly
- Skin nodules
What is Horner’s Syndrome?
Damage to the sympathetic trunk
What is a pancoast tumour?
- Tumour of the lung apex
- Can put pressure on vessels around there
When lung cancer is suspected, what are the initial investigations that should be carried out?
- Chest Xray
- Full blood count
- Renal and liver function (calcium level)
- Clotting screen
- Spirometry
What further investigations could be performed to get a diagnosis of lung cancer?
- Bronchoscopy
- EBUS
- Lung and liver biopsy
- Cervical lymph node sampling
- Bone biopsy
- Mediastinoscopy
What is EBUS?
Endobronchial Ultrasound Guided Transbronchial Aspiration
When would a lymph node sample or a lung, liver and a bone biopsy be performed?
When metastasis is suspected
How many T stages are there in lung cancer?
4
What is a T1 tumour?
- Diameter 0-3cm
- No invasion
What is a T2 tumour?
- Diameter 3-7cm
- > 2cm away from the carina
- Lobar atelectasis
What is lobar atelectasis?
Diminished lung lobe volume
What is a T3 tumour?
- Diameter >7cm
- <2cm away from the carina
- Atelectasis of the whole lung
- Invasion of any of chest wall, diaphragm, mediastinum, pleura, pericardium
What is a T4 tumour?
- Tumour in carina
- Invasion of heart, great vessels, trachea, oesophagus, spine
What is N staging?
Staging involving lymph node spread
What is the N0 stage?
No lymph spread
