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Respiratory System DO > Clinical Features and Staging of Lung Cancer > Flashcards

Clinical Features and Staging of Lung Cancer Flashcards

1
Q

What is the leading cause of cancer death in men and women

A

Lung cancer

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2
Q

How many cancer deaths in the UK are due to lung cancer

A

1 in 5

22%

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3
Q

How many lung cancers are due to smoking

A

Over 85%

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4
Q

Which cancer is most preventable

A

Lung

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5
Q

What are the risk factors for lung cancer

A

Smoking
Passive smoking
Exposure to asbestos, radon, air pollution and diesel exhaust

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6
Q

What are 10 signs and symptoms of lung cancer

A 
Chronic coughing
Coughing up blood
Wheezing
Chest and bone pain
Chest infections
Difficulty swallowing
Raspy, hoarse voice
Shortness of breath
Unexplained weight loss
Nail clubbing
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7
Q

Name 4 symptoms of advanced metastatic disease

A

Bone pain
Spinal cord compression
Cerebral metastases
Thrombosis

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8
Q

What are the signs of spinal cord compression

A

Limb weakness
Paraesthesia
Bladder/bowel dysfunction

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9
Q

What are the signs of cerebral metastases

A 
Headache
Vomiting
Dizziness
Ataxia
Focal weakness
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10
Q

Name 7 symptoms of advanced paraneoplastic disease

A 
Hyponatraemia
Anaemia
Hypercalcaemia
Dermatomyositis/polymositis
Eaton-lambert syndrome
Cerebella ataxia
Sensorimotor neuropathy
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11
Q

What are the signs of hyponatraemia

A

SIADH

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12
Q

What are the signs of hypercalcaemia

A

Parathyroid hormone related protein

Bone metastases

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13
Q

What are the signs of dermatomyositis/polymositis

A

Proximal muscle weakness

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14
Q

What are the signs of Eaton-lambert syndrome

A

Upper limb weakness

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15
Q

What are the clinical signs of lung cancer

A 
Chest signs
Clubbing
Lymphadenopathy
Horner’s syndrome 
Pancoast tumour
Superior vena cava
obstruction
Lymphadenopathy
Hepatomegaly
Skin nodules (metastases)
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16
Q

What are the initial investigations conducted through the GP

A 
Chest X-Ray
Full blood count
Renal, liver functions and calcium
Clotting screen
Spirometry
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17
Q

What type of imaging is used for staging

A

CT of thorax and abdomen

18
Q

What investigations can be done for tissue diagnosis

A 
Bronchoscopy
EBUS
Image guided lung biopsy
Image guided liver biopsy
FNA of neck node or skin metastasis
Excision of cerebral metastasis!
Bone biopsy
Mediastinoscopy/otomy 
Surgical excision biopsy
19
Q

How is bronchoscopy conducted

A

A bronchoscope is used to view the airways and check for any abnormalities

20
Q

How of lung cancer does small cell carcinoma account for by histology

A

15%

21
Q

How of lung cancer does adenocarcinoma account for by histology

A

40%

22
Q

How of lung cancer does squamous cell carcinoma account for by histology

A

30%

23
Q

How of lung cancer does large cell carcinoma account for by histology

A

10%

24
Q

What is the diameter of a T1 tumour

A

T1a is under 2cm

T1b is between 2-3cm

25
Q

What is the diameter of a T2 tumour

A

T2a is between 3-5cm

T2b is between 5-7cm

26
Q

What is the diameter of a T3 tumour

A

Over 7cm

27
Q

What will the scopy of a T1 tumour show

A

No invasion

Lobar bronchus

28
Q

What will the scopy of a T2 tumour show

A

Over 2cm to the carina

29
Q

What will the scopy of a T3 tumour show

A

Under 2cm to the carina

30
Q

What will the scopy of a T4 tumour show

A

Tumour in carina

31
Q

What type of atelectasis will a T2 tumour show

A

Lobar atelectasis or obstructive pneumonia to hilus

32
Q

What type of atelectasis will a T3 tumour show

A

Whole lung

33
Q

State 5 things that should be considered when deciding on treatment

A 
Performance status
Patient wishes
Histological type and stage
Multidisciplinary team
Aims of treatment (e.g. radical or palliative)
34
Q

State the different performance status types

A 
0 = fully active
1 = symptoms but ambulatory
2 = “up and about” over 50%, unable to work
3 = “up and about” under 50%, limited self-care
4 = bed or chair bound
35
Q

What treatments are available for patients

A 
Surgery (18% of patients)
Radiotherapy
Chemotherapy
Best supportive care
Co-ordination (lung cancer specialist nurse)
36
Q

What type of surgery could be preformed

A

Wedge resection
Lobectomy
Pneumonectomy

37
Q

What type of radiotherapy is available

A

Radical
Palliative
Stereotactic

38
Q

What type of chemotherapy is available

A

Part of radical or palliative treatment
Alone, combined with radiotherapy or adjuvant (after surgery)
Targeted agents (e.g. Tyrosine Kinase Inhibitors and monoclonal antibodies)
Small cell e.g. cisplatin/etoposide
Adenocarcinoma e.g. cisplatin/pemetrexed
Squamous e.g. cisplatin/gemcitabine

39
Q

What are the 5 aspects of palliative management

A

Symptom control
Quality of life
Community support
Decisions and planning, resuscitation status, end of life care
Multidisciplinary team including lung cancer nurse and hospice

40
Q

What are the methods of symptom control

A

Chemotherapy
Radiotherapy (e.g. pain, haemoptysis)
Opiates, bisphosphonates, benzodiazepines
Treatment of hypercalcaemia, dehydration and hyponatraemia

Respiratory System DO (33 decks)

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