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Systems: Respiratory AB > Clinical Features of Lung Cancer and Staging > Flashcards

Clinical Features of Lung Cancer and Staging Flashcards

1
Q

What is the leading cause of cancer death?

A

Lung cancer

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2
Q

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

A

1 in 5

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3
Q

Why is lung cancer considered the most preventable cancer?

A

Smoking accounts for >85% of lung cancers

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4
Q

How does lung cancer rates differ with gender and age?

A
  • Men are at higher risk

- Risk increases with age

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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 the 10 symptoms to look out for with lung cancer?

A
  • Chronic cough
  • Coughing up blood
  • Wheezing sound
  • 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

What are the metastatic symptoms of lung cancer?

A
  • Bone pain
  • Spinal cord compression
  • Cerebral metastases
  • Thrombosis
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8
Q

What are the paraneoplastic symptoms of lung cancer?

A
  • Hyponatraemia
  • Anaemia
  • Hypercalcaemia
  • Dermatomyositis/ polymyositis
  • Eaton-Lambert syndrome
  • Cerebellar ataxia
  • Sensorimotor neuropathy
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9
Q

What can spinal cord compression cause?

A
  • Limb weakness
  • Paraesthesia
  • Bladder/bowel dysfunction
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10
Q

What can cerebral metastases cause?

A
  • Headache
  • Vomiting
  • Dizziness
  • Ataxia
  • Focal weakness
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11
Q

What can cause hyponatraemia?

A

SIADH syndrome

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12
Q

What can hypercalcaemia cause?

A

-Parathyroid hormone related protein

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13
Q

What can dermatomyositis/polymyositis cause?

A

Proximal muscle weakness

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14
Q

What does Eaton-Lambert syndrome cause?

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
  • Hepatomegaly
  • Skin nodules
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16
Q

What initial investigations should be carried out?

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

What are CT scan useful in?

A

Staging

18
Q

What investigations are used in 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

What are the 4 most common types of lung cancer by histology?

A
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Small cell carcinoma
  • Large cell carcinoma
20
Q

How is cancer stages?

A

Based on metastasis and cell type

21
Q

What is the staging system for cancer called?

A

TNM staging

22
Q

How does prognosis differ between stages/

A

Prognosis decreases with the increasing stage i.e Stage I has a better prognosis than stage IV

23
Q

What scans are useful in staging?

A

CT and CT-PET

24
Q

What must be considered when thinking about treatment?

A
  • Performance status of patient
  • Patient wishes
  • Histological type and stage
  • Multidisciplinary team involvement
  • Aims of the treatment
25
Q

How is performance status ranked?

A
  1. = fully active
  2. = symptoms but ambulatory
  3. = ‘up and about’ more than 50% of the time but unable to work
  4. = ‘up and about’ less than 50% of the time and has limited self care
  5. = bed or chair bound
26
Q

What is extremely important when working with patients?

A

Communication skills especially when delivering bad news

27
Q

What treatment options are there for lung cancer?

A
  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Best supportive care
  • Co-ordination with lung cancer specialist nurse
28
Q

What palliative management options are there?

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
29
Q

How can symptoms of lung cancer be controlled?

A
  • May include chemotherapy
  • Mya include radiotherapy
  • Opiates, bisphosphonates, benzodiazepines
  • Treatment of hypercalcaemia, dehydration and hyponatraemia

Systems: Respiratory AB (39 decks)

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