Clinical features of lung cancer and staging Flashcards
which is the leading cause of cancer death (both men and women)?
lung cancer
what percentage of cancer deaths are lung cancer (in the UK)?
1 in 5
smoking accounts for what percentage of lung cancers?
> 85% (most preventable cancer)
what are the main risk factors for lung cancer?
smoking (>85%), passive smoking, exposure to asbestos, radon, air pollution and diesel exhaust
what metastatic advanced diseases are there for lung cancer?
- bone pain
- spinal cord compression (limb weakness, paraesthesia, bladder/ bowel dysfunction)
- cerebral metastases (headache, vomiting, dizziness, ataxia, focal weakness)
- thrombosis
what paraneoplastic advanced diseases are there for lung cancer?
- hyponatraemia (SIADH)
- anaemia
- hypercalcaemia (parathyroid hormone related protein, bone metastases)
- dermatomyositis/ polymyositis (proximal muscle weakness)
- Eaton/ Lambert syndrome (upper limb weakness)
- cerebellar ataxia
- sensorimotor neuropathy
what clinical signs are there for lung cancer?
chest signs, clubbing, lymphadenopathy, Horner’s syndrome, Pancoast tumour, SVC obstruction, lymphadenopathy, hepatomegaly, skin nodules (metastases)
what are the initial investigations for lung cancer (by GP)?
CXR, FBC, renal, liver functions and calcium, clotting screen, spirometry
what “tissue diagnosis” investigations are there for lung cancer?
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
what is a bronchoscopy?
looking down the airways with a bronchoscope
what is an EBUS?
scanning outside the airways using a scan which goes down into the bronchi
what factors does staging take into account?
diameter, invasion, atelectasis (partial or total lung collapse), nodules
what characterises a T1 tumour?
under 3cm, no invasion, lobar bronchus
what characterises a T2 tumour?
3-7cm, lobar atelectasis or obstructive pneumonia to hilus
what characterises a T3 tumour?
> 7cm, whole lung atelectasis, invasion of chest wall, diaphragm, mediastinal pleural, pericardium, nodules in the same lobe