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Respiratory System > Clinical Features & Staging of Lung Cancer > Flashcards

Clinical Features & Staging of Lung Cancer Flashcards

1
Q

What are the risk factors associated with lung cancer?

3+

A
  • smoking
  • passive smoking
  • environmental factors:
    asbestos, radon, air pollution, diesel exhaust
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2
Q

What are the local pressure effects of lung cancer?

A
  • chronic coughing
  • SOB
  • wheeze
  • chest and bone pain
  • haemoptysis
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3
Q

What is a local pressure effect?

A

a symptom caused directly by the lung cancer (opposite of a systemic effect).

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4
Q

What are the main symptoms of lung cancer?

10

A
  • chronic cough (>3 weeks)
  • wheeze
  • haemoptysis
  • chest and bone pain
  • recurrent chest infection
  • difficulty swallowing
  • raspy, hoarse voice
  • SOB
  • unexplained weight loss
  • nail clubbing
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5
Q

What are the symptoms of metastases to the bones?

A

bone pain

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6
Q

What are the symptoms of compression on the spinal cord by a tumour?

(3)

A
  • limb weakness
  • paraesthesia
  • bladder/bowel dysfunction
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7
Q

What are the symptoms of cerebral metastases?

5

A
  • headache
  • vomiting
  • dizziness
  • ataxia (lack of voluntary coordination of muscle movements)
  • focal weakness
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8
Q

what may lung tumour metastases cause in the CVS?

A

thrombosis

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9
Q

What are paraneoplastic syndromes?

A

Clinical syndromes involving nonmetastatic systemic effects that accompany malignant disease.

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10
Q

What are some paraneoplastic effects of lung cancers?

4

A
  • hyponatraemia
  • hypercalcaemia
  • anemia
  • sensorimotor neuropathy
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11
Q

What are the clinical signs of lung cancer?

8

A
  • Chest signs
  • Clubbing
  • Lymphadenopathy
  • Horner’s syndrome
  • Pancoast tumour
  • SVC obstruction
  • Hepatomegaly
  • Skin nodules (metastases)
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12
Q

What are the initial investigations carried out for lung cancer?

(5)

A
  • CXR
  • FBC: Ca, Renal & Liver function
  • Clotting screen
  • Spirometry
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13
Q

Why is a FBC carried out if lung cancer is suspected?

A

to check for anaemia

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14
Q

Why is a renal function carried out if lung cancer is suspected?

A

good renal function is essential for a contrast CT to be carried out

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15
Q

Why is a calcium test carried out if lung cancer is suspected?

A

in lung cancers calcium levels are often elevated (bone metastasis)

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16
Q

What is the investigation carried out after an abnormality is discovered on the CXR?

Why is it done?

A

CT or PET CT scan

to stage the cancer

17
Q

Outline the investigations done after the CT scan for tissue diagnosis?

(9)

A
  • Bronchoscopy
  • EBUS
  • Image guided lung biopsy
  • Image guided liver biopsy
  • fine-needle aspiration(FNA) of neck node or skin metastasis
  • Excision of cerebral metastasis!
  • Bone biopsy
  • Mediastinoscopy/otomy
  • Surgical excision biopsy
18
Q

What is the most common type of lung cancer?

A

adenocarcinoma

19
Q

What is the second common type of lung cancer?

A

small cell carcinoma

20
Q

What type of lung cancer has the best prognosis?

A

adenocarcinoma

21
Q

In which stage does a tumour invade other tissues?

A

T3

22
Q

What is characteristic of a T1 tumour?

2

A
  • no invasion

- lobar bronchus

23
Q

In TNM staging, what does M0 mean?

A

distant metastasis absent

24
Q

In TNM staging, what does M1 mean?

A

distant metastasis present

25
Q

In TNM staging, what does N1 mean?

A

involvement of ipslateral hilar/peribronchial nodes

26
Q

In TNM staging, what does N0 mean?

A

no nodal involvement

27
Q

In TNM staging, what does N2 mean?

A

involvement of ipslateral mediastinal/subcarinal nodes

28
Q

How does a PET scan show up ‘hot spots’?

A

cancer cells take up the glucose AND the isotope

29
Q

What is radical treatment of lung cancer?

A

treatment with the intent to cure

30
Q

What is palliative treatment?

A

treatment with the intent to improve quality of life, not cure.

31
Q

What must be taken into account before treatment is started?

4

A
  • performance status
  • patient’s wishes
  • histological type and stage
  • the aims of treatment, radical or palliative
32
Q

What is a performance status of 0?

A

fully active

33
Q

What is a performance status of 1?

A

symptoms but ambulatory

34
Q

What is a performance status of 2?

A

up and about for >50% of the day but unable to work

35
Q

What is a performance status of 3?

A

up and about <50% of the day and limited self care

36
Q

What is a performance status of 4?

A

bed or chair bound

37
Q

What is important to bear in mind when discussing cancer diagnosis with patieint?

A
  • pragmatic, open
  • no false promise
  • empathy
38
Q

What surgical treatment options are considered in lung cancer?

(3)

A
  • wedge resection
  • lobectomy
  • pneumonectomy

Respiratory System (26 decks)

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