deck_1502664 Flashcards
Describe incidence of lung cancer in men
• Commonest male cancer• Mortality around 100 per 100,000• Incidence falling slowly due to reduction in smoking
Describe incidence of lung cancer in females
• Exceeds breast cancer as a cause of death in women• Mortality rate around 40 per 100,000 • Incidence rising
How does incidence of lung cancer vary according to socioeconomic group?
• Wide variation• Rate three times higher in lowest compared with highest
What is the main risk factor for lung cancer?
• Smoking • 90% lung cancers in men 80% lung cancer in women
Give four aeitological factors which influence lung cancer
• Asbestos exposure• Radon exposure• Genetic factors • Dietary factors
What are the main signs and symptoms of lung cancer?
• Relatively non-specific
What are the main symptoms of a primary lung cancer tumour?
• Cough• Dyspnoea• Wheezing • Haemoptysis • Chest pain • Post-obstructive pneumonia • Weight loss • Lethargy/malaise
What are the main four symptoms of regional mestastases?
• Superior vena cava obstruction • Hoarseness (left recurrent laryngeal nerve palsy)• Dypnoea (phrenic nerve palsy)• Dysphagia
What are the main two symptoms of distant metastases
• Bone pain/fractures• CNS symptoms (headache, double vision, confusion)
What is paraneoplastic syndrome?
• Presence of a symptom or a disease due to the presence of cancer in the body, but not due to the local presence of cancer cells
What are the symptoms of paraneoplastic syndrome mediated by?
• Humoral factors (hormones and cytokines) secreted by tumour cells, or the immune response against tumour cells
What are the four main categories of paraneoplastic syndrome?
• Endocrine• Neurological• Skeletal• Haematological
Give two diseases which occur as an endocrine result of paraneoplastic syndrome
• Hypercalcaemia• Cushing’s syndrome
Give two disease which occur as a neurological result of paraneoplastic syndrome
• Encephalopathy• Peripheral neuropathy
Give a skeletal disease which occurs as a result of paraneoplastic syndrome
• Finger clubbing
Give three diseases which occur as a a haemotolofical result of paraneoplastic syndrome
• Anaemia• Throbocytopenia • Disseminated Intravascular Coagulation
What are two other diseases which can come about as a result of paraneoplastic syndrome?
• Nephrotic syndrome• Anorexia or Cachexia
What occurs when lung cancer is first suspected in a patient in terms of investigations
○ Plain chest x-ray
What are three scans used for diagnosis and staging
• CT scan • PET scan• Isotope bone scan
What are the two staging systems for lung cancer?
• NumberTMN
What is a stage 1 cancer?
• Small cancer, localised to one area of the lung
What is a stage 2 and 3 cancer?
• Larger cancer, may have grown into surrounding tissues
What is stage 4 cancer?
Cancer has metastasised
What is the TMN staging system (Outline T, M and N) ?
• T - Size and position of tumour • N - Lymph node involvement• M - Metastases
