Lung Flashcards
What genes are related to non small cell lung cancer?
ALK gene overexpression
EGFR gene mutation
What are the respiratory red flags?
Persistent cough Haemoptysis SoB Chest pain Persistent or recurrent chest infections
What age is the highest peak of lung cancer?
80-84
What are the lung cancer risk factors?
Smoking including passive Previous radiotherapy to chest Occupational exposure: asbestos, acetaldehyde, formaldehyde etc Family Hx Germ line mutations
Where does small cell lung cancer tend to occur?
Arises in the large airways therefore more centrally
What percentage of lung cancers are small cell?
20
What paraneoplastic syndromes can occur with small cell lung cancer?
Cushings - ACTH
SIADH - ADH
Which is the commonest non small cell lung cancer?
Squamous cell carcinoma
How does SCC lung tend to present?
Obstructive lesion of bronchus leading to repeated infections
Where in the lungs does adenocarcinomas tend to occur?
Peripherally
Or in scar tissue
How do most lung Ca patients present?
Persistent cough
Describe the T staging for lung cancer
0 carcinoma in situ
1 <3cm surrounded by lung or visceral pleura
2 >3cm or in main bronchus
3 of any size invading chest wall, diaphragm or parietal pleura
4 of any size invading mediastinum, heart, great vessels, trachea etc
How is local lung cancer treated?
Lobectomy or pneumonectomy
Adjuvant chemotherapy
How is locally advanced lung cancer treated?
Chemotherapy and radiotherapy
How is metastatic lung cancer treated?
Chemotherapy
Cushing’s as a paraneoplastic Syndrome comes from which type of cancer?
Small cell lung
SIADH as a paraneoplastic syndrome comes from which type of cancer?
Small cell lung
And non small cell lung
Hypercalcaemia due to raised PTHrp arises from which cancer type?
Squamous cell lung
How long after asbestos exposure do you get mesothelioma?
20-50 years
What would a CXR of mesothelioma snow?
Thickened, nodular, irregular pleural based mass
What investigations are needed for mesothelioma?
Bloods CXR CT Pulmonary function tests Biopsy
Pulmonary function tests would show what pattern of disease in mesothelioma?
Restrictive
What is the management of mesothelioma?
Surgery (some patients)
Supportive - analgesia, cough suppressant, Abx
RT for mets
Pleural drainage
What is the 5 year survival for mesothelioma?
5%
What is the 5 year survival lung cancer?
9%
What percentage of lung cancers are due to smoking?
80-90%
