Lung cancer Flashcards
Define lung cancer
Primary malignant neoplasm of the lung
WHO classification of lung cancer
2
Bronchocarcinoma –>
Small cell lung cancer - 20%
Non small cell lung cancer - 80%
Aetiology of lung cancer
4
Smoking
Asbestos exposure
Other occupational exposure - polycyclic hydrocarbons, nickel, radon
Atmospheric pollution
Epidemiology of lung cancer
prevalence, gender
Most common FATAL cancer in the west (18% of cancer mortality worldwide)
3x more common in males
Presenting symptoms of lung cancer
general + 3 causes
May be ASYMPTOMATIC
Due to:
- primary
- local invasion
- metastatic disease or paraneoplastic involvement
Presenting symptoms of lung cancer - due to primary
4
Cough
Haemoptysis
Chest pain
Recurrent pneumonia
Presenting symptoms of lung cancer - due to local invasion
5
Brachial plexus invasion —> shoulder/arm pain
Left recurrent laryngeal invasion —> hoarse voice & bovine cough
Dysphagia
Arrhythmias
Horner’s syndrome
Presenting symptoms of lung cancer - due to metastatic disease or paraneoplastic phenomenon
(4)
Weight loss
Fatigue
Fractures
Bone pain
Signs of lung cancer on physical examination
4
May be NO SIGNS
Fixed monophonic wheeze (suggesting there’s single obstruction)
Signs of lobar collapse or pleural effusion
Signs of metastases (e.g. supraclavicular lymphadenopathy or hepatomegaly)
Investigations for lung cancer
4 types
Diagnosis
Staging
Bloods
Pre op
Investigations for lung cancer - diagnosis
5
CXR Sputum cytology Bronchoscopy w/ brushings or biopsy CT/US guided percutaneous biopsy Lymph node biopsy
Investigations for lung cancer - staging
2
Requires CT/MRI of head, chest & abdomen
PET scans may also be useful
Investigations for lung cancer - bloods
5
FBC U&Es Calcium (hypercalcaemia common) ALP (raised w/ bone mets) LFTs
Investigations for lung cancer - pre op
2
ABG
Pulmonary function tests
