Lung Cancer Flashcards
How common is lung cancer?
3rd most common cancer in the UK after breast an prostate.
How much lung cancer is thought to be preventable?
80%
What are the two main types of lung cancer?
Small cell lung cancer - 20%
Non small cell lung cancer - 80%
Within non small cell lung cancer, what are the classifications?
Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
Other types
What is the most common type of lung cancer?
Squamous cell carcinoma
Followed by adenocarcinoma
(Both non small cell lung cancers)
What are the risk factors of lung cancer?
Smoking Passive smoking Asbestos HIV organ transplant Radiation exposure
What are the general symptoms of lung cancer?
cough haemoptysis cachexia weight loss dyspnoea weight loss nausea vomiting chest pain anorexia finger clubbing anaemia
What are the lung signs?
Consolidation
Pleural effusion
Collapse
Which lymph nodes are most likely to be enlarged?
Supraclavicular (then axillary)
What sign does a pan coast tumour present with?
Horners syndrome - partial ptosis, myosis, anhidrosis.
Tumour presses on sympathetic ganglion.
Where is lung cancer most likely to spread to?
Brain
Breast
Bone
Adrenal gland
Via blood
What are the features of squamous cell carcinoma?
X-ray - can’t tell if its abscess or cancer
CT - shows jagged border proving its cancer
Local spread is common
Metastasis is late
Finger clubbing
Infections
What are the features of adenocarcinoma?
Caused by mucous secreting cells Metastasises to brain and bone Cause pleural effusion Can happen in non smokers and women Involves mediastinal lymph nodes Does not cavitate
What are the features of small cell cancer?
Presents with paraneoplastic syndromes
Poor prognosis
Spreads early
Usually inoperable at presentation
In which type of cancer is finger clubbing more common?
Non small cell cancer
When hoarse voice is a symptom, where is the tumour?
Pressing on the recurrent laryngeal nerve.
In diaphragm weakness, where is the tumour?
Causes dyspnoea.
Pressing on the phrenic nerve.
What are the signs of superior vena cava obstruction?
Facial swelling
Difficulty breathing
Venous swelling on face and neck
Facial swelling and cyanosis when raised hand
Medical emergency
What are common paraneoplastic syndromes?
Hyponatraemia - ectopic ADH
Cushing syndrome - ectopic ACTH
Addisons syndrome
Hypercalcaemia - ectopic parathyroid hormone
Most common in small cell cancers.
What is the referral criteria for an urgent chest x-ray (within 2 weeks)?
>40yrs Clubbing Supraclavicular lymphadenopathy Recurrent chest infections Raised platelets Chest signs of lung cancer
Which 2 key findings automatically mean an urgent referral for chest x-ray?
Finger clubbing
Supraclavicular lymphadenopathy
What are the investigations?
Chest x-ray
Staging CT
PET CT
Bronchoscopy with endobronchial ultrasound
What can be seen on chest x-ray?
Hilar enlargement Peripheral opacity Visible obstruction in lung field Pleural effusion (unilateral) collapse of lung tissue
How is a biopsy done?
Bronchoscopy
Percutaneous (through skin)
What is the usual treatment for small cell cancer?
Palliative chemotherapy
+ Radiotherapy
Which cancer has the worst prognosis?
Small cell cancer
What is the usual treatment for non small cell cancer?
1st line - Surgery - if in one place
2nd line - curative chemotherapy + radiotherapy
Chemo for disease control - if it can’t be treated
What are the types of surgery?
Segmentectomy
Lobectomy
Pneumonectomy
In an open thoracotomy, where is the cut most likely to be?
Posterolateral.
