Lung cancer Flashcards
How common is lung cancer?
Third most common cancer in the UK after breast and prostate
What is the biggest cause?
Smoking & ~80% of lung cancers are thought to be preventable
What are the different types of lung cancer?
Non-small cell lung cancer
- squamous cell (35%)
- adenocarcinoma (25%)
Small cell lung cancer SCLC (20%)
What do SCLC cells contain?
Neurosecretory granules which release neuroendocrine hormones which causes many paraneoplastic syndromes
What are the signs and symptoms of lung cancer
Haemoptysis (coughing blood) Cough Shortness of breath Recurrent pneumonia Finger clubbing Weight loss Lymphadenopathy - supraclavicular = first to be found on examination
What are the investigations in lung cancer?
Chest Xray Staging CT scan TAP FDG-PET-CT scan Bronchoscopy with endobronchial ultrasound Histological diagnosis
What is the first line investigation of suspected lung cancer and what would it show
Chest Xray
Hilar enlargement
Peripheral opacifications - visible lesions in the lung field
Pleural effusion - unilateral in cancer
Collapse - where the cancer is blocking a bronchus causing collapse of the lung lobe
Treatment options of non small cell lung cancer
MDT discussion
Surgery - first ling in non-small cell lung cancer - intention to cure
–> lobectomy is first line
other options: segmentectomy or wedge resection
Chemotherapy - adjuvant to improve outcomes or palliative to improve symptoms and quality of life
Radiotherapy in nonsmall cell lung cancer if diagnosed early enough
Treatment options of small cell lung cancer
Usually chemotherapy and radiotherapy
Prognosis is usually worse for small cell lung cancer
What is endobronchial treatment
Using stents/ debulking as part of palliative rx to relieve bronchial obstruction caused by lung cancer
What are the extrapulmonary manifestations/ paraneoplastic syndromes associated with lung cancer?
Recurrent laryngeal nerve palsy Phrenic nerve palsy Superior vena cava obstruction Limbic encephalitis Horner's syndrome SIADH Cushing's syndrome Hypercalcaemia Lambert-Eaton Myasthenic syndrome
