Lung Cancer Flashcards
What are the 3 main types of lung cancer?
Squamous cell carcinoma
Adenocarcinoma
Small cell lung cancer
Which type of lung cancer is associated with smoking?
Squamous cell lung cancer
What is the most common type of lung cancer?
Adenocarcinoma
What is the most common type of lung cancer in non-smokers?
Adenocarcinoma
What are the main signs that would indicate lung cancer?
- Persistent cough
- Haemoptysis
- Unintentional weight loss
- Hoarse voice
- Dyspnoea
What are some possible signs you might find on examination?
- Fixed, monophonic wheeze
- Supraclavicular lymphadenopathy or persistent cervical lymphadenopathy
- clubbing
What lymphadenopathies might occur with lung cancer?
Supraclavicular lymphadenopathy
Persistent cervical lymphadenopathy
What features are associated with adenocarcinoma?
- Gynaecomastia
* Hypertrophic pulmonary osteoarthropathy
What features are associated with squamous cell carcinoma?
- Hypertrophic osteoarthropathy
- Clubbing
- Parathyroid hormone-related protein secretion causing hypercalcaemia,
- Hyperthyroidism due to ectopic TSH
What features are associated with small cell lung cancer?
- Usually central
- ADH → hyponatraemia
- ACTH → Cushing’s syndrome
- Lamberton Eaton syndrome (weakness of limbs)
- Hyponatraemia
What endocrine abnormalities are associated with squamous cell carcinoma?
- Parathyroid hormone-related protein secretion causing hypercalcaemia,
- Hyperthyroidism due to ectopic TSH
What endocrine abnormalities are associated with small cell lung cancer?
- ADH → hyponatraemia
* ACTH → Cushing’s syndrome
What is the main feature of a Pancoast tumour?
Hoarseness of voice- supresses recurrent laryngeal nerve
What is a hoarse voice due to?
Suppression of the recurrent laryngeal nerve
How is a Pancoast tumour diagnosed?
CT chest
What is the first line investigation if you suspect lung cancer?
Chest x-ray
What imaging would you use to investigate suspected lung cancer?
Contrast CT
What is the investigation for getting a histological diagnosis?
Bronchoscopy with EBUS and biopsy
What is the is a PET scan used for in someone with small cell lung cancer?
To establish eligibility for curative treatment
What does a PET scan for small cell lung cancer use?
Uses 18-fluorodeoxygenase
What imaging is used to investigate for metastasis?
PET-CT
When would you refer someone urgently for a chest x-ray? (within 2 weeks)
If they are over 40 with
• persistent or recurrent chest infection
• finger clubbing
• supraclavicular lymphadenopathy or persistent cervical lymphadenopathy
• chest signs consistent with lung cancer
• thrombocytosis
What might you find in the blood of someone with lung cancer?
Thrombocytosis- excess platelets
What percentage of non-small cell lung cancer is suitable for surgery?
20%
What is usually done before surgery for non-small cell lung cancer and why?
Mediastinoscopy-CT doesn’t always show mediastinal lymph node involvement
What is the alternative to surgery for non-small cell lung cancer?
Curative or palliative radiotherapy
What has no effect in the management of small cell lung cancer?
Chemotherapy
What is the management of small cell lung cancer in the early stages?
Surgery (needs to be very early stages)
Why is surgery not normally done for small cell lung cancer?
Because small cell lung cancer is diagnosed late
What is usually used in the management of small cell lung cancer?
Chemotherapy and radiotherapy
What are possible contraindications for lung cancer surgery?
- SVC obstruction
- FEV < 1.5
- MALIGNANT pleural effusion
- Vocal cord paralysis
How common is lung cancer?
Third most common cancer behind breast and prostate
Wha percentage of lung cancer is caused by smoking?
80%
What syndromes is small cell lung cancer responsible for?
Paraneoplastic syndromes
How is small cell lung cancer responsible for paraneoplastic sydromes?
Small cell lung cancer cells contain neurosecretory granules that can release neuroendocrine hormones
What type of cavittaing lesions are now commonly seen in squamous cell carcinoma?
Cavitating lesions
