Lung Cancer Flashcards
How many deaths a year are there from lung cancer?
35000
What is the 5 year survival rate of those diagnosed with lung cancer?
8%
What is the most common cause of lung cancer?
Smoking
Is the risk of lung cancer proportional to the amount smoked?
Yes
Genetically at a cellular level how does smoking lead to lung cancer?
Carcinogens in smoke cause multiple mutation in epithelial cell DNA which accumulate
Multiple hits eventually leads to cell cycle regulation loss
The mutated cells being dividing uncontrollably
What are the key symptoms of lung cancer?
Cough Haemoptysis Chest pain Breathlessness Weight loss (key sign) Hoarseness of voice Wheeze Swollen face
What are the metastatic symptoms of lung cancer?
Bone pain
Headaches-neurological fits
Jaundice
What is the most aggressive form of lung cancer?
Small cell carcinoma
What are the characteristics of small cell carcinoma of the lungs?
Large tumours
Quick growing
Often metastasised before diagnosis
What are the 3 types of non small cell lung cancer?
Large cell carcinoma
Adenocarcinoma
Squamous cell carcinoma
What are common sites of metastasis of lung cancer?
Liver Bone Brain Adrenal glands Skin
What 3 zones is the lung divided into?
Upper
Middle
Lower
What is a pulmonary mass?
Opacity in lung over 3cm with no mediastinal adenopathy or atelectasis
What is a pulmonary nodule?
Opacity in lung up to 3cm with no mediastinal adenopathy or atelectasis
What does a tissue sample of mass in lung allow?
Histology to help stage the sample and diagnose the type of lung cancer
What does the identification of the stage of the cancer allow?
A prognosis and treatment to be outlined
What does TNM stand for?
Tumour size and position
Nodes
Metastases (has the tumour spread anywhere else in the body)
How is T in TNM classified??
T1-4
How is N in TNM classified?
N1-3
How is M in TNM classified?
M0-1
What are some of the other causes of lung cancer?
Asbestos
Occupational
What % of smokers get lung cancer?
10%
What is small cell carcinoma usually called by?
Smoking
Why is lung cancer called ‘clinically silent’?
Because there are no symptoms for ages
Why does lung cancer have such a bad prognosis?
Because by the time the symptoms normally appear the cancer is in too late a stage and the patient will normally die
What is a PET-CT?
Radiolabelled glucose is injected into the body.
Rapidly dividing cells (tumour cells) will use the most glucose
This allows us to see distant metastasis
What are the signs of lung cancer?
Finger clubbing Stridor Signs of consolidation Pleura effusion Cervical lymphadenopathy
What is the most preventable form of lung cancer?
Lung cancer
What initial investigations are done for suspected lung cancer?
CXR FBC Renal, liver functions and calcium Clotting screen Spirometry
What does N0 mean?
No regional node involvement
What does M0 mean?
Distant metastasis absent
What does M1 mean?
Distant metastasis present
What treatment options are available for lung cancer patients?
Surgery
Radiotherapy
Chemotherapy
Palliative care
What does palliative management involve?
Symptom control
Quality of life
Community support
Decisions and planning, resuscitation status, end of life care
Multidisciplinary team including lung cancer nurse and hospice
Is lung cancer easy to treat?
No it is very difficult
Where does the cancer have to start in order to be a primary lung cancer?
In the lung
Give examples of inherited oncogene mutations which increase the likelihood of lung cancer
KRAs
EGRF
BRAF
HER2
What % of lung cancers are large cell?
10%
What % of lung cancers are adenocarcinoma?
27%
What % of lung cancers are squamous cell carcinoma?
35%
What CXR signs may indicate lung cancer?
Hilar vascular structure defined? Is the costophrenic angle sharp? Is the trachea central? No widening mediastinium Lesions? Pleural effusion? Are the lungs inflated? Or is there pneumothorax present
