Lung Cancer Flashcards
Risk factors
Smoking Cooking fumes Asbestos Radon COPD
Types of lung cancer
Squamous - 30%
Adenocarcinoma 40% - smoking
Large cell lung cancer
Small cell lung cancer - most aggressive
Development
Hyperplasia Squamous metaplasia Dysplasia Carcinoma in situ Invasive carcinoma
Symptoms
Weight loss Cough Breathless Hemoptysis Fatigue Chest pain
Metastatic features
Seizures Bone pain Hypercalaemia Cachexia Clubbing Pemberton's sign
Imaging
X ray
Staging CT
PET to exclude occult metastases
Biopsy
Bronchoscopy for tumours of central airway where staging not important
Endobronchial ultrasound and transbronchial needle aspiration of mediastinal lymph nodes
CT guided lung biopsy for peripheral lung tumours
Patient fitness WHO calssification
0 - asymptomatic 1 - symptomatic and ambulatory 2 - symptomatic and <50% bedbound 3 - symptomatic and >50% bedbound 4 - bedbound 5 - dead
Radical treatment only 0-2
Treatment
Lobectomy and lymphadenectomy for early stage
Sublobar resection if stage 1
Radical radiotherapy as alternative if surgery too risky
Systemic treatments
Metastatic with targetable mutation - tyrosine kinase inhibitor
No mutation, PDL1 positive - immunotherapy alone
No mutation, PDL1 negative - chemo and immuno
Also palliative
