Lung Cancer Flashcards

1
Q

What are the features of small cell carcinoma

A

ACTH, siADH (linked with hyperdiuresis and hyponatraemia)

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2
Q

How do you treat small cell lung cancer?

A

4 x chemo + radiotherapy

May use PCT and palliative RT as well

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3
Q

Where can small cell carcinomas metastasise to?

A

Brain

May need PCI and steroids (ompeprazole)

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4
Q

What are some other characteristics of small cell carcinoma?

A

29 days doubling time
Central
Low HB
Lambert Eaton Syndrome (antibodies against Ca2+ channels)

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5
Q

Who is adenocarcinoma regularly seen in?

A

Non-Smokers

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6
Q

What are the translocations and mutations that lead to adenocarcinoma?

A

EGFR, BRAF, HER2 mutations
ALK/ROS1 translocations

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7
Q

What is treatment for adenocarcinoma?

A

Surgery

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8
Q

What is the histolgical pattern of adenocarcinoma?

A

Glandular pattern, mucin

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9
Q

What is the characteristics of squamous cell carcinoma?

A

Linked with male smokers
PTHr (parathyroid) -

Hypercalcemia - signs are polyuria, polydipsia, constipation

Cavitation is also indicative histologically

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10
Q

What are the characteristics of large cell carcinoma?

A

Associated with smoking
Highly anaplastic/undifferentiated

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11
Q

Side effects of chemo?

A

Risk of neutropenic sepsis

Bone marrow suppression

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12
Q

Side effects of radiotherapy?

A

Short term

Legarthy
Osephagitis
SOB due to PNEUMONITIS

Long term:

Pulmonary fibrosis
Oseophageal structure, cardiac issues

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13
Q

When is chemoradiotheapy + prophylactic carnival irradiation used?

A

SCLC

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14
Q

When do you use Sterotactic ablative radiotherapy

A

If not fit for surgery and T <= 4cm

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15
Q

When do you go palliative with chemo?

A

Co morbidity or advanced disease (stage 3/4) is present
- bone metastasis
- cord compression
- haemoptysis

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16
Q

When is immunotherapy used?

A

Palliative - PDL1 inhibitor nivolumab

1st line if PDL1 score > 50 %

Side effects > anything itis. - give steroids

Used if patient not as fit for Nivolumab

17
Q

When is TKI used?

A

Palliative option for adenocarcinoma with driver mutation - ALK/ EGFR / ROS1/ KRAS

Suitable if unfit for chemo