Lung Cancer Flashcards
What are the 3 main risk factors for lung cancer?
Smoking
Asbestos inhalation
Pollution
How are lung cancers denoted?
Small cell (SCLC)
Non-small cell (NSCLC)
What paraneoplastic effects are associated with small cell lung cancer?
Excessive/Ectopic ACTH secretion, resulting in Cushing’s Syndrome.
Synthetic inappropriate ADH secretion (SIADH) - leads to hyponatraemia.
Which form of lung cancer has the worst prognosis?
Small cell lung cancer.
This is due to rapid progression (metastasises early).
Where are small cell lung cancers seen?
Centrally
What are the forms of NSCLC?
Adenocarcinoma (35%)
Squamous cell carcinoma (30%)
Large cell carcinoma (10%)
Which lung cancers are found peripherally?
Adenocarcinoma
Large cell carcinoma
What type of NSCLC is linked with smoking most commonly?
Squamous cell carcinoma
Which type of NSCLC is associated with parathyroid hormone related protein (PTHrP) release?
Squamous cell carcinoma - produces hypercalcaemia.
What is adenocarcinoma associated with?
Asbestos exposure.
This form is more likely to occur in non-smokers as a result.
What are the most common sites of lung cancer metastasis?
Brain
Liver
Adrenal
Bone
What is Lambert-Eaton syndrome?
A disorder of neuromuscular transmission causing muscle weakness.
It may be a paraneoplastic syndrome.
What is hypertrophic pulmonary osteoarthropathy (HPOA)?
A condition causing joint stiffness and severe ankle/wrist pain.
It is a paraneoplastic syndrome.
What is a paraneoplastic syndrome
An immune response to a cancer - results in disease elsewhere in body.
What is a typical presentation of lung cancer?
Cough lasting 3 weeks or more
Dyspnoea
Haemoptysis
Chest/Shoulder pain
Unexplained weight loss
What is Pancoast’s tumour?
When a tumour in the lung apex infiltrates the brachial plexus, causing Horner’s syndrome (miosis, ptosis and anhidrosis).
A terminal diagnosis.
Invasion of what structure causes a hoarse voice?
Recurrent laryngeal nerve
What is used to diagnose a lung cancer?
CXR - better for central forms
CT-guided biopsy - good in peripheral disease
Aspirate analysis of pleural fluid/lymph nodes may aid diagnosis
PET scan used to investigate metastases
How is small cell lung cancer treated?
Chemotherapy and/or radiotherapy.
How are non-small cell lung cancers treated?
In the case of peripheral cancers (e.g. large cell and adenocarcinoma) surgery can be used to excise tumor.
In squamous cell carcinoma, chemotherapy and/or radiotherapy is indicated.
