Lung Cancer Flashcards
What cancer causes the most deaths in the UK in both genders?
Lung cancer
Risk factors of lung cancer
- Smoking
- Asbestos exposure
- Radon exposure
- Family history
- Airflow obstruction
- Occupational carcinogens
Types of lung cancers
Non small cell lung cancers
Small cell lung cancers
Types of non small cell carcinomas
Squamous cell carcinoma
Adenocarcinoma
Large cell carcinoma
What are small cell lung cancers characterised by?
Rapid growth
Tendency to metastasise
Poor survival rates
Staging of lung cancer
TNM staging
Symptoms of patient with lung cancer
Cough
Dyspnoea
Haemoptysis
Recurrent lung infections
Wheeze
Weight loss
Hoarse voice
Malaise
Chest/shoulder pain
Signs of patient with lung cancer
- finger clubbing
- cachexia
- horners syndrome
- consolidation
- muffled heart sounds
- hepatomegaly
- skin metastases
- pale conjunctiva
- cervical lymphadenopaty
What is cachexia?
Weakness + wasting of body
Due to chronic illness
What is Horner’s syndrome?
Triad of:
Miosis
Anhidrosis
Partial ptosis
What type of tumour is Horner’s syndrome associated with?
Pancoast tumours
At very top of lungs
Compress sympathetic nerve pathways in neck
Diagnostic tests of lung cancer
- bloods: FBCs, U&Es, calcium, LFTs, INR
- CXR
- staging CT: spiral CT thorax + supper abdomen
- CT guided biopsy
- PET scan
Prognosis of lung cancer
- generally poor
- usually already metastasised by the time symptoms arise
What is mesothelioma?
Cancer of the pleura
What is the main risk factor for mesothelioma?
Asbestos exposure
List 5 molecular markers of lung cancer
EGFR
ALK
RAS
PD1
PDL1
Outline performance status of lung cancer
- 0: no symptoms + normal activity level
- 1: symptomatic but able to do normal daily activities
- 2: symptomatic but in bed/chair <half day with some assistance for daily activities
- 3: symptomatic + in bed/chair >1/2 day
- 4: bedridden
- 5: dead
What type of lung cancer is most commonly associated with non smokers?
Adenocarcinoma (NSCLC)
What are some paraneoplastic syndromes in small cell lung cancers?
- SIADH + abnormal water retention due to abnormal release of ADH
- Cushing’s syndrome: due to abnormal release of ACTH
- Eaton-Lambert syndrome: body attacks neuromuscular junctions > myasthenia gravis
What are some paraneoplastic syndromes in non small cell lung cancers?
squamous cell carcinoma:
- humeral hypercalcaemia of malignancy due to release of PTHrP > stimulates PTH receptors
.
adenocarcinomas:
- hypertrophic pulmonary osteoarthropathy: triad of serositis, finger clubbing + arthropathy of large joints
What are the 3 ectopic secretions possible from lung cancer?
What does this cause?
- ACTH > Cushing’s syndrome (SSLC)
- ADH > SIADH (SSLC)
- PTH related peptide > raised PTH > hypercalcaemia (NSSLC - squamous cell carcinoma)
How can tissue sampling be obtained for lung cancer staging?
CT biopsy
Bronchoscopy
US guided biopsy
Treatment of lung cancer
- surgery (for NSCLC)
- radiotherapy: radical or palliative
- chemotherapy: radical, neoadjuvant or adjuvant
- palliative care
- combination of chemo + radio
- biological targeted therapies: based on mutation
Types of chemotherapy for lung cancer
- radical
- neoadjuvant: chemo before surgery
- adjuvant: chemo after surgery (only if <stage 2)
What are the two most common types of lung cancers?
Squamous cell carcinomas
Adenocarcinomas
(Both NSCLC)
What are molecular markers?
A biological molecule found in the body that is a sign of a normal or abnormal process, or of a condition or disease
What is a possible game changer for cancer therapy?
Biological (targeted) treatment
Based on mutational analysis
