Lung Cancer

Question 1

Lung Cancer

Answer 1

Leading cause of death in men and women

Question 2

smoking

Answer 2

85% of lung cancer patients smoke
3% are non smokers
40 carcinogens in cigrette smoke
Benzoapyrene is potent carcinogen

Question 3

Radon Gas

Answer 3

Second most common cause of lung caner

Question 4

lung cancer

Answer 4

10-25x higher in smokers than non smokers

Question 5

smoking trends

Answer 5

No decrease in smoking has been observed in ages 18-24

leading cause of death and disability

Question 6

formaldehyde and ammonia

Answer 6

free basing agents causing high levels of nicotine to occur which increase addiction

Question 7

Alpha 4 and beta2

Answer 7

nicotine increase the # of these receptors and remodels the brain stem
nicotine addiction occurs in the brain stem due to increase in

Question 8

dopamine

Answer 8

release from Alpha4 and Beta2 Receptors

Question 9

children of smoking mothers

Answer 9

increase chance of a smoking addiction
born with remodelled brain stems
addiction driven by brain stem not voluntary

Question 10

NSCC

Answer 10

Adenocarcinoma
-Brochoalveolar cell carinoma
Squamous cell carinoma
Large cell carminoma

Question 11

Adenocarcinoma

Answer 11

Forms GLANDULAR structures arise from lung scars
30 to 35% of all lung cancer
MOST COMMON CANCER

Question 12

Brochoalveolar cell carcinoma

Answer 12

Type of Adenocarcinoma
15% of adenocarcinomas
Unique histologic+clinical presentation
isolated nodule or multiple shadows
resectable (if localized)

Question 13

Squamous cell carinoma

Answer 13

accounts for 30% of bronchogenic carcinoma
composed of flattened or polygonal stratified epithelial cells
form intercellular bridges and elaborate keratin

Question 14

Bronchogenic carcinoma

Answer 14

squamous cell carcinoma

large cell carcinoma

Question 15

squamous cells carinoma

Answer 15

arises from areas of damaged epithelium and are prone cavitation

Question 16

large cell carcinoma

Answer 16

15 to 20% of bronchogenic carcinoma
pleomorphic cells, enlarged nuclei, abundant cytoplasm
usually large, aggressive behavior, peripheral lesion
metastasize widely

Question 17

pancoast tumor

Answer 17

slow growing 
late metastasising
right apex of lung common
non specific plural thickening
squamous followed by large cell

Question 18

small cell bronchogenic carcinoma

Answer 18

20 to 25% of primary lung cancer
common pulmonary stem cell
80% centrally located
spreads into mediastinallymph nodes

Question 19

small cell carcinoma (prognosis)

Answer 19

13% for 5 years same for 30 years
median survival is 10 months
40 to 70% 5 yr survival for stage 1a

Question 20

TMN staging

Answer 20

T-Status of the primary tumor
N-local and regional lymph node involvement
M-presence of metastasis

Question 21

Screening

Answer 21

A tumor nodule has to be 3 to 5 mm before its visible on X-ray,
A solitary pulmonary nodule is a focal lesion seen on x-ray

Question 22

Chest ct

Answer 22

major imaging modality for lung cancer

more sensitive then X-ray to detect calcification, satellite nodules, direct extension of tumor, lymph node enlargement

Question 23

PET

Answer 23

assesses metabolic activity of soft tissue
function of tissue rather then anatomy
more sensitive+specific than CT for staging the mediastinum + distant metastasis

Question 24

MRI

Answer 24

Not better then CT for evaluating pul nodules or mediastinal metasteses
more expensive

Question 25

MRI

Answer 25

better to show chest wall invasion

Question 26

image-guided percutaneous transthoracic needle aspiration

Answer 26

(95% diagnostic)

Question 27

mediastinal lymph nodes

Answer 27

30-44% of all cancer patients

mediastinoscopy

Question 28

5 year survival

Answer 28

stage 1 60-70%

stage 2 30-50%

Question 29

Endoscopic photodynamic therapy

Answer 29

uses a hematophorphyrin derivative injected into the blood, which is activated y direct exposure to a special light source being placed in the airway to create oxygen radicals that locally destroys tumor tissue

Question 30

Radiation therapy

Answer 30

an effective form of primary treatment in early stages NSCC who are medically inoperable

Question 31

Chemotherapy

Answer 31

not used as a primary form of treatment for NSCC except in advance cases
Used in treatment of SC lung cancer