Lung Cancer Flashcards
Lung Cancer
Leading cause of death in men and women
smoking
85% of lung cancer patients smoke
3% are non smokers
40 carcinogens in cigrette smoke
Benzoapyrene is potent carcinogen
Radon Gas
Second most common cause of lung caner
lung cancer
10-25x higher in smokers than non smokers
smoking trends
No decrease in smoking has been observed in ages 18-24
leading cause of death and disability
formaldehyde and ammonia
free basing agents causing high levels of nicotine to occur which increase addiction
Alpha 4 and beta2
nicotine increase the # of these receptors and remodels the brain stem
nicotine addiction occurs in the brain stem due to increase in
dopamine
release from Alpha4 and Beta2 Receptors
children of smoking mothers
increase chance of a smoking addiction
born with remodelled brain stems
addiction driven by brain stem not voluntary
NSCC
Adenocarcinoma
-Brochoalveolar cell carinoma
Squamous cell carinoma
Large cell carminoma
Adenocarcinoma
Forms GLANDULAR structures arise from lung scars
30 to 35% of all lung cancer
MOST COMMON CANCER
Brochoalveolar cell carcinoma
Type of Adenocarcinoma 15% of adenocarcinomas Unique histologic+clinical presentation isolated nodule or multiple shadows resectable (if localized)
Squamous cell carinoma
accounts for 30% of bronchogenic carcinoma
composed of flattened or polygonal stratified epithelial cells
form intercellular bridges and elaborate keratin
Bronchogenic carcinoma
squamous cell carcinoma
large cell carcinoma
squamous cells carinoma
arises from areas of damaged epithelium and are prone cavitation
large cell carcinoma
15 to 20% of bronchogenic carcinoma
pleomorphic cells, enlarged nuclei, abundant cytoplasm
usually large, aggressive behavior, peripheral lesion
metastasize widely
pancoast tumor
slow growing late metastasising right apex of lung common non specific plural thickening squamous followed by large cell
small cell bronchogenic carcinoma
20 to 25% of primary lung cancer
common pulmonary stem cell
80% centrally located
spreads into mediastinallymph nodes
small cell carcinoma (prognosis)
13% for 5 years same for 30 years
median survival is 10 months
40 to 70% 5 yr survival for stage 1a
TMN staging
T-Status of the primary tumor
N-local and regional lymph node involvement
M-presence of metastasis
Screening
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
Chest ct
major imaging modality for lung cancer
more sensitive then X-ray to detect calcification, satellite nodules, direct extension of tumor, lymph node enlargement
PET
assesses metabolic activity of soft tissue
function of tissue rather then anatomy
more sensitive+specific than CT for staging the mediastinum + distant metastasis
MRI
Not better then CT for evaluating pul nodules or mediastinal metasteses
more expensive
MRI
better to show chest wall invasion
image-guided percutaneous transthoracic needle aspiration
(95% diagnostic)
mediastinal lymph nodes
30-44% of all cancer patients
mediastinoscopy
5 year survival
stage 1 60-70%
stage 2 30-50%
Endoscopic photodynamic therapy
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
Radiation therapy
an effective form of primary treatment in early stages NSCC who are medically inoperable
Chemotherapy
not used as a primary form of treatment for NSCC except in advance cases
Used in treatment of SC lung cancer
