Lung cancer

Question 1

Define lung cancer?

Answer 1

Growth of abnormal cells that start in one or both lungs

Two types:
- small-cell lung cancer (80%)
- non-small cell lung cancer (20%)

Squamous cell carcinoma
Adenocarcinoma -most common

Question 2

Presentation of lung cancer?

Answer 2

Persistent cough >3/12
Haemoptysis
Dyspnoea
Wheezing
Chest pain
Cough
SOB
Recurrent infection
Smoking
Weight loss
n+v
Recurrent pneumonia
Lymphadenopathy – often supraclavicular nodes

Question 3

Diagnosis/IVx of lung cancer?

Answer 3

CT scan for staging -CONFIRM DIAGNOSIS

CXR
- nodules
- lung collapse
- pleural effusion (unilateral)
- consolidation
- bony metastases
- Peripheral opacity (a visible lesion in the lung field)
- hilar enlargement

Sputum cytology
Bronchoscopy

Endobronchial US transbronchial needle aspiration (biopsy of lymph nodes, lung lesions)

Question 4

Management of lung cancer?

Answer 4

Small cell:
- palliative chemo/radiotherapy

Non-small cell:
- lobectomy
- curative radiotherapy

Question 5

Referral suspected 2ww for lung cancer?

Answer 5

CXR suggests lung cancer
OR
age ≥40 with unexplained haemoptysis

Question 6

Urgent CXR 2ww for lung cancer criteria?

Answer 6

age ≥40 with:

Persistent or recurrent chest infection.
Finger clubbing.
Supraclavicular lymphadenopathy or persistent cervical lymphadenopathy.
Chest signs consistent with lung cancer.
Thrombocytosis.