Lung cancer

Question 1

RF for lung cancer

Answer 1

Smoking / passive smoking
Occupational exposure - arsenic, asbestos, coal, silica
Age
Family history

Question 2

Where does lung cancer usually metastasise to?

Answer 2

Lymph nodes
Brain
Bones
Liver
Pleura
Adrenal glands

Question 3

Which cancers metastasis to the lung?

Answer 3

Bladder
Breast
Colon
Kidney
Prostate
Sarcoma

Question 4

What is mesothelioma and what is it caused by

Answer 4

Cancerous tumour arising from the mesothelium (lining of organs) causes by asbestos exposure

Question 5

Mesothelioma management

Answer 5

12 month life expectancy
- treatable symptoms but not treatable condition

Question 6

Sx and clinical signs of lung cancer

Answer 6

Cough
Haemoptysis
Breathlessness
Weight loss
Fatigue
Appetite loss
Ches pain
Chest infections

Clinical signs
- DVT
- finger clubbing
- lymphadenopathy
- cachexia
- thrombocytosis

Question 7

Ix for lung cancer

Answer 7

Urgent 2ww referral if chest X ray suggests lung cancer of mesothelioma or if aged over 40 with haemoptysis

Chest X ray - first line
CT scan with contrast to identify location and size of cancer
PET scan - shows active cancer cells
Bronchoscopy - see airways
Biopsy - classify tumour and lymph nodes for metastastes
Blood - thrombocytosis, anaemia, liver and kdiney function

Question 8

TNM staging for cancer

Answer 8

T - size of tumour
N - spread to lymph nodes
M - metastases

Question 9

Lung cancer management

Answer 9

Surgery - depending on location
Radiotherapy
Chemotherapy
Immunotherapy
Palliative care

Question 10

Side effects and long term complications
of radiotherapy

Answer 10

Fatigue
Nausea
Loss of appetite
Skin discolouration
Hair loss

Long term complications
- pericarditis
- oesophageal stricture
- chronic radiation pneumonitis
- spinal cord damage

Question 11

Side effects of chemotherapy

Answer 11

Nausea
Vomiting
Diarrhoea
Weight loss
Fatigue
Bleeding
Hair loss
Neutropenia - sepsis