lung cancer

Question 1

how common is lung cancer?

Answer 1

the 4th most common in Ireland after prostate, breast and colorectal

Question 2

list some risk factors for lung cancer?

Answer 2

-smoking -80% of cases
-air pollution
-occupational hazards
-genetics
-links to COPD, CF , head and neck cancer

Question 3

what are the symptoms of lung cancer?

Answer 3

-cough lasting more than 3 wks
-haemoptysis (coughing up blood)
-dyspnoea (SOB)
-unexpected weight loss
-fatigue
-pain in chest/ shoulder/ bones

Question 4

what are further tests that confirm lung cancer diagnosis?

Answer 4

-MRI
-lung biopsy
-PET scan
-isotope bone scan (imaging used to detect fractures, tumours etc)

Question 5

what are the treatment options for lung cancer?

Answer 5

-chemotherapy
-radiotherapy
-surgery - lobectomy (lobe of lung removed)

Question 6

what are other complications associated with a lung tumour/ cancer?

Answer 6

-pleural effusion
-pneumothorax
-rib fracture
-cough issues

Question 7

name the 3 types of lung cancer

Answer 7

-non small cell lung cancer NSCLC
-small cell lung cancer SCLC
-mesothelioma

Question 8

describe NSCLC

Answer 8

-most common (4/5 cases)
-squamous cell carcinoma, adenocarcinoma, large cell carcinoma etc

Question 9

describe NSCLC staging

Answer 9

stage 1 - invasion of underlying lung tissue but no spread to lymph nodes
stage 2- spread to neighbouring lymph nodes or invaded chest wall
-stage 3A- spread to lymph nodes in mediastinum
-stage 3B- local spread
-stage 4- metastatic spread

Question 10

describe the treatment for NSCLC for stage 1

Answer 10

-stage 1 often removed w/ surgery
-if patient is not fit for surgery, RT used
-chemo

Question 11

how is stage II treated?

Answer 11

-can also be possible to remove w/ surgery
- radiotherapy used If pt not suitable for surgery
-may also be given chemo

Question 12

how is stage III treated?

Answer 12

-surgery often not possible
-chemo sometimes combined w/ RT

Question 13

how is stage IV treated?

Answer 13

-spread to other parts of body or affects more than 1 lobe of lung
-radiotherapy may be used to shrink cancer & reduce symptoms / relieve pain
-aim is to maintain the QOL as best as possible

Question 14

describe small cell lung cancer

Answer 14

-1/5 lung cancers
-staged diff from NSLCLC

Question 15

explain limited vs extensive SCLC

Answer 15

limited: cancer is confined to 1 lung and to its neighbouring lymph nodes
extensive: cancer has spread beyond 1 lung and nearby lymph nodes, may have invaded both lungs, other organs or more remote lymph nodes

Question 16

describe the Rx for SCLC

Answer 16

-most SCLC have spread beyond the lungs by time of diagnosis
-surgery usually not option
-most effective treatment is chemo, alone or in combo w/RT

Question 17

what is a mesothelioma?

Answer 17

-the mesothelium is a thin layer of tissue that surrounds internal organs
-mesothelioma is a cancer that affects this lining, it is common in the mesothelium of the lungs
-at advanced stages of disease it may spread / metastasise

Question 18

what is the physiotherapy treatment for lung cancer patients?

Answer 18

-NB pt becomes gradually reconditioned through disease and treatment
-often treatment w/ chemo regimen
-may need O2 therapy
-mobility may decline due to SOB
-may need education re activity tolerance

Question 19

what’s the difference between neoadjuvant chemo and adjuvant chemo?

Answer 19

1. neoadjuvant chemo - given before the main Rx eg surgery - goal is to shrink the tumour before
2. adjuvant chemo - given after the treatment eg surgery - primary goal is to eliminate any cancer cells that cant be moved surgically or are undetectable