Lung cancer Flashcards
What is a targeted therapy used for non small cell carcinoma?
Osimertinib (JS on oncology ward/lady who lived by herself, didn’t smoke but had exposure in a pub)
Osimertinib side effects
Diarrhoea
Rash
Pneumonitis
Arrhythmias
Deranged liver function tests
How can you tell on a CT scan what an artery is?
Arteries follow the bronchial trees
CT can be timed so contrast is still in systemic circulation- timed within seconds.
Pulmonary veins are outside
Are thymomas malignant?
Yes all of them- however on a spectrum
1/3 of people will have myasthenia gravis
Thymectomy will not cure myasthenia gravis
Classifications for thymomas
- WHO staging
- TNM
- Masaoka-Koga
What is the Masaoka-Koga staging based on
The Masaoka-Koga Staging system is based on the local micro- and/or macroscopic invasion of the tumor and the presence of lymphogenous or hematogenous metastasis.
Are thymomas chemosensitive?
No- don’t grow that quickly. Doubling every day- no one would call them a thymoma.
What is the advantage of adjuvant over neo-adjuvant?
Neo-adjuvant you can measure the response
More likely to get complications from neo-adjuvant therapy
How do you know whether adjuvant has worked?
You can never really measure response
What percentage of lung cancer patients receive adjuvant therapy?
40% of patients eligible go onto receive it
What is the benefit of neo-adjuvant?
You can measure a response
More people can start it- not as many patients will be fit enough after surgery to have adjuvant therapy
Benefits of MRI of the thymus
Shows cystic vs normal thymic tissue
What part of the heart lights up on a PET scan?
Only the left ventricle- most metabolically active part of the heart
What is the most common site of metastasis from thymoma
Droplet metastasis to the pleura
Are all biopsies accurate?
30-40% of biopsies may not be accurate.
False negatives
What treatment is given to prevent a myasthenic crisis?
IV IG
Neutralises harmful antibodies: IVIG helps reduce the autoantibodies attacking the acetylcholine receptors, improving nerve-muscle communication.
Reduces inflammation: It blocks the immune system’s damaging actions, particularly by preventing complement system activation, which helps reduce muscle damage.
Provides short-term relief: IVIG quickly improves muscle strength, often used during severe symptoms or crises, but the effect is temporary, lasting weeks to months.
When do you get symptoms with lung cancer?
Advanced stages
Early stages of lung cancer- very asymptomatic
Important question to ask in a lung cancer history
Cannabis use- lung damage is a worse driver of emphysema than tobacco smoking
Vanishing lungs