Lung Cancer Flashcards
Which, small cell or non-small cell lung cancer is more aggressive and has a worse prognosis?
Small cell lung cancer
Define a “high risk” individual who needs to be screened annually for lung cancer
Age 55-74, with 30+ pack year history
if former smoker, have quit within 15 years
Symptoms (4) related to the distant metastasis of lung cancer, and which is most common?
- Anorexia, weight loss, and fatigue are most common
- Bone metastasis
- Liver metastasis
- Brain metastasis
What must be checked before deciding to use immuno/chemotherapy in a lung cancer patient without a targetable mutation?
Check PS (patient strength) score to see if they can tolerate immuno/chemotherapy
Non-smoking women from this region have the highest chance of getting lung cancer
Asia
How does immunotherapy (broadly) help treat cancer?
Blocks PD1/PDL1 and allows body’s T cells to recognize and kill cancer cells
Is lung cancer in non-smokers more common in men or women
Women
What is the number one cause of cancer deaths worldwide?
Lung cancer
Definition of a “never smoker”
Less than 100 cigarettes in a persons lifetime
Treatments for stage 3 non-small cell lung cancer and how is treatment path determined?
Early/resectable
- Surgical resection + perioperative chemo/immunotherapy
Advanced/unresectable
- Chemoradiation followed by consolidation immuno/targeted therapy
Screening method used for lung cancer in high risk patients
Annual low-dose CT
Treatments for stage 1-2 of non-small cell lung cancer and how is the treatment path determined?
- Surgical resection if PFTs confirm patient can tolerate it
- Perioperative chemo/immunotherapy to prevent recurrence from micro-metastases
Describe the four stages of non-small cell lung cancer
Stage 1 = lung nodule
Stage 2 = + lymph node metastasis
Stage 3 = larger tumor and more lymph nodes
Stage 4 = Distant metastasis or both lungs involved + pleural effusion
The main thing that is required to confirm a diagnosis of lung cancer
Tissue biopsy
Symptoms (4) related to the intra-thoracic spread of lung cancer
- Hoarseness
- Pericardial effusion
- Pleural effusion
- SVC syndrome (headache, red head, big veins)
Number one risk factor for lung cancer
Cigarette smoking
Treatments for stage four non-small cell lung cancer
- Un-resectable, no surgery
- Systemic treatments
- Radiation only for symptom relief (brain mets)
Which is more common, small cell or non-small cell lung cancer?
Non-small cell (87% of lung cancers)
How is small cell lung cancer staged?
- Limited = confined to one area of the body that can be treated with localized radiation
- Extensive = spread beyond a localized area
Gene mutation associated with lung cancer in non-smokers
EGFR
Symptoms (7) related to the primary lesion in lung cancer
- Cough (endobronchial erosion/irritation)
- Sputum production
- Dyspnea
- Hemoptysis
- Chest pain
- Unilateral/localized wheezing/stridor
- Weight loss
Paraneoplastic syndromes of lung cancer
- Digital clubbing
- Hypercalcemia
- Ectopic hormone production
SIADH = hyponatremia
ACTH = Cushing’s
HCG = gynecomastia - Neurologic syndromes
Eaton-Lambert, peripheral neuropathy
Types of non-small cell lung cancer and which is most common?
Non-squamous
- Adenocarcinoma (most common, and leading lung cancer in non-smokers)
- Large cell carcinoma
Squamous
What does TNM staging in lung cancer stand for?
T = Tumor size in lung
N = lymph Node involvement
M = Metastasis around the body
