Lung Cancer Flashcards
Epidemiology
Lung
Leading cause of cancer death.
Male/female ratio 1:1.
Etiology
Lung
Significant tobacco exposure. Smoking causes 87% LC.
Radon (2nd).
Occupational exp (tar, nickel, arsenic, chromium).
Pollution.
Carina vertebral level
T4-T5
Mediastinum components
Heart
Thymus
Great vessels
Clinical presentation
Local disease
Lung
Cough
Hemoptysis
Dyspnea
Chest pain
Clinical presentation
Regional disease
Lung
Dysphagia
SVCO
Hoarseness
Pancoast tumor
Pain in shoulder and arm
Atrophy of hand muscles
Horner’s syndrome
Bone erosion of ribs
Horner’s syndrome
Ipsilat miosis
Ptosis
Enophthalmos
Anhydrosis
Detection
Lung
Chest x-ray CTdirected PFNA Sputum cytology Bronchoscopy Mediastinoscopy
Pathology
Lung
Adenocarcinoma (40%)
SCC (30%)
SCLC (20%)
Mets
Lung
Liver Brain Bones Adrenal glands Kidneys Contralat lung
Chemo
Lung
Cisplatin and VP-16 for SCLC
PCI
Lung
SCLC
Adenocarcimoma
Doses
Lung
SCLC 45-54Gy
NSCLC 60-70Gy
OAR
Lung
SC 45Gy
Heart 45Gy
Normal lung 15Gy whole
Acute side effects
Lung
Dermatitis Erythema Esophagitis Dysphagia Cough Dry throat Excessive mucus secretions
Dysphagia occurs at what dose
30Gy
Chronic SE
Lung
Dry unproductive cough
Fibrosis of lung and skin
Pneumonitis
Pneumonitis symptoms
Dyspnea
Fevers
Night sweats
Cyanosis
WBC level pt cannot be treated
2 000/mm^3 or less
Platelet level pt cannot be treated
50 000/mm^3 or less
Doxorubicin (Adriamycin) SE
Cardiac toxicity
Lung ca not associated with smoking
Adenocarcinoma
