Lung Cancer Flashcards
What are the presenting symptoms of lung cancer?
Haemopytosis Recurrent Pneumonia Stridor Chronic cough Weight loss
What can cause invade locally?
Recurrent laryngeal nerve Pericardium Oesophagus Brachial Plexus Pleural cavity Superior Vena cava
What are signs of a superior vena cava obstruction?
Puffy eyelids and headache
Distension of superficial veins
What are symptoms of local invasion to the recurrent laryngeal nerve?
Hoarse voice
What are symptoms of local invasion to the pericardium?
Breathless
Atrial fibrillation
Pericardial effusion
What are symptoms of local invasion to the Oesophagus?
Dysphagia
What are signs that the brachial plexus has been invaded?
Wasting of small muscles of the hand
Due to T1 infiltration
This is called a pancoast tumour
What are common sites of metastases ?
Liver brain Bone Adrenal Skin Lung
What are sign of cancer infiltration to the brain?
May Mimic stroke Visual distrubance headaches - worse in morning No photophobic Fits
What are signs of bone infiltration in cancer?
Pathological fracture
What parneoplastic features are associated with lung cancer?
Finger clubbing Hypertrophic Pulmonary Oestoarthropathy - tenderness of long bones near the adjacent joints Weight loss Thrombophlebitis Hypercalaemia Hyponatraemia Weakness - Eaton lambert syndrome
What investigations should be done for lung cancer?
FBC Spirometry CXR CT scan PET scan Bronchoscopy
How can you make a tissue diagnosis?
Bronchoscopy
CT guided biopsy
Endobronchial ultrasound - enable vision of mediastinal and hillier structures
Position emission Tomography (PET) - scan to asses the function of the tumour. Analysis of tissue uptake of radio labelled glucose
What ectopic hormone production is related to squamous cancer?
Parathyroid hormone
What ectopic hormone production is related to small cell cancer?
Adrenocorticotropic hormone
Histologically what characterises squamous carcinoma?
production of Keratin by cells
In immunohistochemistry what antigen is found in small cell lung cancer and adenocarcinoma?
TTF - 1 (Thyroid transcription factor)
What are the genetic abnormalities in SCLC?
Oncogene: MYC
Tumour suppressor P53, Rb, 3p
What are the genetic abnormalities in NSCLC?
Oncogene: K-ras, EGFR
What is often the mutation in adenocarcinomas?
K -ras mutation
What cancer is related to smoking?
Adenocarcinoma
What is Gefitinib and what is its use?
Tyrosine kinase inhibitor - shows activity in NSCLC patients
What is a carcinoid neoplasm?
A neuroendocrine neoplasms with low grad malignancy
What cancer is related to asbestos?
Mesothelioma - mainly
Bronchial carcinoma
What types of non-small cell cancers are there?
Adenocarcinoma
Squamous cell
What is the treatment for SCLC?
Chemotherapy
What is the treatment for NSCLC?
Surgery
Radical chemotherapy/Radiotherapy
What surgery options are there for lung cancer?
Pneumonectomy (removal of whole lung)
Lobectomy (removal of a lobe of lung)
