Lung Cancer

Question 1

What are the 2 types of Lung ca?

Answer 1

Small Cell (15%)
Non-small Cell (85%)

Question 2

What are the subtypes of NSCLC?

Answer 2

1. Adenocarcinoma (40%)
2. Squamous cell carcinoma
3. Large cell carcinoma

Question 3

In what part of the lung is Lung Adenocarcinoma usually located?

Answer 3

Peripheral regions

Increased occurrence d/t cigarette filters which cause deeper inhalation

Question 4

In what part of the lung is SCC usually located?

Answer 4

Central region of the lungs

Question 5

What is limited stage SCLC?

Answer 5

30% of SCLC cases
Located on 1 side /1 lung
Can include nodes above
Can be tx’d with 1 XRT portal

Question 6

What is extensive stage SCLC?

Answer 6

70% of SCLC cases
Mets outside of originating lung
Must be treated with >1 XRT field

Question 7

Characteristics of SCLC

Answer 7

More aggressive
Rapid doubling time
High growth fraction
Early, widespread mets 
Large hilar mass
Bulky CENTRAL adenopathy

Question 8

SCLC often presents with?

Answer 8

Paraneoplastic syndromes

• ACTH (cushings syndrome)
• ADH (hyponatremia )

Question 9

What is a Pancos tumor and presentation?

Answer 9

Also called superior sulkis tumor
High apical tumor; invades brachial plexus
1. Upper shoulder, back, chest pain
2. Facial weakness

Question 10

Treatment of NSCLC

Answer 10

Surgery
XRT
Chemo
Targeted therapy

Question 11

Types of surgery

Answer 11

Lobectomy
Pneumonectomy
Seg/Wedge
VATS

Question 12

Targeted Therapy types for NSCLC

Answer 12

EGFR (often present in adenocarcinoma)

VEGF (Avastin w/ chemo)

Question 13

Treatment for SCLC

Answer 13

Limited SCLC- Chemo and XRT
-better cure rate
Extensive SCLC-Chemo
-responsive but relapse is common
-cure is rare

Question 14

Common sites for metastasis of lung cancer

Answer 14

1. Regional nodes
2. Lung
3. Bone
4. Adrenal
5. Liver
6. Brain

Question 15

Lung cancer stats

Answer 15

1. 3mil diagnosed every year

1. 4mil deaths