Lung Cancer Flashcards
what are the symptoms of cancer?
cough - a long standing cough that gets worse
breathlessness - many patients with lung cancer also have COPD
haemoptysis
chest pain
wheeze
hoarseness
dysphagia
nerve compression
puffy eyelids and headache
what causes the breathlessness?
large tumours occluding airways
what causes chest pain?
peripheral tumours invading the chest wall
what causes hoarseness?
mediastinal, nodal or direct tumour invasion of the mediastinum results in compression of the recurrent laryngeal nerve
what causes dysphagia?
invasion of the phrenic nerve/ oesophagus
what 4 things may people present with ?
primary tumour
local invasion
metastases
non-metastatic
- paraneoplastic
what are the symptoms you get from primary tumour?
haemoptysis
recurrent pneumonia
stridor
breathlessness
what causes the recurrent pneumonia ?
tumour causing partial obstruction of an airway results in post-obstructive pneumonia
what symptoms may you get from local invasion
hoarseness
pericardium local invasion
- breathlessness
- atrial fibrillation
- pericardial effusion
oesophagus
- dysphagia
brachial plexus
what may happen because of invasion to the brachial plexus ?
may get pancoast tumour in the apex of the lung which may invade the brachial plexus causing C8/T1 palsy with small muscle wasting in the hand and weakness as well as pain down the arm.
what may happen because of invasion of the pleural space?
pleural effusion
what may happen because of invasion of the superior vena cava ?
- obstructs drainage of blood from the arms and head
- leads to a distended external jugular vein
- patients may present with puffy eyelids and a headache
what may happen as a result of SVC obstruction?
anastamoses to inferior vena cava - the blood flow is bypassing the obstructed SVC by opening up anastamoses with the IVC tributaries
where are the common sites of metastases for bronchial carcinomas?
mediastinal, cervical and even axillary or intra-abdominal nodes
liver
brain
bone
adrenal glands
what are the symptoms of liver metastases?
anorexia, nausea and weight loss
pain across abdomen
what are the symptoms of brain metastases?
- presentation due to raised intra-cranial pressure
- weakness - may mimic a stroke but develops slowly unlike stroke
- visual disturbance
- headaches
- fits - if the metastases involved the cortex
what are the symptoms of bone metastases?
localised pain which is worse at night
- pathological fracture
what are the characteristics of headaches from metastases?
worse in the morning
not photophobic
what do you know if someone presents with a sore arm and you know it is cancer?
that it is not curable
what are the non-metastatic features of lancer?
finger clubbing
- hypertrophic pulmonary osteoarthropathy
- weight loss
- weight loss
- thrombophlebitis
- hypercalcaemia
- hyponatraemia
- weakness
- Ectopic hormone production
why do people get thrombophlebitis?
increased coagulability of cancer patients
why do people get hypercalcaemia?
results from the tumour producing a substance which mimics the effects of a parathyroid hormone.
what are features of hypercalcaemia?
Headaches, thirst and constipation
why do people get hyponatraemia?
may result from the production of a substance which mimics ADH.
