Lung Cancer

Question 1

Lung cancer can be ____ or ____ in relation to the site of origin?

Answer 1

Primary or Secondary

Question 2

Is lung cancer largely aviodable?

Answer 2

Yes.

Question 3

What are the three most common sites of spread for lung cancer?

Answer 3

Bone, Liver, and Brain

Question 4

What is the common characteristic of the three most popular sites of metastasis?

Answer 4

They are highly vascularized organs/structures.

Question 5

Is Lung cancer aggressive, invasive, and meatstatic?

Answer 5

Yes.

Question 6

What are the four major types of primary Lung Cancer? What is the fifth major type? How can the four major types be further broken down and categorized?

Answer 6

Adenocarcinoma (30%), Squamous Cell Carcinoma (30%), Ig Cell Carcinoma (12%), Small Cell Carcinoma (22%). These four types can be divided into Non-Small-Cell Lung Cancer, and Small-Cell Lung Cancer, respectively.
The fifth major type makes up about 5% of primary cancer and is called “mixed-group”.

Question 7

What is the etiology of Lung Cancer?

Answer 7

Smoking (80%), Toxins, Genetic predisposition

Question 8

What is an example of a Lung Cancer causing toxin?

Answer 8

Asbestos

Question 9

What does it mean when there is a genetic disposition to Lung Cancer?

Answer 9

There is a trait amongst smokers which certain people are predisposed to lung cancer.

Question 10

What is a hilus?

Answer 10

A hilus is a point or area where blood vessels, ducts, nerve fibers enter or leave an organ.

Question 11

What is the pathophysiology of Squamous Cell Carcinoma?

Answer 11

Squamous Cell Carcinonma is a non-small cell cancer which arises in the central bronchi (Hilum) which spreads to hilar nodes. It is more common in men.

Question 12

What is a consequence if Squamous cell carcinoma occurs in the left lung/bronchi?

Answer 12

It can affect the heart, and lead to cardiac temponade.

Question 13

What is the pathophysiology of Adenocarcinoma?

Answer 13

Adrenocarcinoma is of peripheral origin occuring in the alveoli or bronchioles. It is common in women and non-smokers.

Question 14

What is the pathophysiology of Large Cell Carcinoma?

Answer 14

Large cell carcinoma is of peripheral origin occuring in the alveoli and bronchioles. It is characterized by large undifferentiated cells. It undergoes metasis early and has a poor prognosis.

Question 15

What is the pathophysiology of Small Cell Carcinoma?

Answer 15

This type of carcinoma is seen in smokers 99% of the time. It is aggressive, invasive, and has early metasis particularily to the brain. It is characterized by small oval cells which are non-resectable. Typically, small cell carcinoma has already undergone metasis at diagnosis. It is radiosensitive. Small cell carcinoma is also known to cause paraneoplastic syndrome.

Question 16

What does it mean when small cell carcinoma is non-resectable?

Answer 16

Non-resectable small cell carcinoma consists of small diffuse cells which have not formed a large mass. It consists of many tiny tumors, making surgical removal impossible.

Question 17

What is paraneoplastic syndrome?

Answer 17

Paraneoplastic syndrome is a consequence of cancer in which an ectopic tumour releases hormone-like substances leading to conditions such as Cushing’s Syndrome, and SIADH.

Question 18

What are the manifestations of Lung Cancer?

Answer 18

Manifestations will be based on the type and location, the extention and metasis, and if there are any paraneoplastic syndroms. Hemoptysis, Pain, and Cardiac manifestations may also present.

Question 19

What manifestations will be present is the Lung Cancer is central?

Answer 19

Centrally located lung cancer will impair ventilation and lead to coughing, wheezing, and dyspnea.

Question 20

What is hemoptysis?

Answer 20

The coughing up of blood.

Question 21

Why might pain present in lung cancer?

Answer 21

Pain could be due to inflammation, but the tumor also needs space, so it will push against other structures.

Question 22

How is lung cancer diagnosed?

Answer 22

Diagnosis is not difficult. First, respiratory infections must be excluded. History, Presentation will follow. Chest X-ray, US, CT, MRI. Bronchoscopy, needle biopsy and cytology.

Question 23

What is cytology?

Answer 23

Cytology is the examination of tissue samples from the body.

Question 24

What is treatments for Lung Cancer? How does treatment differ for NSCLC and SCLC?

Answer 24

Non-Small Cell Lung Cancer: Surgery, Radiation and Chemo.

Small Cell Lung Cancer: Chemo and Radiation

Question 25

What is the prognosis for lung cancer? Why?

Answer 25

Prognosis for lung cancer is poor. This is due to the fact that there is no screen for lung cancer, especially small cell lung cancer.