Lung Cancer

Question 1

What is the most common type of lung cancer?

Answer 1

NON small cell = 70 - 80 %
1. Adenocarcinoma
2. Squamous cell carcinoma
Small cell carcinoma = 20% - prognosis poor

Question 2

Name eight symptoms arising from local tumour effects with lung cancer?

Answer 2

Hoarse voice (RLN compression)
Haemoptysis
Cough (persistant/worsening)
SOB
Chest pain (bone/pleura involvement)
Unilateral wheeze
Shoulder pain (referred from diaphragm)
Dysphagia

Question 3

What type of tumour can lead to Horner’s syndrome and what are the clinical findings?

Answer 3

Pan-cost tumour

1. Meiosis (constricted pupil)
2. Anhydrosis
3. Partial Ptosis
4. Enepthalmous

Question 4

With mets - which two sets of lymph nodes are most commonly affected with lung tumour?

Answer 4

Cervical
Supraclavicular
Affected in 30% of patients

Question 5

Mets can affect bones and lead to hypercalcaemia - Describe the clinical features of hypercalcaemia?

Answer 5

Moans - (GI stuff - pain/LOA)
Bones - pain and ache
Stones - renal stones and flank pain
Psychic groans - confusion/psuedo-dementia/memory loss

Question 6

O/E of a patient with suspected lung carcinoma - what features may indicate pancost syndrome?

Answer 6

Wasting of the arms and hands

Question 7

O/E and Hx of a patient with suspected lung carcinoma - what features may indicate SVCO?

Answer 7

Fullness of face
SOB
Headaches

Question 8

Name five investigations to be completed aside from bloods?

Answer 8

CXR
CT - TMN staging
Bronchoscopy
EBUS
Spirometry