Lung Cancer

Question 1

What are the common examination findings?

Answer 1

Inspection - Cachexic, tachypnoeic, muscle wasting

Hands - Tar staining, clubbing (muscle wasting if pancoast)

Neck - Raised JVP or lymphadenopathy

Face - Horners

Chest:

Increased TVF over mass

Dull percussion over mass

May have wheeze or crackles

Question 2

What are the investigations?

Answer 2

By the bed - History, obs, peak flow, spirometry and sputum, cardiovascular exam

Bloods - FBC, CRP, U/E for SIADH, Bone profile for SCC

Other - CXR, ECG,ABG, CT/biopsy for staging

Question 3

What are the key investigation findings?

Answer 3

CXR - Mass

Sputum - Malignant cells

Bloods may show what type of tumour it is

Question 4

What is the treatment?

Answer 4

Conservative - Explain what it is and the need for MDT management - Physios, OT, GP, Consultant

Stop smoking

Medical - Radiotherapy and chemo if SCLC

Surgical - Resection if possible and NSCLC

Question 5

What are the causes

Answer 5

Smoking

Asbestos

Industrial expossure

Question 6

Where does lung cancer metastatise to??

Answer 6

Bone

Brain

Liver

Adrenals