Lung Cancer Flashcards
LC accounts for what percentage of cancers diagnosed?
14%
LC is more common in what gender?
Men
What is the median age of diagnosis with lung cancer?
70
What is the prognosis of diagnosis with LC?
80% die within 1 yr.
5% alive after 5 years.
What causes lung cancer?
Smoking: >90% of cases.
Length of time spent as a smoker is more important than number of cigarettes per day.
Stopping smoking immediately reduces the risk. after 15 yrs non-smoking: same risk as that of non-smoker.
Other than smoking, what are the other risk factors for smoking?
Passive smoking, asbestos exposure, radon gas exposure, previous lung disease or family history of lung cancers.
What are the two types of LC?
Small cell lung cancer: 15%
Non-small cell lung cancer: 85%.
How do SCLCs and NSCLCs differ in terms of cells?
SCLC: Small cells, uniform.
NSCLC: Several different types: squamous cell, adenocarcinoma, large cell.
How do SCLCs and NSCLCs differ in terms of surgery for treatment?
SCLC: limited role for surgery.
NSCLC: surgery is used more often.
How do SCLCs and NSCLSs differ in terms of response to chemo?
SCLCs: responds well to chemo and radio therapy.
NSCLCs: Less responsive to chemo.
What are the main attributes of SCLCs?
15% total cases of LC. Cells small and uniform. Aggresive tumours. Usually metastatic at diagnosis. Surgery has a limited role. Responds well to chemo + radiotherapy however. Overall survival 5-10% at 5 years.
What are the main attributes of NSCLCs?
Make up 85% of diagnosed cases.
Several different types: squamous, adenocarcinoma, large cell. Surgery is an option more often, less responsive to chemo: metastasises to the brain, liver and bones.
How does LC typically present?
No symptoms in the early stage.
Symptoms are usually due to tumour causing pressure, pain or obstruction.
What are the typical presentation symptoms of LC?
Persistent chronic cough. SOB/Wheezing (dyspnoea) Haemoptysis - coughing up blood. Chest/Shoulder/Back pain. Weight loss Fatigue.
What percentage of patients will have metastatic disease at presentation?
> 50%
What type of LC is less responsive to chemo?
NSCLC
Surgery used more often.
Most common type.
Early LC can be mistaken for what?
COPD
Early LC can often be diagnosed on routine:
Chest X-Ray.
What are the main diagnostic tests for LC? [5]
- CXR
- Bronchoscopy/biopsy.
- Sputum cytology.
- CT scan (to assess suitability for surgery & sites of common metastases: Liver)
- Lung function tests to establish baseline condition.
What type of LC is less responsive/not treated with surgery?
SCLC.
Better response to chemo/radio
LC treatment is primarily determined by what?
The staging:
- size of tumour + location
- Invasive/not
- How many lymph nodes (if spread)
What are the two different stages of SCLC?
One of them accounts for 30% of cases, the other for the remaining 70%.
Limited stage disease: 30%.
The cancer is confined to one side of the chest & involved lymph nodes can be treated with radiotherapy.
Extensive stage disease: 70% - cancer has metastasised to distant organs.