Lung Cancer

Question 1

How common is lung cancer?

Answer 1

The most common type of cancer in Scotland and third most common in UK.

  - >45,000 new cases per year
  - rates of lung cancer in Scotland are among the highest in the world
  - most common cause of cancer death in men & women in Scotland (90% incurable at time of diagnosis)

Question 2

List some general features of ‘cancer’.

Answer 2

• malignant growth
• uncontrolled replication
• local invasion
• metastasis- secondary cancer
  - lymphatic spread
  - blood stream
  - serous cavities
• non-metastatic systemic effects

Question 3

What symptoms should be watched out for to detect lung cancer early? i.e. symptoms someone might go to the GP with

Answer 3

• cough for 3 weeks/more
• feeling breathless for no reason
• chest infection that doesn’t clear up
• coughing blood
• unexplained weight loss
• chest or shoulder pains
• unexplained tiredness or lack of energy
• hoarse voice
• stridor

Question 4

List some of the areas a lung tumour can invade?

Answer 4

• Recurrent laryngeal nerve
• Pericardium
• Oesophagus
• Brachial plexus
• Pleural cavity
• Superior vena cava

Question 5

What is the carina?

Answer 5

The part of the trachea that splits into two bronchi

Question 6

What is stridor?

Answer 6

Stridor= distressing symptom of difficulty breathing in.

Description= having a rope gradually tighten around your neck

Presentation= coarse audible wheeze during inspiration

NB: almost all other forms of airways disease produce an expiratory wheeze & symptoms of difficulty breathing out

Question 7

Have i finished these flashcards?

Answer 7

NO go to Week 3, 03 Clinical Aspects of Lung Cancer to get images that show how certain symptoms arise

Question 8

What symptoms would arise from a tumour invading the pericardium?

Answer 8

Breathlessness
Arterial fibrillation
Pericardial effusion

Question 9

What symptoms would arise from a tumour invading the oesophagus?

Answer 9

Dysphagia

difficulty in swallowing

Question 10

What symptoms would arise from a pancoast tumour?

Answer 10

A pancoast tumour can invade the brachial plexus which can cause weakness in the hand on that side of the body.
The wasting of the small muscles of the hand is due to T1 root infiltration by a primary lung cancer in the apex of the lungs.

Question 11

What symptom arises from a tumour invading the pleural space?

Answer 11

Tumour invades pleural space –> build-up of vol. of pleural fluid –> breathlessness

Question 12

What symptoms arise from a tumour invasion of superior vena cava?

Answer 12

• Puffy eyes
• Headache
• Distension of the superficial veins
• Distended veins on abdomen and thorax
• Normal pulsation is lost

Question 13

Explain the symptoms associated with a tumour invasion of the SVC.

Answer 13

• prevents drainage of blood from arms and head
• distended veins on abdomen & thorax
  - blood flow is bypassing obstructed SVC by opening up anastamoses with Inferior Vena Cava tributaries

Question 14

What symptoms are associated with chest wall invasion by lung cancer?

Answer 14

• localised chest pain, worse with movement

- when there’s bone erosion patient will often say pain is worse at night

Question 15

What are the common site for metastases associated with lung cancer?

Answer 15

• liver
• brain
• bone
• adrenal
• skin
• lung