Lung cancer Flashcards
What % of lung cancer is caused by smoking?
90% in men and 80% in females
Where do lung cancers commonly metastasise to?
brain, nodes, pericardium, liver, adrenals and bone
How are lung cancers classified?
Small cell carcinoma- 12%, these derive from neuroendocrine tissue
Non small cell carcinoma, subtypes of which are:
- squamous cell carcinoma (40%)
- adenocarcinoma (35%)
- large cell carcinoma (5%)
The remaining 5% are rarer such as carcinoid tumours.
What are the signs and symptoms of primary lung cancers?
- Cough lasting longer than 3 weeks
- dyspnoea
- wheeze
- haemoptysis
- lung infections
- chest/ shoulder pain
- weight loss
- malaise
- clubbing, anaemia, consolidation, pleural effusions may also be seen in some cases
Most will not present with symptoms until they’re quite advanced
What symptoms may lung cancer metastasis cause?
- bloated face (SVC obsturction)
- voice hoarseness
- dysphagia
- bone fractures
- CNS symptoms
How is lung cancer investigated and diagnosed?
CXR
CT scan
PET CT, head CT and pelvic CT to look for mets
Bronchoscopy and needle biopsy to confirm cancer and type
How are small cell carcinomas treated?
- 20-25% operable
- chemo and radiotherapy may improve symptoms but unlikely to be curative
- some immunotherapies may help
How is non small cell carcinoma treated?
- very few operable
- chemo and radiotherapy more likely to be curative
- some immunotherapies are starting to emerge
What is the prognosis like for lung cancer?
Very poor- picked up so late
What type of cancer may cause SIADH?
Small cell tumours can secrete ADH related peptide, causing hyponaturaemia and water retention
What type of cancer may cause cushings syndrome?
small cell carcinomas may also release ACTH related peptide, increasing cortisol release. It is also broken down in excess to a- MSH, which increases melanin production and causes hyperpigmentation, normally seen in addisons
What paraneoplastic syndrome can squamous cell carcinoid tumours cause?
Hyperparathyroidism- as they can release PTHrp, which increases calcium release and causes hypercalcaemia.
Hypercalcaemia may also be due to bone mets, which are osteolytic.
How can a lung cancer cause horners syndrome?
impinges on sympathetic trunk in neck
How can a lung cancer cause a hoarse voice?
if it impinges on the left recurrent laryngeal nerve, causing paralysis of the left vocal cords.
