Lung Cancer

Question 1

Risk factors for lung Cancer

Answer 1

1. Smoking
2. Asbestos - main cause of mesothelioma
3. Randon Gas
4. Other Chemicals - Aluminum, Cadmium, Chromium, Arsenic, Nicket, Diesel
5. Lung disease
6. Miscellaneous - HIV, genetics, ionising radiation

Question 2

Histopathological Varieties of Lung Cancer

Answer 2

• Small cell carcinoma
• Non-small cell carcinoma / lung cancer
  
  • Squamous
  • Adenocarcinomas
  • large cell anaplastic

Question 3

What is the most common histopathological variety of cancer

Answer 3

Adenocarcinoma - not always related to smoking

Question 4

Clinical Features due to local growth

Answer 4

Cough

Pain

Haemoptysis

Dyspnoea

Wheeze

Question 5

CXR finding in cancer

Answer 5

• Mass or mass like lesion with irregular border with or without cavitation
• solitary pulmonary nodule
• hilar and/or medistinal adenopathy
• presistent lung collapse
• presistent large pleural effusion
• lymphagitis
• regional skeletal abnormalities

Question 6

Role of CT in Lung Cancer

Answer 6

• indentifying lesion for biopsy
• should include liver, adrenals, supravlavicular nodes

Question 7

Role of PET scan in lung cancer

Answer 7

• important is diagnosis and staging
• false negative and positives

Question 8

System used for staging of lung cancer

Answer 8

TNM staging system

• T = tumour descriptor
  
  • size, spread, location
• N = nodal description
  
  • N0-N3
  • N1 = hilar
  • N2 = ipilateral medistinal or subcarinal node involvement
  • N3 = contralateral hilar or medistinal node or ipsilater or contralateral supravlavicular node
• M = Metastatic description

Question 9

Mangement of lung Cancer

Answer 9

1. Surgery
2. Radiotherapy with a curitive intent
3. Pallative radiotherapy
4. Chemotherapy
5. Combination radiotherapy with chemotherapy
6. Palliative mangement
   
   • symptom relief
   • supportive
   • palliative chemotherapy and radiotherapy
   • multidisciplinary approach

Question 10

Indications for sugery in lung cancer

Answer 10

• Localised disease
• Stage 1 or 2 in absence of contraindications
• Consider adjuvant chemotherpy in complete resected tumour
• Consier adjuvant radiotherapy in positive surgical margins

Question 11

Contraindications of surgery in lung cancer

Answer 11

• Mediastinal involvement
• Pleural involvement
• Pericardial involvement
• Extrapulmonary involvement