Lung Cancer Flashcards
Symptoms of lung cancer
chronic cough Breathless Wheeze Stridor Haemoptysis (50%) Dysphagia Hoarse voice Chest pain Bone pain Neurology Anorexia Weight loss
Signs of lung cancer
Anorexia / weight loss
Clubbing
Tachypnoea
Signs of collapse / consolidation / effusion (fluid on lungs, outpouring of fluid)
Lymphadenopathy (inflammation of lymph nodes)
SVC obstruction
Horner’s syndrome (constricted pupil, drooping eyelid)
Signs from metastatic spread eg Neurological / bone pain etc
What tissue is affected?
all lung tissue, particularly bronchi
What are the two types of lung cancer?
Small cell
Non-small cell (NSCLC)
Which group most commonly has lung cancer?
Men > 65
What is Horner’s syndrome?
interruption of sympathetic nerve supply Miosis (constricted pupil) Partial Ptosis (drooping) Anhidrosis (loss of hemifacial sweating)
Why does lung cancer cause Horner’s syndrome?
Tumours at the top of the lung (Pancoast tumours) press on brachial nerve plexus, sympathetic supply to the eye (like Burke in Gray’s except he doesn’t have Horner’s syndrome)
What is clubbing?
tissue at base of male is thickened
no angle between nail bed and fold
no space between nails
What is Lambert-Eaton myastheniac syndrome and why is it caused by lung cancer?
immune condition of muscle weakness of the limbs
caused by auto-antibodies fighting the cancer
What is hypercalcaemia and how does lung cancer cause it?
High blood calcium
cancer causes elevated parathyroid hormone, which causes bone to release calcium
What are Pancoast tumours?
Tumours at the top of the lung - can press on brachial plexus and cause Horner’s syndrome
What is syndrome of inappropriate antidiuretic hormone production (SIADH)?
Too much ADH in the blood, which leads to water retention, electrolyte imbalances and a low level of sodium in the blood
What investigations would be done for suspected lung cancer?
CXR CT/PET (positron emission tomography) Bronchoscopy Percutaneous fine needle aspiration/biopsy Mediastinoscopy Endobronchial ultrasound (EBUS) Bone scan/head CT
What is a PET scan?
Similar to C - system detects gama rays emitted by a tracer (radioactive glucose) to indicate metabolic activity of tissue.
Cancer tissue is metabolically active so takes up glucose and shows up as active
also shows lymphatics
Where do most lung cancers arise?
Large bronchi
Can most tumours be seen/biopsied on a bronchoscopy?
yes
What is the treatment for small cell cancer?
chemo
radiotherapy
What is the treatment for non-small cell cancer
surgery (lobectomy, pneumonectomy)
radiotherapy
chemo maybe
What is EGFR-TK mutation testing?
tests for epidermal growth factor receptor in those with advanced/metastatic non-small cell lung cancer
genetic mutations are known to play roles in the progression to metastatic disease, and can affect the response of tumours to chemo
Why does lung cancer have low survival outcome?
2/3 of patients diagnosed at late stage
Other than smoking, what can cause lung cancer?
asbestos exposure radioactive minerals radon gas arsenic, nickel, pyrene family history
What does aetiology mean?
causes
What are paraneoplastic syndromes?
rare disorders that are triggered by an altered immune system response to cancer/a growth
Name some common sites of lung cancer metastasis?
brain bone adrenal glands other lung liver pericardium kidney
