Lung Cancer Flashcards
Main classification of lung cancer?
small-cell
non-small-cell
Non small cell carcinoma examples?
Squamous cell carcinoma,
Adenocarcinoma
Large-cell
RFs for Squamous cell carcinoma of lung M:F?
M>F
smoking
radon gas
Squamous cell carcinoma site?
central near bronchi
Squamous cell carcinoma ectopic hormone
PTHrP → ↑ Ca2+
Adenocarcinoma RFs?
F>M
non-smoker,
far east
Adenocarcinoma site
peripheral
Large cell carcinoma site
Central or peripherally located
Differentiation level of non- small cell carcinoma
Squamous cell carcinoma (squamous) adenocarcinoma (glandular)
large-cell (poorly differentiated)
Small cell carcinoma site
central near bronchi
Small-cell carcinoma differentiation
poorly differentiated
Small-cell carcinoma prognosis
very chemo sensitive, poor prognosis though
Complications of lung cancer?
Recurrent laryngeal N. palsy
Phrenic N. palsy
SVC obstruction
Horner’s (Pancoast’s tumour)
AF
Endocrine complications of lung cancer?
- ADH → SIADH ( euvolaemic ↓Na+)
- ACTH → Cushing’s syndrome- Serotonin → carcinoid (flushing, diarrhoea)
- PTHrP → 1O HPT (↑Ca2+, bone pain)
Non-small cell lung carcinoma management?
- Surgical Resection
- Curative radiotherapy
- Chemo ± radio for more advanced disease
Small cell carcinoma of lung management?
Palliation
- Radio: bronchial obstruction, haemoptysis, bone or CNS mets
- SVC obstruction: stenting + radio + dexamethasone
- Endobronchial therapy: stenting, brachytherapy
- Pleural drainage
- Analgesia
Prognosis of small cell
1-1.5yrs median survival treated;
3mo untreated
Prognosis of non-small cell
50% 5ys w/o spread
10% ̄c spread
Malignant mesothelioma def
mesothelial cell tumour in pleura
Cause of mesothelioma
asbestos
Dx of mesothelioma
thoracoscopy, biopsy + histology
normally post-mortem
Rx of mesothelioma
Pemetrexed + cisplatin chemotherapy
Pleurodesis and indwelling intra-pleural drain may help
Pleurodesis
adhering visceral and parietal pleurae
stops air/fluid building up
