Lung Cancer Flashcards
Name some risk factors for lung cancer
Smoking - primary and secondary
Asbestos - causes lung cancer and mesothelioma
Radon - mining and indoor exposure
Occupational carcinogens like heavy metals
Genetic/familial factors - Asian populations have genetic predisposition
What does a screening process require for it to be used to screen for a condition
Condition requires a decrease in disease specific mortality for it to be screened for
Disease needs to have serious consequences
High prevalence of detectable disease
Test must detect little pseudo-disease and must detect disease before critical point
Test must cause little morbidity and must be affordable and available
Treatment for condition must exist and be more effective when applied before symptomatic detection
Name some primary tumour symptoms of lung cancer
Asymptomatic
Cough
Dyspnoea
Wheeze
Haemoptysis
Recurrent lung infection
Chest/shoulder pain
Weight loss
Lethargy/maliase
Breathless - bronchial carcinoma
Name some symptoms that regional and distant lung metastases can produce
Regional: SVC obstruction (oedema of hands, face and arms; visible chest vasculature; raised ICP causing confusion and headaches), hoarseness, dysphagia, chest pain
Distant: bone pain, bone #, CNS symptoms
Name some signs of lung cancer
May have no signs
Cachexia
Pale conjunctiva
Cervical lymphadenopathy
Horner’s syndrome
Consolidation
Signs of pleural effusion
Muffled heart sounds
Hepatomegaly
Skin metastases
Neurological long tract signs
Paralysis of one side of the diaphragm is phrenic nerve impinged
What paraneoplastic syndromes can occur in lung cancer
Endocrine - hypercalcaemia (PTHrP), Cushing’s syndrome, SIADH
Neurological - encephalopathy, peripheral neuropathy, Eaton-Lamert syndrome, Pancoast syndrome
Haematological - anaemia, thrombocytosis
Cutaneous - dermatomyositis
Skeletal - finger clubbing
What are the types of lung cancer (cells affected)
Non-small cell lung carcinoma - squamous cell carcinoma, adenocarcinoma, large cell carcinoma
Small cell lung carcinoma
Rare tumours
Describe small cell lung carcinomas and how they differ to NSCLC
SCLC grow at a faster rate than NSCLC so are typically diagnosed at a later stage
SCLC are more likely to metastasise and are most likely to produce paraneoplastic syndromes
Chemotherapy is the typical treatment because of the high chance of metastases
How are molecular markers used in lung cancer treatment and name the markers
Molecular markers are mutations in lung cancer cells that cause the neoplasia
Treatment of lung cancer can be targeted to the type of mutation that the lung cancer has using biological treatment
Mutations include: EGFR, ALK, FRAS, PD1, PDL1
What imaging tests are used in staging and diagnosis of lung cancer
CXR
CT scan
Staging CT scan
PET scan
USS
Bone scan
ECHO
When are biopises taken in lung cancer staging and name some ways biopsies are taken
Biopsies are only taken if doing one will make a difference to a patients survivial as taking biopsies has complications assocaited with it
Biopsy of metastasis is always taken first
Methods to take biopsy include: bronchoscopy, USS, CT biopsy, thoracoscopy, surgery
Where does lung cancer typically spread to
Brain
Draining lymph nodes
Pericardium
Lung
Pleura
Liver
Adrenals
Bone
What are the treatment options for a patient with lung cancer
Surgery - mainly for NSCLC
Radiotherapy - mainly for palliative care
Combined chemo - tneds to be used to slow progression and improve QoL. Used in neoadjuvant and adjuvant treatment
Combined therapy
Biological therapies - based on mutations
Palliative care
Other treatments - active symptoms control, treatment of other conditions
