Lung Cancer

Question 1

What percentage of lung cancer occurs in smokers or exsmokers?

Answer 1

85%

Question 2

What is the 5 year survival for lung cancer?

Answer 2

13%

Question 3

How may lung cancer present?

Answer 3

Asymptomatic/incidental finding
any resp symptom/ resp deterioration
SVC onstruction
Horners syndrome
Metastatic disease - liver, adrenals (addison), bone, pleural, cns
paraneoplastic - clubbing, hypercalcaemia, anaemia, SIADH, cushings, Lambert-eaton myasthenic syndrome, thromboembolic disease

Question 4

What are risk factors for lung cancer?

Answer 4

Smoking
Airflow obstruction
Age
Family history 
Exposure to carcinogens eg asbestos

Question 5

What is Performance Status?

Answer 5

WHO scale that gives an indication of a patients level of fitness 0-5

Question 6

What diagnostic tests should be performed if lung cancer is suspected?

Answer 6

Bloods: FBC, U&E, calcium, LFT, INR
CXR
Staging CT

Question 7

What histology options are there fore lung cancer?

Answer 7

US guided neck node FNA for cytology
Bronchoscopy
CT biopsy
Thoracoscopy

Question 8

What is a PET scan useful for?

Answer 8

MDT decision if patient is a surgical candidate and initial CT suggestive of low stage
Helps to detect small mets not seen on staging CT

Question 9

What are the two main classifications of lung cancer?

Answer 9

Small cell (oat cell) 
Non-small cell

Question 10

Name two other histological types of lung cancer?

Answer 10

Bronchial gland cancer, carcinoid tumour

Question 11

What types of lung cancer are included in NSCLC?

Answer 11

Squamous cell, adenocarcinoma, large cell carcinoma, bronchoalveolar cancer

Question 12

Summarise lung cancer treatment

Answer 12

Curative surgery stages 1-2
Chemo
Radiotherapy 
Palliative care
Watch and wait

Question 13

Discuss SCLC treatment and prognosis

Answer 13

Rapid growth rate and almost always too extensive for surgery at time of diagnosis
Main treatment is chemo but also palliative radiotherapy