Lung Cancer Flashcards
In which age group is lung cancer normally seen?
Uncommon under the age of 45
Most common cancer in men aged over 65
What are the 2 main types of lung cancer?
Small cell and non-small cell
What are non-small cell lung cancers comprised of?
adenocarcinomas
squamous cell carcinomas
large cell carcinomas
How do SCLCs vary compared to NSCLCs?
they are comprised of much smaller cells and will rapidly metastasise (spread) to other organs
It can be fatal in a few weeks untreated as it spreads rapidly in the early stages
What % of lung cancers are small cell?
15 - 20%
rare in non-smokers
what are the main symptoms of lung cancer?
- cough
- tachypnoea
- wheeze
- stridor
- haemoptysis
- dysphagia
- hoarse voice
What is stridor?
a harsh vibrating noise when breathing caused by an obstruction of the airways
What is haemoptysis?
coughing up blood
this occurs in 50% of cases
what is dysphagia?
difficulties with swallowing
Why does lung cancer cause bone pain?
due to the spread of the cancer
if bone metastases involve the spine, compression of the spinal cord by the tumour can cause pain with walking and weakness in the legs
How does lung cancer affect appearance?
It causes anorexia and weight loss due to lost appetite
What is clubbing?
A deformity of the finger or toe nails associated with diseases of the lung and heart
How does the nail bed and the ends of the fingers appear in clubbing?
The ends of the fingers are enlarged and appear warm and red
The nail bed becomes spongy and nail bed angle is lost
How does the nail change in clubbing?
Nails form a sharper angle with the cuticle
The nail and the skin around it eventually becomes shiny and the nail develops ridges
What is lymphadenopathy?
A disease of the lymph nodes where they are abnormal in size, number or consistency
Why does lung cancer lead to lymphadenopathy?
Lung cancer spreads first to the lymph nodes near the tumour
these are the regional lymph nodes
How does lung cancer cause superior vena cava obstruction?
The vessel wall is compressed by a malignant tumour in the mediastinum
This blocks the blood flow in the vein
What is Horner’s syndrome?
Damage to the sympathetic nerves of the face
What is Horner’s syndrome characterised?
miosis - constriction of the pupil
ptosis - drooping of the upper eyelid
anhidrosis - absence of sweating in the face
What are the investigations for lung cancer?
- chest x-ray
- CT/PET scan
- Bronchoscopy
- Percutaneous fine needle aspiration/biopsy
- Mediastinoscopy
- VATS
- Bone scan/CT scan of the head
- Endobronchial ultrasound
How does a PET scan work?
It detects gamma rays emitted by a positron-emitting radionuclide (tracer)
Flurodeoxyglucose (FDG) is an analogue of glucose that indicates tissue metabolic activity (cancer)
What is a percutaneous fine needle aspiration?
A CT or ultrasound machine is used to guide a small needle through the skin and into the growth in the lung to take a sample
The sample may be taken from tissue in the chest, lymph nodes, lung or the lining of the lung
What is a mediastinoscopy?
A way of obtaining a biopsy to see if lung cancer has spread to the lymph nodes around the trachea
What is VATS?
Video-assisted thoracoscopic surgery
A surgeon makes one or more small cuts in the chest and uses a small flexible camera to look at parts of the lung
A small biopsy is then taken
What is an endobronchial ultrasound (EBUS)?
Uses ultrasound along with a bronchoscope to visualise the airway wall and structures adjacent to it
Ultrasound image shows abnormal structures in the lungs and lymph nodes where biopsies will be taken
How is small cell lung cancer treated?
Chemotherapy and radiotherapy
It is not removed by surgery as it is likely to have already spread
How is non-small cell lung cancer treated?
Surgery, chemotherapy, radiotherapy
How many lung cancer patients are diagnosed at a late stage?
What are the survival rates like?
One of the lowest survival outcomes of any cancer
Over two thirds of patients diagnosed at a late stage
Younger patients have much higher survival rates
What % of lung cancer cases are caused by tobacco smoking?
How much does this increase the risk of lung cancer?
90%
smoking increases risk of lung cancer by 8 to 20 times
What are the other factors that can cause lung cancer?
- asbestos exposure
- radioactive minerals such as radon gas
- pyrene, arsenic, nickel and napthalene
- family history
What is a paraneoplastic syndrome?
A syndrome that is the consequence of cancer in the body
Unlike mass effect, it is NOT due to the local presence of cancer cells
