Lung Cancer Flashcards
outdoor pollution/particulate matter is associated mainly w/ what cancer
adenocarcinoma- in smokers and non smokers
women smokers are more likely than men to develop _____
adenocarcinoma
which mutation is screened for in lung cancer
EGFR (epidermal growth factor receptor)- more common in women, non smokers, adeno
what is the PD-1 receptor
checkpoint on T cell surface- binding to PD-L1 ligand on tumor cells and dendritic cells helps the tumor evade immune targeting, this binding inhibits T cell activity
drugs targeting PD-1
by blocking this receptor, can stimulate the immune control of tumor growth
3 types of non small cell lung cancer
adenocarcinoma, squamous cell, large cell
triad seen w/ adenocarcinoma
Hypertrophic osteoarthritis (HPO): clubbing, periostitis in long bones, arthritis
adenocarcinoma location
peripheral
notable adenocarcinoma subtype
mucinous or non mucinous adenocarcinoma w/ lepidic features- mucinous can present w/ bronchorrhea sputum produciton
location of squamous cell carcinoma
usually proximal airways
sequelae of squamous cell
obstruction of airway w/ distal atelectasis, post obstructive pneumonia
cavitation
hypercalcemia and the assoc Sx (mental change, weakness), clubbing
describe location of small cell lung cancer
bulky central tumor w/ mediastinal lymph node involvement
2 factors that make SCLC worse
rapid progression and metastases
worse paraneoplastic syndrome
what are paraneoplastic syndromes
clinical disorders unrelated to tumor size or metastasis
best time to use sputum cytology
lesions in bronchi w/ hemoptysis
more reliable w/ squamous or small cell
ways tumors can interfere w/ bronchus (visible w/ bronchoscopy)
exophytic endobronchial lesions, submucosal infiltration, peribronchial tumor causing extrinsic compression
Dx test for peripheral lesions
transthroacic needle biopsy
staging for NSCLC
TNM:
T-size and location, w/ atelectasis or effusion
N- node involvement
M-distant metastases
Tx for early stage disease
surgery, maybe followed by chemo in stage II
Tx for locally advanced disease (IIIa and b)
chemo and radiation, sometimes surgery and/or immunotherapy
Tx for advanced metastatic (IV)
chemo, radiation for brain and bone, targeted genetic therapy
staging SCLC
not w/ TNM system
limited stage: confined to hemithorax
extensive stage: beyond radiation port, includes malignant effusion
tx for limited stage SCLC vs extensive
limited: chemo and thoracic radiation combo, prophylactic cranial radiation
extensive: chemo, radiation to bone or brain
approved screening for lung cancer
low dose CT scans for 55-80 year-olds w/ 30 pack year history
