Lung Cancer

Question 1

lung cancer

Answer 1

• primary or secondary tumors develop here b/c lungs are large and richly vascularized
• most develop in epithelial tissue
• leading cause of death
• aggressive, invasive locally, and mets to bone, liver and brain

Question 2

etiology

Answer 2

• smoking (>85%)
• toxins (asbestos, when inhaled forms tiny fibers in lungs)
• marijuana

Question 3

types of lung cancer

Answer 3

1. small cell carcinoma
2. large cell carcinoma
3. squamous cell carcinoma
4. adenocarcinoma

Question 4

small cell carcinoma

Answer 4

• ~12%
• aka oval cell carcinoma or oat cell carcinoma
• SCLC
• worst type (aggressive, invasive and early mets especially to brain)
• mets at dx (70%)
• paraneoplastic syndromes (ie. SIADH, ACTH, Cushing’s)
  -> tumor secretes hormone like substances that has
  same action as affected hormone
• non-resectable d/t size of malignant cells

Question 5

large cell carcinoma

Answer 5

• ~12%
• NSCLC
• large undifferentiated cells
• peripheral origin (bronchioles, alveoli)
• early mets, poor prognosis

Question 6

squamous cell carcinoma

Answer 6

• ~27%
• NSCLC
• more common in men
• originates in central bronchi (epithelial cells lining a/w); intralumenal
• impacts mediastinum (impacts heart)
• spreads to hilar lymph nodes

Question 7

hilus

Answer 7

area of the lung where vessels and bronchi enter

Question 8

adenocarcinoma

Answer 8

• ~30%
• NSCLC
• more common in women and non-smokers
• CA of glandular epithelium
• peripheral origin

Question 9

manifestations

Answer 9

• depends on type, site, extent, mets, and paraneoplastic syndromes
• pain r/t impact on nerves (perivascular) and inflmtn
• hemopytosis
• if central:
  * impacts breathing = wheezing, coughing, dyspnea
  * cardiac mnftns d/t proximity of pericardium

Question 10

diagnosis

Answer 10

• Hx, Px
• CXR, US, CT, MRI
• cytology (bronchial wash or sputum)
• bronchoscopy and biopsy

Question 11

what is the advantage of a bronchoscopy?

Answer 11

can take biopsy samples and manipulate interventions

Question 12

treatment

Answer 12

SCLC = chemo and radiation 
NSCLC = Sx, chemo and radiation