Lung Cancer Flashcards
Where does local invasion occur
Recurrent laryngeal nerve Pericardium Oesophagus Brachial Plexus Pleural Cavity Superior Vena Cava
Hypercalcaemia
High level of Ca2+
Hypercalcaemia Treatment
Rehydration
IV Bisphosphonate
PET scan
Assess function rather than structure
Analysis of tissue uptake of radio-labelled glucose
Tissues with high metabolic tissue light up
Bronchial carcinoma
Asbestos + smoking synergistic
Imaging features of lung cancer
Peripheral tumours (behind hilum) Central tumours (at or close to hilum) can result in collapse of lobe and enlargement of hilum
Early clinical features of lung cancer
Cough (3 weeks) Breathless for no reason Chest infection doesn't clear up Weight loss Chest or shoulder pain Tiredness Coughing up blood Hoarse voice
Paraneoplastic
Non-metastatic effects that accompany malignant disease
Finger clubbing Weight loss Thrombophlebitis Hypercalcaemia Hyponatraemia Weakness
Hyponatraemia
low sodium concentration
4 common smoking associated types of lung tumours
Adenocarcinoma
Squamous carcinoma
Small cell carcinoma
Large cell carcinoma
Hormone production
PTH - squamous cancer
ACTH - small cell cancer
Prognosis
Small cell = worst
Large cell = worse that squamous or adenocarcinoma)
Small Cell Lung Cancer treatment
Chemotherapy
Rapidly emerging resistance
Small cell lung cancer genetic abnormalities
Oncogenes - myc
Tumour supressor genes - p53, Rb, 3p
Non small lung cancer treatment
Surgery
Chemo
Radiotherapy
Adenocarcinoma expresses
TTF
Squamous cell cancer expresses
p63 and high molecular wt. cytokertins
Genetic abnormalities of non small lung cancer
Oncogenes - myc, K-ras, her2(neu)
Tumour supressor genes - p53, 1q, 3p, 9p, 11p,
TNM staging
Tumour - size?
Node - how many nodes involved?
Metastasis - has it?
Carcinoid
Lung neoplasm in neuroendocrine system
Low grade malignancy
Bronchial gland neoplasm
seen in salivary gland
Small cell lung cancer
Rapidly progressive
Early metastases
Surgery
If localised
Must look at staging
Chemotherapy
Tissue sampling + staging + assess fitness first
Good response in small cell
Rarely curative
Targets rapidly dividing cells, treats whole body
Side effects of chemo
Bone marrow suppression Nausea Tiredness Hair loss Pulmonary fibrosis
Radiotherapy
Ionising radiation
Cure or delay
Drawbacks of radiotherapy
Maximum cumulative dose Collateral damage (oesophagus)
Palliative Treatment
Stent insertion
Photodynamic therapy
Laser therapy
Radioactive therapy
Investigations to determine staging
Bronchoscopy (vocal cord palsy, proximity to carina, cell type)
Mediastinoscopy (lymph nodes)
CT scan of brain (mets)
CT scan of thorax (tumour size, lymph nodes, mets, local invasion)
PET scan (mets)
