lung cancer Flashcards
what is lung cancer morbidity vs other cancers
The Most Common Malignancy and Leading Cause of Cancer-Related Mortality
what are some diagnostic imaging technique for lung cancer
chest x-ray
CT
bronchoscopy
staging PET scan
what is the 4 types of lung cancer
Non-small cell - squamous
non-small cell - adenocarcinoma
small cell lung cancer (15%)
large cell carcinoma
what is the doubling time for non small cell lung cancer
129 days
what % of non-small cell lung cancers are operable/ resectable
25%
5 year survival of Non small cell is
40%
what is the doubling time of small cell lung cancers
29 days
what is the treatment of non small cell LCs
surgery then adjuvant chemotherapy
what is the treatment choice of small cell lung cancers
4 cycles - combination chemotherapy
cisplatin and etoposide
what is true about Non small cell lung cancers
90% of patients are effected by stage 3/4
what is true about stage 4 NSCLC
incurable
where might lung cancer metastases
bone
what is true about all lung disease
for 80% of patients it is too late to cure
what is the aetiology of lung cancer
TOBACCO!!!!!
asbestos
environmental radiation
what are the two main pathways of carcinogens in the lungs
in the lung periphery (bronchioalveolar epithelium)
the central lung airways (bronchial epithelium)
what cancer appears in the lung periphery
adenosarcoma
what cancer appears in the central lung airways
squamous cell carcinomas
which of the lung cancers is more strongly associated with smoking
squamous cell carcinomas
what oncogenes are smoking endued
KRAS
what oncogenes are not related to carcinogenesis
EGFR
BRAF
HER2
how common is lung metastases
very common
when do primary lung cancers present
late presentation
symptomatic lung cancers - very advanced - fatal
what are the local effects of lung cancers
bronchial obstruction
pleural inflammation/metastases
direct evasion of the chest wall
lymph node metastases
where does lung cancer metastasis too
liver
bone
brain
skin
what are some non metastatic effects
finger clubbing
hypertrophic pulmonary osteoarthropathy (inflamed joints and bones)
what are some lung cancer investigations
chest x-ray
pleural effusion - biopsy
bronchoscopy
bronchoscopy - biopsy
CT, MRI, PET
what are the prognostic factors of lung cancer
stage of disease
classification of disease
in general its bad
which gender is more likely to die of lung cancer
men
what is the prognosis of a patent after a year with stage 1 lung cancer
80% survival
what is the prognosis of a patent after a year with stage 2 lung cancer
75% survival
what is the prognosis of a patent after a year with stage 3 lung cancer
50% survival
what is the prognosis of a patent after a year with stage 4 lung cancer
20% survival
what are the types of surgery patients can have for lung cancer
wedge resection
lobectomy
pneumonectomy
how many patients get surgery
18%
what are the 3 types of radiotherapy offered to patients
radical
palliative
stereotactic
when is chemotherapy used
alone, combined with radiotherapy, adjuvant after surgery
what is done for lung cancer in the case of palliative care
chemotherapy
radio therapy
opiates, benzodiazepines
treatment of secondary conditions
where should you look for lung cancers on a x-ray
lung apices
Hila
behind the heart
behind the diaphragm (bases)
what is a pulmonary nodule
a opacity in the lung up to 3cm in size
no mediastinal lymph node enlargement or lung collapse
what might a pulmonary module suggest
lung cancer
a metastasis
benign lump
vascular hematoma
how is a lung cancer stages
clinical history, exam
performance status, pulmonary function
TNM staging
what is TNM staging
T - size of Tumour
N - lymph Node spread
M - are there any Metastasis
what scans are used to look at T in TMN (the tumour)
CT
PET-CT
bronchoscopy
what scans are used to look at N in TNM (lymph nodes)
PET-CT
mediastinoscopy
CT
what scans are used to look for M in TNM (metastasise)
PET - CT
CT
bone scan
what are blood tests that would be ordered for the staging of cancers
anaemia
abnormal Liver function tests (LFTs)
abnormal bone profile
why would a ECHO be used
to see if there was a pericardial effusion
what is the operative mortality of a pneumonectomy
5-10%
what is the operative mortality of a lobectomy
3-5%
what is the operative mortality of a wedge resection
2-3%
what might lung surgery be for if not cancer
TB
abscess
benign tumour
granuloma
fibrosis
