lung cancer

Question 1

what is lung cancer morbidity vs other cancers

Answer 1

The Most Common Malignancy and Leading Cause of Cancer-Related Mortality

Question 2

what are some diagnostic imaging technique for lung cancer

Answer 2

chest x-ray

CT

bronchoscopy

staging PET scan

Question 3

what is the 4 types of lung cancer

Answer 3

Non-small cell - squamous

non-small cell - adenocarcinoma

small cell lung cancer (15%)

large cell carcinoma

Question 4

what is the doubling time for non small cell lung cancer

Answer 4

129 days

Question 5

what % of non-small cell lung cancers are operable/ resectable

Answer 5

25%

Question 6

5 year survival of Non small cell is

Answer 6

40%

Question 7

what is the doubling time of small cell lung cancers

Answer 7

29 days

Question 8

what is the treatment of non small cell LCs

Answer 8

surgery then adjuvant chemotherapy

Question 9

what is the treatment choice of small cell lung cancers

Answer 9

4 cycles - combination chemotherapy

cisplatin and etoposide

Question 10

what is true about Non small cell lung cancers

Answer 10

90% of patients are effected by stage 3/4

Question 11

what is true about stage 4 NSCLC

Answer 11

incurable

Question 12

where might lung cancer metastases

Answer 12

bone

Question 13

what is true about all lung disease

Answer 13

for 80% of patients it is too late to cure

Question 14

what is the aetiology of lung cancer

Answer 14

TOBACCO!!!!!

asbestos

environmental radiation

Question 15

what are the two main pathways of carcinogens in the lungs

Answer 15

in the lung periphery (bronchioalveolar epithelium)

the central lung airways (bronchial epithelium)

Question 16

what cancer appears in the lung periphery

Answer 16

adenosarcoma

Question 17

what cancer appears in the central lung airways

Answer 17

squamous cell carcinomas

Question 18

which of the lung cancers is more strongly associated with smoking

Answer 18

squamous cell carcinomas

Question 19

what oncogenes are smoking endued

Answer 19

KRAS

Question 20

what oncogenes are not related to carcinogenesis

Answer 20

EGFR

BRAF

HER2

Question 21

how common is lung metastases

Answer 21

very common

Question 22

when do primary lung cancers present

Answer 22

late presentation

symptomatic lung cancers - very advanced - fatal

Question 23

what are the local effects of lung cancers

Answer 23

bronchial obstruction

pleural inflammation/metastases

direct evasion of the chest wall

lymph node metastases

Question 24

where does lung cancer metastasis too

Answer 24

liver
bone
brain
skin

Question 25

what are some non metastatic effects

Answer 25

finger clubbing hypertrophic pulmonary osteoarthropathy (inflamed joints and bones)

Question 26

what are some lung cancer investigations

Answer 26

chest x-ray pleural effusion - biopsy bronchoscopy bronchoscopy - biopsy CT, MRI, PET

Question 27

what are the prognostic factors of lung cancer

Answer 27

stage of disease classification of disease in general its bad

Question 28

which gender is more likely to die of lung cancer

Answer 28

men

Question 29

what is the prognosis of a patent after a year with stage 1 lung cancer

Answer 29

80% survival

Question 30

what is the prognosis of a patent after a year with stage 2 lung cancer

Answer 30

75% survival

Question 31

what is the prognosis of a patent after a year with stage 3 lung cancer

Answer 31

50% survival

Question 32

what is the prognosis of a patent after a year with stage 4 lung cancer

Answer 32

20% survival

Question 33

what are the types of surgery patients can have for lung cancer

Answer 33

wedge resection lobectomy pneumonectomy

Question 34

how many patients get surgery

Answer 34

18%

Question 35

what are the 3 types of radiotherapy offered to patients

Answer 35

radical palliative stereotactic

Question 36

when is chemotherapy used

Answer 36

alone, combined with radiotherapy, adjuvant after surgery

Question 37

what is done for lung cancer in the case of palliative care

Answer 37

chemotherapy radio therapy opiates, benzodiazepines treatment of secondary conditions

Question 38

where should you look for lung cancers on a x-ray

Answer 38

lung apices Hila behind the heart behind the diaphragm (bases)

Question 39

what is a pulmonary nodule

Answer 39

a opacity in the lung up to 3cm in size no mediastinal lymph node enlargement or lung collapse

Question 40

what might a pulmonary module suggest

Answer 40

lung cancer a metastasis benign lump vascular hematoma

Question 41

how is a lung cancer stages

Answer 41

clinical history, exam performance status, pulmonary function TNM staging

Question 42

what is TNM staging

Answer 42

T - size of Tumour N - lymph Node spread M - are there any Metastasis

Question 43

what scans are used to look at T in TMN (the tumour)

Answer 43

CT PET-CT bronchoscopy

Question 44

what scans are used to look at N in TNM (lymph nodes)

Answer 44

PET-CT mediastinoscopy CT

Question 45

what scans are used to look for M in TNM (metastasise)

Answer 45

PET - CT CT bone scan

Question 46

what are blood tests that would be ordered for the staging of cancers

Answer 46

anaemia abnormal Liver function tests (LFTs) abnormal bone profile

Question 47

why would a ECHO be used

Answer 47

to see if there was a pericardial effusion

Question 48

what is the operative mortality of a pneumonectomy

Answer 48

5-10%

Question 49

what is the operative mortality of a lobectomy

Answer 49

3-5%

Question 50

what is the operative mortality of a wedge resection

Answer 50

2-3%

Question 51

what might lung surgery be for if not cancer

Answer 51

TB abscess benign tumour granuloma fibrosis