Lung Cancer

Question 1

epidemiilogy of lung cancer

Answer 1

Most common cancer
Especially central/ Eastern Europe & Eastern Asia

Men>women Mortality as women started smoking later

Lowest 5 year survival rate

Question 2

Risk factors for lung cancer

Answer 2

1st/2nd Hans smoking

Air pollution

Diesel exhaust

Toxic metals: arsenic, cadmium, chromium

Radiation

Family history

Question 3

Types of lung cancer

Answer 3

Non small cell lung cancer (85%)

• adenocarcinoma 40%
• squamous cell cell 25%
• large cell 25%
• other

Small cell lung cancer (15%)

Question 4

Symptoms of

Answer 4

Chest pain , Hemoptyis, wheezing,

Throat pain and voice changed

Weight loss & fatigue

Bone pain: back and hips

Nervous system: headache, dizzy, seizures LOB, d/2 spread to the spinal cord

Hornets syndrome: ptosis, mitosis, anhydrosis

Question 5

Staging of lung cancer

Answer 5

T1: over 3cm
T2:3-7
T3:over 7
T4: invasion into mediastinal bodies

N0
N1: same side hilar
N2: same side mediastinal
N3: contralateral mediatinal

M0
M1: distant metastasis and pleural effusions

Question 6

Rx of small cell lung cancer

Answer 6

Stage 1: surgical resection

Stage 2: surgery/ +adjuvant chemo

Stage 3: same as 2/ radiation alone/ chemoradio

Stage 3b: radiation alone / chemoradiotherapy

Stage 4: no rx/ chemo/ radio for sx

Question 7

Immunotherapy for non small cell lung cancer

Answer 7

Non squamous
1st line: EGFR: erlotinib ALK:crizotinib
2nd line: osimertinib

Squamous cell
Immunotherapy combo w/ chemotherapy

Question 8

Rx of small cell lung cancer

Answer 8

Limited stage: radiation/chemo/ surgery

Extensive stage: radiation/ chemo/ prophylactic radiation to brain & palliative surgery