Lung Cancer Flashcards
What are the different types of lung cancers?
Non small cell:
Squamous cell carcinoma
Adenocarcinoma
Small cell lung cancer (releases neuroendocrine hormones)
What are the signs and symptoms of lung cancer?
Haemoptysis SOB Cough Finger clubbing Weight loss
May see lymphadenopathy, fixed monomorphic wheeze and clubbing
What are the features of squamous cell cancer?
Associated with PTH-related protein
Causes hypercalcaemia
Strongly associated with finger clubbing
Can cause hyperthyroidism
What is the most common type of lung cancer in non smokers?
What lung cancer can cause gynaecomastia?
Adenocarcinoma
Adenocarcinoma
What tumours may secrete b-hCG and cause HPOA?
large cell lung carcinoma
What are the features of small cell lung cancer?
associated with ectopic ADH and ACTH secretion
ADH = hyponatraemia
ACTH = Cushing’s syndrome (HTN, hyperglycaemia, hypokalaemia are the most typical features). Can also cause bilateral adrenal hyperplasia
What investigations can you do for lung cancer?
1) CXR
2) CT contrast
3) Bronchoscopy (usually for biopsy)
4) PET-CT scanning
Which patients should you refer for a 2WW appointment in suspicion of lung cancer?
- Anyone with CXR findings that make you suspect cancer
- Aged >40 or over with unexplained haemoptysis
In which patients should you offer an urgent CXR to within 2 weeks?
- > 40 who have 2+ of the following symptoms
- a smoker with 1+ of the following symptosm
cough fatigue SOB chest pain weight loss appetite loss
What will you see on a CXR in someone with lung cancer?
hilar enlargement
peripheral opacity
pleural effusion
collapse
What is the treatment of lung cancers?
Non small cell lung cancers: usually lobectomy and radiotherapy (chemotherapy can be added)
Small cell lung cancers: have a worse prognosis. usually radiotherapy and chemotherapy
What are the features of superior vena cava obstruction?
SOB facial swelling headaches visual disturbance pulseless JVP
pemberton’s sign may be seen
most commonly associated with lung cancer
What is the management of superior vena cava obstruction?
dexamethasone, balloon valvuloplasty, stenting
What are the possible extrapulmonary manifestations of SVCO?
recurrent laryngeal nerve palsy phrenic nerve palsy SVCO horner's syndrome (caused by pancoast's tumour) SIADH cushing's hypercalcaemia
what occurs in lambert-eaton myasthenic syndrome?
antibodies are created against the small cell cancer cells. the antibodies also damage voltage gated calcium channels causing proximal muscle and intraocular weakness.
