Lung Cancer Flashcards

1
Q

Signs and symptoms of lung cancer

A
  • Shortness of breath
  • Cough
  • Haemoptysis (coughing up blood)
  • Finger clubbing
  • Recurrent pneumonia
  • Weight loss
  • Lymphadenopathy – often supraclavicular nodes are the first to be found on examination
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What Ix to do in suspected lung ca?

A
  • CXR - 1st line -> characteristic findings
  • CT scans -> staging
  • PET-CT -> to identify metastasis
  • Endoscopy with endobronchial ultrasound (EBUS) -> USS at the end of scope + biopsy
  • histological diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Principles of PET-CT (how does it work)

A

PET-CT (positron emission tomography) scans

  • injecting a radioactive tracer (usually attached to glucose molecules) and taking images using a combination of a CT scanner and a gamma ray detector
  • to visualise how metabolically active various tissues are
  • useful in identifying areas that the cancer has spread to by showing areas of increased metabolic activity suggestive of cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of lung cancer is surgery offered for?

A
  • Non- small cell ca -> if a patient has a disease limited to a single area (intention to cure the ca)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Types of surgeries used in lung cancer?

A

*surgeries used in non-small cell lung ca (if limited to the single area)

Types:

  • Lobectomy (removing the lung lobe containing the tumour) is first line
  • Segmentectomy or wedge resection (taking a segment or wedge of lung to remove the tumour) is also an option
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Other than surgeries Rx for non-small lung ca

A
  • radiotherapy (may be curative in early stages)
  • chemotherapy (in addition to surgery and radiotherapy, or as palliative)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment of small-cell lung cancer

A
  • chemotherapy
  • radiotherapy

*but worse prognosis than in non-small cell lung ca

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Palliative treatment surgeries

A

Endobronchial treatment with stents or debulking

Aim: to reduce symptoms due to obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Recurrent pharyngeal n palsy in lung ca

A
  • present with hoarse voice
  • cancer presses on recurrent pharyngeal n.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Phrenic n. palsy in lung ca

A
  • presents with SOB due to weakness of diaphragm
  • cancer compressing phrenic n.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Superior vena cava obstruction in lung cancer

  • cause
  • presentation
A
  • direct compression of the tumour on the superior vena cava
  • presents with facial swelling, difficulty breathing and distended veins in the neck and upper chest

Pemberton’s sign” is where raising the hands over the head causes facial congestion and cyanosis. This is a medical emergency.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is Pemberton’s sign?

A

Caused by direct compression of the tumour on superior vena cava

Pemberton’s sign - raising the hands over the head causes facial congestion and cyanosis. This is a medical emergency!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is Horner’s syndrome?

  • triad
  • cause
A
  • Triad of: ptosis, anhidrosis and miosis
  • Cause: Pancoast tumour (lung apex) pressing on sympathetic ganglion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

SIADH

  • cause (type of lung ca)
  • presentation
A
  • ectopic ADH secretion
  • in small cell lung ca
  • presentaiton: hyponatraemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Cushing’s syndrome in lung ca

  • type of lung ca
  • cause
A
  • ACTH ectopic secretion
  • small cell lung ca
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Hypercalcaemia in lung ca

  • cause
  • type of cancer
A
  • ectopic PTH secretion
  • squamous cell carcinoma
17
Q

Limbic encephalitis in lung ca

  • type of cancer
  • what happens
  • presentation
  • detection
A
  • Small cell lung cancer
  • cancer -> immune system produce antibodies against parts of the brain
  • presentation: short term memory loss, hallucinations, seizures and confusion
  • anti-Hu antibodies
18
Q

What to consider in a smoker with symptoms of Lambert-Eaton Syndrome?

A

Small- cell lung cancer

19
Q

Lambert-Eaton syndrome in lung cancer

  • cause

-

A

antibodies produced by the immune system against small cell lung cancer cells

20
Q

Mesothelioma

  • parts of the lung affected
  • association
A
  • mesothelial cells of the pleura affected
  • associated with asbestos exposure
    *
21
Q

When does mesothelioma present?

A

There is a huge latent period between exposure to asbestos and the development of mesothelioma of up to 45 years

22
Q

Prognosis and treatment of mesothelioma

A
  • very poor prognosis
  • chemotherapy use is mainly paillative
23
Q

Common sites of lung cancer metastasis

A

brain, liver, adrenal glands and bone

24
Q

What further tests to perform on a patient with lung adenocarcinoma?

A
  • mutation is present in eGFR -> we have specific treatments that may target it; same for ALK
  • PDL -1 -> tests for anything that is not small-cell cancer (e.g. adenocarcinoma and squamous cell) -> specific immunotherapies available
25
Q

What scale is used to measure performance status in a patient?

  • use
A

ECOG scale

  • prognostic tool, as a selection criterion for cancer research, and to help determine treatment