Lung Cancer Flashcards
Lung cancer normally occurs in what age group?
> 75 years
What is the biggest risk factor for the development of lung cancer?
Smoking
Lung cancer has a good prognosis. T/F?
False
What types of lung cancer is smoking particularly associated with?
Squamous and small cell lung cancer
Stopping smoking reduces the risk of lung lung cancer. T/F?
True - but this takes time
Other than smoking, what are the risk factors for lung cancer?
Environmental tobacco smoke Ionising radiation such as radon or uranium Air pollution Asbestos Other fibrosing conditions of the lung HPV
What are the signs and symptoms of lung cancer?
Cough Haemoptysis Shortness of breath Chest pain Weight loss/anorexia General malaise
What can result from thoracic duct involvement in lung cancer?
Chylothorax
What can result from pericardial involvement in lung cancer?
Pericarditis
Effusion
What can result from recurrent laryngeal nerve involvement in lung cancer?
Hoarseness
Vocal cord paralysis
What can result from eosophageal involvement in lung cancer?
Compression dysphagia
Pneumonia
Tracheoesopahgeal fistula
What can result from mediastinal involvement in lung cancer?
Superior vena cava obstruction - oedema of face and arms, raised JVP, plethoric face
Recurrent laryngeal nerve compression
Phrenic nerve compression resulting in hemidiaphragm paralysis
Where do lung cancer spread to via haematogenous spread?
Liver
Bone
Brain
Adrenal glands
What are the non-metastatic effects of lung cancer?
Emotional disturbance Enlarged sella turcica Moon faces Osteoporosis Cardiac hypertrophy Buffalo hump Obesity Adrenal tumour or hyperplasia Thin, wrinkled skin Abdominal striae Muscle weakness Purpura Skin ulcers
Small cell cancers are usually advanced at diagnosis and respond to chemotherapy. T/F?
True
Non-small cell cancers may be localised at diagnosis and can be treated by surgery or radiotherapy. T/F?
True
What cancers are encompassed by non-small cell lung carcinoma?
Adenocarcinoma
Squamous cell. carcinoma
Large cell carcinoma
Other lung cancers
Other than small or non-small cell, what are the other lung cancers?
Tumours of mesenchymal tissues Salivary gland type tumours Tumours of ectopic origin Tumours of neuroendocrine cells Tumours of lymphatic system
Why has there been a recent rise in adenocarcinoma and small cell carcinoma with a fall in squamous carcinoma?
Changes in smoking habits
Composition of cigarettes
What type of cancers are central lung tumours usually?
Squamous or small cell carcinomas
What type of tumours are peripheral lung tumours usually?
Adenocarcinomas
What is the most aggressive form of lung cancer?
Small cell carcinoma
What histological changes occur in small cell carcinoma?
Oval to spindle shaped cells
Inconscpicuous nucleoli
Scant cytoplasm
Show nuclear moulding
What type of cancer commonly results from squamous metaplasia in the lungs?
Squamous cell carcinoma
Squamous cell carcinoma is slow growing and often metastasise late. Therefore how can it be treated?
Surgically
What is the histological appearance of squamous cell. carcinomas in the lung?
Malignant epithelial tumour showing keratinisation and/or intracellular bridges
Adenocarcinomas of the lung are more common in which gender?
Women
The majority of adenocarcinomas arise in the centre of the lung. T/F?
False- 2/3 of adenocarcinomas arise in the periphery of the lung
Large cell carcinoma of the lung is a diagnosis of exclusion. T/F?
True
What is a carcinoid tumour of the lungs?
A tumour of the neuroendocrine cells
How can lung cancer patients with an ECFR receptor mutation be treated?
Tyrosine kinase inhibitor
How can lung cancer patients with an EML4-ALK gene mutation be treated?
ALK-inhibitor
How can lung cancer patients with PD-1 over expression be treated?
PD-1 inhibitors
Metastases are the most common tumours found in the lung. T/F?
True
Other than the pleura, where can a mesothelioma occur?
Peritoneum
Pericardium
Tunica vaginalis testis
Mesothelioma is almost always caused by exposure to…?
Asbestos
What are the two possible appearance of a mesothelioma histologically?
Epithelial
Sarcomatous
Combination
What CXR changes might be seen in lung cancer?
Mass lesion Lobar or lung collpase Mediatinal widening or hilar lymph node pleural effusion Slowly resolving consolidation
What investigations might be conducted to assess a patient’s fitness to undergo surgical resection of a lung tumour?
Spirometry
ECG
Echocardiogram
Give an example of an EGFR inhibitor used in the treatment of lung cancers with EGFR mutations?
Erlotinib
Give an example of an ALK inhibitor used in the treatment of lung cancers with ALK mutations?
Crizotinib
Give two examples of emergencies associated with lung cancer.
Superior vena cava obstruction
Spinal cord compression
What are the symptoms of superior vena cava obstruction?
Breathlessness
Dysphagia
Stridor
Swollen oedematous face and right arm
How is superior vena cava obstruction due to a lung cancer treated?
High dose steroids
Vascular stents
Anti-coagulation
Radiotherapy/chemotherapy
What are the signs and symptoms of spinal cord compression (which may be a result of lung cancer)?
Leg weakness and numbness
Reduce bladder and bowel control
Upper motor neurone signs in legs
How is spinal cord compression as a result of lung cancer treated?
High dose steroids
Urgent oncology input (radiotherapy) and/or neurosurgical input
