Lung Cancer Flashcards by Lauren Horsburgh

Lung cancer normally occurs in what age group?

> 75 years

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What is the biggest risk factor for the development of lung cancer?

Smoking

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Lung cancer has a good prognosis. T/F?

False

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What types of lung cancer is smoking particularly associated with?

Squamous and small cell lung cancer

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Stopping smoking reduces the risk of lung lung cancer. T/F?

True - but this takes time

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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

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What are the signs and symptoms of lung cancer?

Cough
Haemoptysis
Shortness of breath
Chest pain
Weight loss/anorexia
General malaise

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What can result from thoracic duct involvement in lung cancer?

Chylothorax

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What can result from pericardial involvement in lung cancer?

Pericarditis

Effusion

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What can result from recurrent laryngeal nerve involvement in lung cancer?

Hoarseness

Vocal cord paralysis

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What can result from eosophageal involvement in lung cancer?

Compression dysphagia
Pneumonia
Tracheoesopahgeal fistula

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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

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Where do lung cancer spread to via haematogenous spread?

Liver
Bone
Brain
Adrenal glands

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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

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Small cell cancers are usually advanced at diagnosis and respond to chemotherapy. T/F?

True

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Non-small cell cancers may be localised at diagnosis and can be treated by surgery or radiotherapy. T/F?

True

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What cancers are encompassed by non-small cell lung carcinoma?

Adenocarcinoma
Squamous cell. carcinoma
Large cell carcinoma
Other lung cancers

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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

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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