Lung cancer Flashcards
What does paraneoplastic mean?
- non-metastatic systemic side effects of a malignant tumour
- finger clubbing, weight loss, tiredness etc.
What are the main causes of a bronchial carcinoma?
- smoking (90%)
- radon exposure
- asbestos
- genetics
Types of lung cancers?
- small cell
- non-small cell:
- adenocarcinoma
- squamous cell carcinoma
- large cell carcinoma
Symptoms of lung cancer?
- cough (more than 3 weeks)
- haemoptysis
- unexplained weightloss
- breathlessness
- hoarse voice (recurrent laryngeal nerve)
- stridor (inspiraton)
- recurrent pneumonia
Regions of metastic spread?
- brain
- liver
- skin
- adrenal glands
- bone
Symptoms of liver metasis
- nausea
- anorexia
symptoms of brain metasis
- headaches
- confusion
Pancoast tumour?
- apex of lungs
- muscle wasting
SVC tumour
- superior vena cava
- reduced drainage from the head and neck
- swelling in face
Oesphageal tumour
- dysphagia (difficulty swallowing)
Pain associated with lung cancer?
- invading chest wall
- sharp localised pain
Pleural effusion?
- Fluid in the pleural space
- compresses lung
- breathlessness
What drug can you give for swelling in the brain?
Dexamethasone
What causes hypercalcaemia?
- tumour produces hormones that mimic the parathyroid hormone
- tends to be squamous cell carcinomas
Treatment of hypercalcaemia?
- Rehydration
- IV bisphosphonate
Treatment of SIADH
- Fluid restrictions <1.5l
- Demeclocycline
Investigations into lung cancer?
- CXR
- CT
- PET
- bronchoscopy
Why is it important to investigate type of lung cancer?
- appropriate treatment
Lung cancer staging?
TNM
- T = Tumour size
- N = Nodal spread?
- M = Metasis
Treatment of small cell carcinoma
- Chemotherapy (pallitative)
- Pallitative radiotherapy
Treatment of non-small cell carcinomas
- depending on metasis
- non-metasis - surgery, radiotherapy
- pallitative radiotherapy
- pallitative care?
What is the most common lung cancer in smokers?
- squamous cell carcinoma
k-ras and EGFR mutations associated with?
- non-small cell
Associated with liver metasis?
- ALP
- Alkaline Phosphatase
