Lung Cancer

Question 1

Main classification of lung cancer?

Answer 1

small-cell

non-small-cell

Question 2

Non small cell carcinoma examples?

Answer 2

Squamous cell carcinoma,

Adenocarcinoma

Large-cell

Question 3

RFs for Squamous cell carcinoma of lung M:F?

Answer 3

M>F

smoking

radon gas

Question 4

Squamous cell carcinoma site?

Answer 4

central near bronchi

Question 5

Squamous cell carcinoma ectopic hormone

Answer 5

PTHrP → ↑ Ca2+

Question 6

Adenocarcinoma RFs?

Answer 6

F>M

non-smoker,

far east

Question 7

Adenocarcinoma site

Answer 7

peripheral

Question 8

Large cell carcinoma site

Answer 8

Central or peripherally located

Question 9

Differentiation level of non- small cell carcinoma

Answer 9

Squamous cell carcinoma (squamous) adenocarcinoma (glandular)

large-cell (poorly differentiated)

Question 10

Small cell carcinoma site

Answer 10

central near bronchi

Question 11

Small-cell carcinoma differentiation

Answer 11

poorly differentiated

Question 12

Small-cell carcinoma prognosis

Answer 12

very chemo sensitive, poor prognosis though

Question 13

Complications of lung cancer?

Answer 13

Recurrent laryngeal N. palsy

Phrenic N. palsy

SVC obstruction

Horner’s (Pancoast’s tumour)

AF

Question 14

Endocrine complications of lung cancer?

Answer 14

• ADH → SIADH ( euvolaemic ↓Na+)
• ACTH → Cushing’s syndrome- Serotonin → carcinoid (flushing, diarrhoea)
• PTHrP → 1O HPT (↑Ca2+, bone pain)

Question 15

Non-small cell lung carcinoma management?

Answer 15

1. Surgical Resection
2. Curative radiotherapy
3. Chemo ± radio for more advanced disease

Question 16

Small cell carcinoma of lung management?

Answer 16

Palliation

1. Radio: bronchial obstruction, haemoptysis, bone or CNS mets
2. SVC obstruction: stenting + radio + dexamethasone
3. Endobronchial therapy: stenting, brachytherapy
4. Pleural drainage
5. Analgesia

Question 17

Prognosis of small cell

Answer 17

1-1.5yrs median survival treated;

3mo untreated

Question 18

Prognosis of non-small cell

Answer 18

50% 5ys w/o spread

10% ̄c spread

Question 19

Malignant mesothelioma def

Answer 19

mesothelial cell tumour in pleura

Question 20

Cause of mesothelioma

Answer 20

asbestos

Question 21

Dx of mesothelioma

Answer 21

thoracoscopy, biopsy + histology

normally post-mortem

Question 22

Rx of mesothelioma

Answer 22

Pemetrexed + cisplatin chemotherapy

Pleurodesis and indwelling intra-pleural drain may help

Question 23

Pleurodesis

Answer 23

adhering visceral and parietal pleurae

stops air/fluid building up