Lung Cancer

Question 1

Where does almost all lung CA arise?

Answer 1

In the epithelial tissue of the airways and alveoli (95%)

Question 2

T or F:

Lung CA can be either primary or secondary

Answer 2

T

Question 3

Where is lung CA likely to metastasize to?

Answer 3

• Bone
• Liver
• Brain

Question 4

What are 5 primary types of lung CA?

Answer 4

• Small cell carcinoma (12%) → SCLC (small cell lung cancer)
• Large cell carcinoma (12%) → NSCLC (non-small cell lung cancer)
• Squamous cell carcinoma (27%) → NSCLC
• Adenocarcinoma (30%) → NSCLC
• Mixed group (5%) (Ex. Neuroendocrine cancers, lymphoma)

Question 5

What are 3 possible causes for lung CA?

Answer 5

• Mostly smoking (>85%)
• Toxins (ex. Asbestos)
• Marijuana?

Question 6

Overview of Small (oat) cell carcinoma (size of oat grains)

Answer 6

• 99% in smokers, worst form
• Small, oval cells, non resectable
• Aggressive, invasive, early metastasis (especially to the brain)
• Metastasis already occurred at diagnosis (70%)
• Paraneoplastic syndromes (aka ectopic tumor) (ex. tumor releasing ACTH causing Cushings; tumor
  releasing ADH)

Question 7

What is the most common form of lung CA?

Answer 7

Adenocarcinoma

Question 8

Who is typically affected by adenocarcinomas?

Answer 8

• Women

- Non-smokers

Question 9

Where does an adenocarcinoma originate?

Answer 9

In the bronchioles and alveoli (peripheral)

Question 10

T or F:

Squamous cell carcinoma is more common in women.

Answer 10

F, men

Question 11

Where does squamous cell carcinoma originate?

Answer 11

Has a central origin in the trachea and bronchi

Question 12

For this CA to arise, it must arise in ________ cells.

Answer 12

Existing

Arises in the intraluminal cells

Question 13

What other body structure is affected by squamous cell carcinoma? Why?

Answer 13

The mediastinum due to its location

Question 14

What/where are the hilar nodes and how does this relate to squamous cell carcinoma?

Answer 14

• Hilar = where the bronchi enter the lungs

- Lymph nodes are located in the hilar node region which will contribute to metastasis

Question 15

Overview of large cell carcinoma:

3

Answer 15

• Large, undifferentiated cells
• Originates in periphery
• Early metastasis → poor prognosis

Question 16

What is hemoptysis and why does this occur in lung CA?

Answer 16

Coughing up blood due to hemorrhaging of vessels

Question 17

If central tumor will obstruct the airway and cause irritation, what mnfts of this would you expect to see?

Answer 17

• Coughing, wheezing, dyspnea

- Cardiac manifestations (ex. Cardiac tamponade)

Question 18

What are the Dx for lung CA?

Answer 18

• Hx, Px
• Imaging
• Bronchoscopy, needle aspiration (biopsy sample)
• Cytology (sputum/bronchial wash)

Question 19

What is the Tx of lung CA?

Answer 19

• SCLC: chemo, radiation

- NSCLC: surgery, radiation, chemo