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Lung cancer Flashcards

1
Q

How common in lung cancer?

A

It is the most common malignant tumour worldwide and the 3rd most common cause of death in the UK after IHD and cerebrovascular disease

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2
Q

What are the two types of bronchial carcinoma?

A
  1. Small cell lung carcinoma

2. Non small cell lung carcinoma

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3
Q

What type of cancer make up the non small cell?

A
  • Squamous carcinoma
  • Adenocarcinoma
  • large cell and differentiated carcinoma
  • Carcinoid tumours and neuroendocrine
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4
Q

Where can the tumours locally spread to?

A

The chest and may directly involve the pleura and ribs resulting in bone pain and fractures

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5
Q

What is the location of SCLC?

A

Central bronchus

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6
Q

What cell type is involved in SCLC?

A

Neuroendocrine cells

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7
Q

What do SCLC’s tend to excrete?

A

Polypeptide hormones e.g ADH and adrenocorticotropic

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8
Q

In general terms what is the rate of metastasis like in SCLC?

A

Very fast and widespread

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9
Q

What is the prognosis like in SCLC?

A

Poor

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10
Q

What is NSCLC associated with?

A

Smoking

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11
Q

Which NSCLC is mostly associated with smoking?

A

Squamous cell carcinoma

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12
Q

Where are squamous cell carcinomas most commonly located?

A

central

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13
Q

What cell type is involved in squamous cell carcinoma?

A

Epithelial cells

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14
Q

What do squamous cell carcinomas secrete?

A

Keratin

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15
Q

What is the metatasis nature of squamous cell carcinoma?

A

Local spread is common but mets are later

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16
Q

What is the most common lung cancer in none smokers?

A

Adenocarcinoma

17
Q

What is the location of adenocarcinomas?

A

Tend to be peripheral e.g bronchioles or alveoli wall

18
Q

What type of cell is effected in adenocarcinoma?

A

Glandular cells

19
Q

What are the secretions of an adenocarcinoma?

A

Mucus

20
Q

Where do adenocarcinomas metastasise to?

A

Metastasis are common and usually go to the pleura, lymph nodes, brain, bones and adrenal glands

21
Q

What cell type are involved in carcinoid tumours?

A

Neuroendocrine cells

22
Q

What is the nature of the metastasise in carcinoid tumours?

A
  • Relatively low rates of invasion
23
Q

What are the most common sites of metastatic lung cancer spread?

A
  • Mediastinum and hilar lymph nodes
  • Liver
  • Bone
  • Lung pleura
  • Heart
  • Breasts
  • Adrenal glands
  • Brain
24
Q

What is more common primary or secondary lung cancer?

A

Secondary e.g breast, bowel, kidney, bladder

25
Q

What are the risk factors for lung cancer?

A
  • Cigarette smoking
  • Occupational e.g Asbestos
  • Environmental e.g Ionising radiation
  • Host factors e.g pre-existing lunch disease
26
Q

What presenting symptoms are seen in local disease?

A
  • Cough
  • Breathlessness
  • Haemoptysis
  • Recurrent infections
27
Q

What presenting symptoms are seen in metastatic disease?

A
  • Bone pain
  • Headache
  • Seizures
  • Neurological deficit
  • Hepatic pain
  • Abdo pain
28
Q

What are paraneoplastic changes?

A

Conditions which occur as a side effect of the tumour and occur in 10% of patients

29
Q

What hormones can be secreted in paraneoplastic syndromes?

A
  • PTH
  • ADH
  • ACTH
30
Q

What is the TNM classification?

A
  • Tumour - how big it is
  • Nodes: how many and where they are
  • Metastasis (M1a = tumour on same side, M1b = tumour elsewhere)
31
Q

What do you find on a CXR in lung cancer?

A
  • Appears as a round shadow - ‘coin lesion’
  • Edge has a fluffy spiked appearance
  • Hilar enlargement
  • Consolidation
  • Lung collapse
  • Pleural effusion
32
Q

Why would you use a CT in the investigations for lung cancer?

A

To stage the tumour

33
Q

Why would you use a bronchoscopy in investigation lung cancer?

A
  • To give histology and assess operability

- Tells you about infections which also appear as round spots on a CXR

34
Q

What is the treatment for NSCLC?

A
  • Surgical excision
  • Curative radiotherapy
  • Chemotherapy
35
Q

What is the treatment for SCLC if the disease is limited?

A

Combined chemotherapy and radiotherapy

36
Q

What is the treatment for SCLC if the disease is extensive?

A

Chemotherapy but relapse is likely

37
Q

What palliative care is used in SCLC?

A

Radiotherapy and dexamethasone for superior vena cava obstruction

38
Q

What drugs could be used in the treatment of SCLC?

A
  • Analgesia
  • Steroids
  • Antiemetics
  • Codeine
  • Bronchodilators
  • Antidepressents

Resp (8 decks)

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