LUNG CANCER

Question 1

WHAT ARE THE RISK FACTORS FOR LUNG CANCER?

Answer 1

1) Smoking
2) Family history
3) Increasing age
4) Exposure to carcinogens- asbestos

Question 2

WHAT ARE THE SYMPTOMS OF LUNG CANCER?

Answer 2

UNEXPLAINED!!

1) Cough
2) Fatigue
3) Dyspnoea
4) Chest pain
5) Weight loss
6) Appetite loss
7) Haemoptysis

Question 3

WHAT IS THE WHO PERFORMANCE STATUS?

Answer 3

Indicates patients fitness level whilst living with cancer and gives an indication to their tolerance to treatment.
On a scale of 0 (normal) to 5 (dead)

Question 4

WHEN SHOULD YOU REFER A PERSON WITH SUSPECTED LUNG CANCER?

Answer 4

• CXR finding suggestive of lung cancer

- Aged >40 with unexplained haemoptysis

Question 5

WHEN SHOULD AN URGENT CXR FOR SUSPECTED LUNG CANCER BE OFFERED?

Answer 5

People aged 40 and over with 2 or more of the unexplained symptoms.
Performed within 2 weeks

Question 6

WHAT ARE THE SIGNS OF LUNG CANCER?

Answer 6

• finger clubbing
• cachexia
• anaemia
• bone tenderness and hepatomegaly - metastases

Question 7

WHAT STAGING SYSTEM IS USED FOR LUNG CANCER?

Answer 7

TNM staging

Question 8

WHAT INVESTIGATIONS ARE CARRIED OUT FOR LUNG CANCER?

Answer 8

1) Bloods – FBC, U&E, Calcium, LFT’s, INR
2) CXR
3) Staging CT – Spiral CT Thorax and Upper Abdo – helps to stratify TNM stage , identify metastases
4) PET scan - helps identify metastases not seen on CT, usually for surgical candidate
5) Biopsy - bronchoscopy, CT biopsy

Question 9

WHICH 2 GROUPS ARE LUNG CANCERS CLASSIFIED INTO?

Answer 9

1) Small cell lung cancer- metastasise quicker

2) Non small cell lung cancer

Question 10

WHAT IS THE TREATMENT FOR LUNG CANCER STAGE 1 AND 2?

Answer 10

Curative surgery- assuming fir for surgery

Question 11

WHAT IS THE TREATMENT FOR LUNG CANCER STAGE 3?

Answer 11

Surgery and adjuvant chemotherapy clinical trials

Question 12

WHAT IS THE TREATMENT FOR LUNG CANCER STAGE 3/4?

Answer 12

Chemotherapy

Question 13

WHEN IS RADIOTHERAPY CONSIDERED?

Answer 13

• curative for people not fit for surgery

- palliative

Question 14

WHAT ARE THE COMPLICATIONS/ EFFECTS OF LUNG CANCER?

Answer 14

1) Paralysis of diaphragm due to tumour impinging of phrenic nerve, leads to ipsilateral elevation of diaphragm
2) Pancoast tumour (high in lung) has 4 effects

Question 15

WHAT ARE THE EFFECTS OF A PANCOAST TUMOUR?

Answer 15

1) Hoarse voice - caused by impingement of recurrent laryngeal nerve that loops under aorta
2) Horner’s syndrome - compression of sympathetic trunk leads to miosis (constricted pupil), ptosis (droopy upper eyelid), anhidrosis (localised inability to sweat).
3) Pain and paraesthesia in the forearm - compression of C8 and T1 roots of brachial nerve
4) Wastage of muscle in lower forearm and hands (thenar eminence) caused my compression of C8 and T1 roots of brachial nerve in brachial plexus