Lung cancer Flashcards
SCLC main stuff
Agressive
Sensitive to chemotherapy
Smoking
Surgery is not commonly used
Which patients with NSCLC are candidates for surgical resection
Patient diagnosed in early stages (Until stage IIIA)
Which lung cancer form is the most common in women?
Adenocarcinoma
Adenocarcinoma is frequently (location)
Peripheral
Squmous cell carcinoma is more often found in which population?
Smokers
men
T1 stage
Tumor < 3 cm
Not involving main bronchus
T2 stage
Tumor > 3 cm
or
Involving main bronchus
T3 stage
Tumor into the chest wall/diaphragm but nor beyond carina or mediastinum
T4 stage
Tumor into the carina and/or mediastinal structures, heart, great vessels
N0
No lymph node involvement
N1
Ipsilateral peribronchial or hilar nodes
N2
Ipsilateral mediastinal or subcranial nodes
N3
Contralateral mediastinal/Hilar, supraclavicular, bilateral or scalenus lymph node bil.
M0
No metastasis
M1
Distant metastasis (Beyond regional lymph nodes)
SCLS stage I-III first line of treatment
Ciplatin/ Carboplatin + Etoposide
Chemotherapy 6 cycles
Thoracic radiotherapy is given after the 3rd course
SCLS stage IV second line of treatment
Topotecan OR
Epirubicine-Cyclophosphamis-Vincristine
4 cycles
NSCLC surgucal treatment is for what stages
IA-IIIA
What is Adjuvent chemotherapy?
After surgery to improve the outcome
For patients with stage IB-IIIA
What is Neo-Adjuvent chemotherapy?
Before surgery to make the lesion resecable (IIIA)
What does Palliative mean?
Relieving pain without dealing with the cause of the condition
NSCLC- Contraindication for surgery
Old MI in past 3 months Arrhythmias Pulmonary HTN Severe COPD
NSCLC stages IIIB-IV chemotherapy is _____ based
Platinum
When will we give second/third line of treatment?
Id first line fails
or
Progression occurs within 6 months after previous line
second/third line of treatment drugs
Docetaxel
Pemetrexed monotherapy
Chemotherapy MOA
Kills cells that divide rapidly
Chemotherapy side effects
Bone marrow- Myelosuppression
GI- Nausea, Vomiting
Hair
Fatigue
Neuropathy
Molecular targeted therapy in locally advanced IIIB and metastatis IV adenocarcinoma
Bevacizumab- VEGF inhibitor (With chemotherapy)
Gefitinib, Erlotinib- EGFR Antag. (Tyrosine-Kinase inhibitor)
Bevacizumab- VEGF inhibitor side effects
Bleeding
Haemoptysis
HTN
VEGF inhibitor drug name
Bevacizumab
What is ALK+
Anaplastic Lymphoma Kinase +
Cancer may grow more quickly
ALK+ occurs in what % in NSCLC?
5%
NSCLC types and %
Adenocarcinoma 40%
SCC 25-30%
LCC 10-15%
Others 15-25%
SCLC is usually treated with ___
Why?
Chemotherapy
High sensitivity
Origin of SCLS
Neuroendocrine cells
TNM staging
T 1-4
N 0-3
M 0/1
Adenocarcinoma can manifest in what syndrome and why?
Horner syndorme
Pancoast tumor that compress nearby vessels and nerves- Brachial plexus, Cervial symp. chain
Horner syndrome
Ptosis
Miosis
Anhydrosis
Which hormone can be released by SCC
Parathyroid hormone
Symptoms in case of carcinoid lung cancer
Serotonin/Carcinoid syndrome
Serotonin induced valvular fibrosis and bronchoconstriction, Flushing
Most common metastasis sites of lung cancer
Bone Liver Lymph Adrenal Brain
What causes hoarseness?
Recurrent laryngeal nerve palsy
If the cancer lesion is present in the middle of the lung, how can we take biopsy?
VATS
Video Assisted Thoracic Surgery
