Lung Cancer Flashcards
Define Lung Cancer?
Primary Malignant Neoplasm of the lung
What is the WHO classification of bronchocarcinoma?
Small Cell Lung Cancer - 20%
Non-Small Cell Lung Cancer- 80%
What are the risk factors for lung cancer?
Smoking
Asbestos Exposure
Other occupational exposure: polycyclic hydrocarbons, nickel, radon
Atmospheric Pollution
What is the epidemiology of Lung Cancer?
Most common fatal cancer in the west (18% of cancer mortality worldwide)
3x more common in males
What are the presenting symptoms of lung cancer?
May be asymptomatic
Symptoms due to primary
Symptoms due to local invasion
Symptoms due to metastatic disease or paraneoplastic phenomenon
What are the symptoms due to primary in Lung Cancer?
Cough
Haemoptysis
Chest pain
Recurrent pneumonia
What are the symptoms due to local invasion in Lung Cancer?
Brachial Plexus Invasion leads to shoulder/arm pain
Left recurrent laryngeal nerve invasion leads to hoarse voice and bovine cough
Dysphagia
Arrhythmias
Horner’s Syndrome
What are the symptoms due to metastatic disease or paraneoplastic phenomenon in Lung Cancer?
Weight Loss
Fatigue
Fractures
Bone Pain
What are the signs of Lung Cancer on physical examination?
May be no signs
Fixed monophonic wheeze (suggesting there is a single obstruction)
Signs of lobar collapse or pleural effusion
Signs of metastases (e.g. supraclavicular lymphadenopathy or hepatomegaly)
What investigations would you do for diagnosis for lung cancer?
CXR Sputum Cytology Bronchoscopy with brushings or biopsy CT/US-guided percutaneous biopsy Lymph node biopsy
What would you do for staging of Lung Cancer?
Requires CT/MRI of head, chest and abdomen
PET scans may also be useful
What bloods would you do for Lung Cancer and what might they mean?
FBC U&Es Calcium (hypercalcaemia is a common feature) ALP (raised with bone metastases) LFTs
What investigations would you do Pre-Op in Lung Cancer?
ABG
Pulmonary Function Tests