Lung cancer Flashcards
%wise how many lung cancers are caused by smoking?
90%
what are the two categories of lung cancers,
and their commonness as a &.
Small cell lung cancer 15%
Non-small cell lung cancer 85%
of the two categories of lung cancer which is more aggressive with a worse prognosis?
Small cell lung cancer
of the two categories of lung cancer, which will rarely every have surgery done.
and why?
Small cell lung cancer
mets because it divides rapidly.
SCLC is derived from which neuroendocrine cell?
Kulchitsky cells
is smoking a RF for SCLC?
yes
why is called small cell lung cancer?
because cells are small
generally is prognosis good or bad for lung cancer?
bad
what are the three most common types of NSCLC?
and their commonness %wise?
Adenocarcinoma (40%)
Squamous-cell (25-30%)
Large-cell (10-15%)
which non-small cell lung cancer has a weak link to smoking?
Adenocarcinoma
Adenocarcinoma is derived from what type of tissue?
glands
which non-small cell lung cancer are peripheral lesions?
- 2
Adenocarcinoma
Large-cell
which non-small cell lung cancer is a central lesion?
Squamous-cell
Cushing’s syndrome is associated with what type of lung cancer.
small cell lung cancer
how does ADH affect Na+ levels.
which category of lung cancer is associated with increased ADH?
lowers [Na+]
small cell lung cancer
Hypertrophic pulmonary osteoarthropathy is associated with which category of lung cancer?
non - small cell lung cancer
increased β-HCG is associated with which type of cancer?
Large-cell
hypercalcaemia is associated with which type of cancer?
Squamous-cell
lung cancer pt has hoarseness of voice,
why is he/she having this symptom?
lung mass pressing on left recurrent laryngeal nerve
lung cancer pt has raised hemidiaphragm on CXR,
why is he/she having this symptom?
phrenic nerve pressed on by mass
lung cancer pt has dyspnoea + wheezing.
why is he/she having this symptom?
mass pushing on airways
lung cancer pt has:
dyspnoea
pulseless jugular venous distension
swelling of the face, neck and arms
diagnosis?
svc obstruction
pt has lung cancer,
you are suspicious of bone mets.
what scan do you do to confirm?
bone scan.
how many lung cancer pts will have cervical lymphadenopathy % wiise?
30%
why is there haemoptysis with lung cancer?
- 2 reasons
neovascularisation from tumour
airways erode causing bleeding
symptoms of lung cancer?
- 8 in total
(remember the standard cancer symptoms)
Cough Haemoptysis SOB Pleuritic chest pain Fever, weight loss, lethargy, night sweats
sign of lung cancer when auscultating?
wheeze
sign of lung cancer when percussing?
explain the cause of this sign.
Stony dull percussion
pleural effusion
sign of lung cancer around the fingers?
clubbing
sign of lung cancer around the neck on palpating?
lymphadenopathy
which type of lung cancer is particularly associated with lung cancer?
squamous
pt suspected of lung cancer based on history.
CXR done.
what features will come on CXR for a lung cancer pt?
- 4 things
big hilars, pleural effusion, consolidation, opacities
pt suspected of lung cancer.
what bloods do you do and why?
- 3
FBC – anaemia of chronic disease & thrombocytosis
Na+ - low=ADH secretion
Ca2+ - high=bone mets
CXR shows features of lung cancer.
what is the next IX to confirm this which is also the gold. S IX?
CT chest with contrast
which scan is used for staging after the CT?
- the scan is used more so for NSLC.
PET scan
which radionuclide is used in PET scanning?
18-fluorodeoxygenase
what method is used for biopsy of central lesion and peripheral lesion lung cancer?
if pt is not suitable for standard biopsy method in regards to central lesion, what is the next method??
Peripheral lesions – percutaneously
Central lesions – bronchoscopy
sputum cytology if bronchoscopy not tolerated.
how many CXR are negative with lung cancer pts (% wise)?
10%
usual Mx for SCLC?
chemoradiotherapy
of SCLC and NSCLC, which is surgery more viable on?
and why?
NSCLC
SCLC very aggressive, so mets
before doing lung cancer surgery, a mediastinoscopy needs to be done.
why so?
check for lymphadenopathy (that can be missed n CT)
CI for lung cancer surgery?
- 4
cancer has metastasised, tumour near hilum, malignant pleural effusion, vocal cord paralysis
of SCLC and NSCLC which has a poor response to chemo?
NSCLC
define lobectomy
remove lobe
define pneumonectomy
remove lung
1st lifestyle MX for lung cancer?
quit smoking
Ix to check Mets?
PET scanning
which Ix do you do before surgery?
why?
mediastinoscopy
shows mediastinal lymph node involvement if any
most people’s Mx if the have lung cancer?
after lifestyle factor changes
chemo + radiotherapy
clubbing is a sign of what particular lung cancer?
squamous cancer
stony dull percussion is a sign of what on percussion?
pleural effusion
Hoarseness of voice comes what from tumour, i.e. give the name of the tumour?
what is happening to cause this hoarseness of voice?
Pancoast tumour
presses on recurrent laryngeal nerve
for lung cancer CXR is normal in how many pts?
- % wise
10%
Horner’s syndrome is caused by what exactly?
what will be the classic symptoms?
something pressing on sympathetic trunk
miosis, ptosis, anhidrosis (all on one side)
Ix of choice for lung cancer?
CT
Ix to get histological diagnosis of lung cancer?
bronchoscopy + biopsy
which lung cancer secretes beta-hCG and is on periphery?
Large Cell cancer
which lung cancer causes ↑PTH?
the ↑PTH will cause a rise in what mineral in the blood?
Squamous
↑Ca2+
