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PHAM02 > lung cancer JH > Flashcards

lung cancer JH Flashcards

1
Q

% 10yr survival for lung cancer

A

10%

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2
Q

% of lung cancers that are preventable

A

79%

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3
Q

biggest RF for lung cancer

A

cigarette smoking

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4
Q

RF for lung cancer

A
  • smoking, passive smoking
  • asbestos
  • ionising radiation
  • occupation RF
  • air pollution
  • genetic predisposition
  • previous malignancies
  • old age
  • obesity
  • poor diet
  • physical inactivity
  • alcohol
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5
Q

what has the most effect on lung cancer risk with smoking

A

duration of smoking

started at a younger age

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6
Q

most common lung cancers associated with smoking

A

small cell lung cancer

SCC - squamous cell carcinoma

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7
Q

2 12 week programmes for smoking cessation in community pharmacy

A

NRT - patches, gum, inhalers, nasal spray

Champix - start 1-2 weeks before stopping

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8
Q

smoking after lung cancer surgery

A

can increase risk of pulmonary complications

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9
Q

sings/Sx of lung cancer

A
  • cough that won’t go away
  • change in cough had for long time - more painful sounds different, bringing up coloured mucus/phlegm
  • SOB
  • haemoptysis
  • pain in chest/shoulder
  • loss of appetite/weight
  • fatigue
  • ongoing chest infection
  • reduced breath sounds over lobe, inspiratory crackles over a lobe, unilateral wheeze
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10
Q

most common lung cancer in UK

A

NSCLC - non small cell lung cancer

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11
Q

types of lung cancer

A

NSCLC 80%
SCLC 15%
mesothelioma 5%

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12
Q

types of NSCLC

A
  • adenocarcinoma
  • squamous cell carcinoma
  • large cell lung cancer
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13
Q

appearance of SCLC

A

SCLC cells appear closely packed together with large nuclei

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14
Q

growth of NSCLC

A

grows at slower rate

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15
Q

features of SCLC

A
  • most aggressive
  • has nearly always metastasised at diagnosis
  • chemo sensitive
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16
Q

features of mesothelioma

A
  • aggressive
  • most caused by asbestos exposure
  • linked with heavy industry
  • not common in certain areas, might need specialist opinion
17
Q

Tx options for NSCLC

A
  1. surgery
  2. radical radiotherapy
  3. radical chemotherapy
  4. neoadjuvant chemotherapy + surgery
  5. palliative chemotherapy
18
Q

type of radical radiotherapy used for NSCLC

A

CHART

continuous hyperfractionated accelerated radiotherapy

19
Q

When is surgery Tx choice in NSCLC?

A

in stage I-II

20
Q

When can chemo be used in NSCLC?

A

before or after surgery

before, after of with radiotherapy Tx

21
Q

What is chemo before surgery called?

A

neo adjuvant chemotherapy

22
Q

common chemo drugs used for NSCLC

A

cisplatin
carbopatin

with 1+ other drug

23
Q

What mutation can occur in lung cancer?

A

EGFR

mutation in epidermal growth factor receptor gene

24
Q

What does EGFR control?

A

cell proliferation and growth

25
Q

targeted therapies for EGFR mutation

A

TKIs (EGFR inhibitors)

Erlotinib
Gefitinib
Afatinib

26
Q

adverse effects of TKIs (2)

A

skin disorders
- acneiform rash
- dry skin
- itching

diarrhoea

27
Q

Tx for skin disorders with TKIs

A

steroids
topical/oral ABX
topical retinol

28
Q

serious s/e with EGFR inhibitors

A
  • serious cases of keratitis and ulcerative keratitis (inflammation of cornea)
  • rarely can result in corneal perforation and blindness
  • present with Sx of keratitis, refer to opthalmology specialist
29
Q

stage when palliative chemo is used in lung cancer

A

stage 3B or 4

30
Q

high risk of what with SCLC

A

brain metastases

31
Q

staging for SCLC

A
  1. limited stage disease
    - cancer contained in single area that can be treated
    - chemotherapy then radiotherapy/chemoradiotherapy
    - few get surgery
  2. extensive stage disease
    - cancer spread beyond single area that can be treated
    - advanced disease
    - Tx aims to control cancer for as long as possible and help with Sx -> palliative Tx
32
Q

1st line Tx in SCLC in limited stage disease

A

chemotherapy

33
Q

chemo drugs for SCLC

A

carboplatin/cisplatin + etoposide

4-6 cycles

PHAM02 (32 decks)

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