Lung Cancer Oct 16 M2 Flashcards
most frequent cause of cancer death in North America in males and females
lung cancer
how lung cancer deaths compare to 3 next most deadly cancers
greater than deaths of colon, prostate and breast cancer combined
what percentage of patients presetn with locally advanced or metastatic lung cancer
85%
main risk factor for lung cancer
cigarette smoking
what % of lung cancer patients never smoked
1 out of 5 (20%)
how lung cancer rates are varying in non smokers
increasing
lung cancer most strongly associated with cigarette smoking
small cell carcinoma
what components of cigarette smoking influence risk of dev cancer
duration, quantity, age of start
T-F: when stop smoking: cancer risk can go back to baseline
False. drops but never back to as if never smoked
asbestos and smoking together: risk for lung cancer
multiplicative effect (increase risk by 40x)
other risk for lung cancer (related to previous diseases (2)
old TB scars
pulmonary fibrosis
first sutdy showing screening method for lung cancer and conclusion
National Lung Screening Trial study: low dose CT in pop at risk shows reduction in mortality
how small cell lung cancer differs from others
has the worst prognosis
lung cancers that are proximal
neuroendocrine (small cell, carcinoid) and squamous cell CA
lung cancers that are peripheral
adenocarcinoma, large cell
most common lung cancer in non smokers
adenocarcinoma
what lung cancer tends to cavitate on CXR
squamous cell carcinoma
in non-small cell Ca patients, how symptoms and disease progression correlate
75% of symptomatic patients have advanced stage disease
small cell lung CA: how many patients have symptoms and how correlates with advanced disease
90% of small cell have symptoms. most have advanced disease
main locoregional lung cancer symptoms
cough, chest pain, dyspnea, hemoptysis
superior vena cava obstruction syndrome symptoms
facial swelling, collateral veins swelling
Pancoast syndrome symptoms and cause
hand or arm pain, Horner’s (ptosis, myosis, anhydrosis) bc involvement of brachial plexus (SS chain)
what lung CA associated with hypercalcemia
squamous cell CA
paraneoplastic syndromes def
syndromes related to ectopic hormones or anomalies related to Ig formation
paraneoplastic syndromes more common in what lung CA
small cell CA
paraneoplastic syndromes in small cell CA
Cushing’s (ectopic ACTH), neuro syndromes, SIADH)
paraneoplastic syndromes in NSCLC
hypercalcemia, hypertrophic osteoarthropathy and clubbing
complicated name for clubbing
hypertrophic pulmonary osteoarthropathy
good diagnostic test with central tumours
bronchoscopy
staging tests important to know (3)
Chest X ray. CT from thorax to adrenals.
Pathological confirmation
Useful method for cancer staging
PET scans
What method used for lung cancer staging
TNM method
what lung CA is staged differently from others
small cell CA
limited vs extensive: definition when use that in staging
limited: one hemithorax and regional lymph nodes (fits in single radiation field)
main treatment for small cell lung cancer and when to expect improvement
chemotherapy. improvement after 1st treatment
