Lung Cancer - Pathology Flashcards
What is the most common category of lung cancers?
Carcinomas
Name the most common 4 lung carcinomas and their porportion:
Squamous Cell Carcinoma (40%)
Adenocarcinoma (41%)
Small Cell Carcinoma (15%) (SCLC)
Large Cell Carcinoma (4%) (LCLC)
What is NSCLC?
Non-Small Cell Lung Cancer.
It is used to catergoize the other 3 types of lung carcinoma.
However its an outdated term as they are vastly different cancers.
It should only be use it is in diagnosis when they only thing we can tell about the cancer is that its definetely not small cell.
What other types of cancer can appear in the lung beyond the carcinomas?
- Carcinoid Tumours
- Bronchial Tumours
- Lymphoma
- Sarcoma
- Metastases from elsewhere
How is important is lung cancer specifically?
IT is the 3rd most prevalent cancer in the world.
It also has the alrgest mortality of all cancers.
How many deaths does ,ung cancer cause in the UK?
~6% of all UK deaths
What are the possible causes of Lung Cancer?
- Smoking
- Asbestos
- Enviromental Radon
- Occupational Exposure
- Air pollution
- Radiation
- Pulmonary Fibrosis
Which cause is the most important in lung cancer aetiology?
Smoking accounts for >85% of lung cancers.
What kind of materials are people exposed to at work that can cause lung cancer?
Chromates
Hydrocarbons
Nickel
Etc.
How do we meausre someones tobacco consumption?
In pack years
Which packs per day per year
How does passive smoking affect cancer risk?
Passive smoking doubles your risk of cancer.
It accounts for 1/4 of non-smoking lung cancers
Does the cancer risk from smoking stop when you do?
No genomic damage persists but it does very slow improve over years
How many recognised carcinogens are there in tobacco smoke?
~60
What do inherited polymorphisms predispose some people to regarding smoking?
Some people are predisposed to nicotine addiction
Others metabolise pro-carcinogens into carcinogens.
What divides the 2 main carcinogenisis pathways in the lung?
Location.
One is peripheral and one central
Describe the peripheral pathway for lung carcinogensis?
Bronchioalveolar epithelial cells transform
-> Adenocarcinoma
Describe the central pathway of carcinogenenisis?
Bronchial epithelial stem cells transform
-> Squamous Cell Carcinoma
Define oncogene addiction?
Despite containing many genetic abnormalities, a cancer is often reliant upon a sinle oncogene mutation known as the key driver.
How is oncogene addiction useful to us?
It provides the basis for targeted molecular therapy. Targeting the key driver oncogene can disable the whole cancer
What is the most common oncogene addiction?
KRAS.
~35% of oncogene addictions are to KRAS/
This mutation is smoking induced.