Lung Cancer -Rajukar Flashcards
Which cancers more commonly present with a cough? Why?
squamous cell and small cell carcinomas
central airway involvement
What cancers will more commonly present with bronchorrhea or cough productive of large volumes of thin, mucoid secretions?
Bronchioalveolar cell carcinoma
indicated advanced disease
What will superior vena cava syndrome present with?
prominent venous pattern on the chest, facial edema and a plethoric appearance
from SVC obstruction from lung cancer
What is Pancoast Syndrome?
When lung cancers arise in the superior sulcus
pain in the shoulder
Horner’s syndrome (ptosis, miosis and anhydrosis)
bony destruction
atrophy of hand muscles
Where does lung cancer like to spread to?
*adrenals (asymptomatic)
liver (can elevate liver enzymes)
bone (elevated all phis and Ca2+)
brain (HA, vomiting, visual field loss)
Does a negative pleural fluid cytology rule out involvement of the pleura by lung cancer?
NO
What causes hypercalcemia in lung cancer?
bony metastasis or tumor secretion of PTHrP
Tx: IV fluids and bisphosphonates
What lung cancer can lead to SIADH?
small cell lung cancer
too much ADH secreted –> hyponatremia and dec Urine output
In a diagnosis of lung cancer, what should be checked?
scan of the brain for metastasis
changes treatment and most lung cancer presents in the advanced stages
What lab tests should be ordered in lung cancer?
●Complete blood count ●Electrolytes ●Calcium ●Alkaline phosphatase ●Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ●Total bilirubin ●Creatinine ●Albumin
What is the sequence of imaging for a suspected lung cancer pt?
Chest X Ray
Computerised Tomography (CT) scan of the Chest with IV contrast
Whole Body (PET) Positron Emission Tomography/CT scan
MRI Brain with Gadolinium
What is the treatment for Stage I and II NSCLC?
Surgery (if adequate lung function)
Stereotactic body radiation therapy
Radio-frequency Ablation
Adjuvant Chemotherapy if Stage II
What is the treatment for Stage III NSCLC?
- Concurrent Chemotherapy and Radiation
What is the treatment for stage IV NSCLC?
Chemotherapy or Targeted therapy
Brain mets: Whole Brain XRT or Gamma-knife XRT
Bone mets: Zoledronic acid or Denosumab
What is the treatment for stage I -III small cell lung cancer?
Cisplatin + Etoposide with Radiation therapy
*Prophylactic Whole-Brain Radiation if good response to Chemoradiation
