Lung Cancer (Thomas) Flashcards
overall survival of patients diagnosed with lung cancer is ___% @ 5 years, with a separation between people in early and late stage disease.
14%
Name 3 features of lung cancer that are evident on a CT scan
- tumor of >1.0 cm
- spiculated (radiating spikes)
- irregular, lobular border
second leading cause of lung cancer
radon exposure
what are the 4 biggest thoracic symptoms present in patients with lung cancer?
cough
dyspnea
chest pain
hemoptysis
Procedure in which a needle is inserted between the ribs
and pleural effusion is suctioned out. Collected fluid can be centrifuged and any cells present examined microscopically on a “cytology exam.”
Thoracentesis;
Malignant pleural effusion is assigned M1 status in TNM system, which translates to Stage IV.
Because symptoms occur late in the course of lung cancer, ____ disease is often present at the time of diagnosis.
metastatic
Why would lung cancer screening guidelines stop at age 74?
Because heavy smokers older than this age are unlikely to have a survival benefit even if lung cancer were detected.
Which of the following is associated with substantially increased risk of lung cancer in a non-smoking individual?
a) Age 50
b) Brother with lung cancer
c) Works in a rubber tire factory
d) Lives in a urban environment
e) Has a natural gas cook stove
b
Which of the following statements about lung cancer in the United States is correct?
a) Lung cancer is the most common incident cancer as well as the most common cause of cancer mortality
b) Given the large number of lung cancer causes, it is unlikely that further decline in lung cancer deaths can be achieved by tobacco cessation and restriction
c) Reducing barriers to health care access and health education may benefit patients with lung cancer risk factors
d) Lung cancer is a less important cause of death in the United States than stroke and chronic obstructive pulmonary disease
c
The symptoms of lung cancer most concerning for distant disease or metastasis include:
a) back pain
b) hemoptysis
c) shortness of breath
d) headache
e) all of the above
e
How would you approach a patient with suspected lung cancer who has dullness to percussion on the left chest and a CT scan confirming a large pleural effusion?
a) Biopsy not necessary, pursue palliative care
b) Thoracentesis with cytology exam of fluid
c) Surgical procedure with open lung biopsy
d) Bronchoscopy with lymph node biopsy
B. The presence of malignant cells confirms diagnosis of cancer and provides important staging information.
A 70 year old patient presents with cough and chest pain. He is found to have a large central chest mass with multiple enlarged lymph nodes. PET imaging is obtained
showing an adrenal mass which is biopsied to show non small cell lung cancer. What treatment approach would you recommend?
a) Surgical resection
b) Chemotherapy with radiation
c) No treatment at this time
d) Chemotherapy, radiation and palliative care
e) Discuss the patient’s goals, preferences and expectations
d or e
A 58 year man old comes to clinic with anxiety about lung cancer, and he is asking for a lung cancer screening test. He is not currently having any respiratory symptoms. He was a smoker and smoked age 19 through age 31 about 1 pack per day.
Which of the following is true about whether or not he should be screened?
a) The decision for lung cancer screening must take into account his underlying health status including if he has significant heart or lung disease such as COPD.
b) He is in a high risk group and should be screened with a CT scan of the lung
c) He is in a high risk group and should be screened with a chest x-ray
d) He is in a high risk group and should be screened with an MRI of the chest
a
A 59 year old male with a long history of cigarette smoking has a lung mass identified on CT scan of the chest. He has had recent development of hemoptysis and dyspnea. You do a detailed review of systems.
Which of the following symptoms, if present and of recent onset, in this patient would raise the MOST concern for metastatic lung cancer?
a) Easy bruising and bleeding from gums
b) Hair loss
c) Seizures
d) Hematuria
e) Rash on lower extremities
c
