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Respiratory > Lung Cancer Treatment > Flashcards

Lung Cancer Treatment Flashcards

1
Q

What are the 5 steps in treating lung cancer?

A 
Giving the diagnosis
Surgery
Radiotherapy
Chemotherapy
Supportive care
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2
Q

What are the steps of giving a diagnosis?

A 
Prepare the ground
Bring a relative
Make sure they understand
Prepare for obvious questions
Tell their GP
Arrange follow up
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3
Q

What are the survival rates of lung cancer in scotland?

A

median= 5.8 months

1 year survival = 30%

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4
Q

What are the clinical options of small cell carcinoma?

A 
At time of presentation, usually spread beyone primary site- can't operate
12% of lung cancers
Rapidly progressive
Early metastases
Good initial response to chemotherapy
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5
Q

What are the clinical options of non small cell carcinoma?

A

Can be potentially cured with surgery or radical chemotherapy
Paliative chemotherapy
Most of lung cancers are non-small cell

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6
Q

What is the survival rate of non small cell?

A

7.7 months

39% survive a year

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7
Q

What is the survival of small cell?

A

5.9 months

24% survive a year

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8
Q

what is the survival of unknown lung cancers?

A

4.9 months

26% survive a year

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9
Q

What do you consider when thinking of lung cancer surgery?

A

Can it be cut out?
Is it localised?
Will the patient survive the operation?
What willthe residual lung function be?

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10
Q

After surgery, what are the survival rates?

A

42.7 months

81% survive a year

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11
Q

what tests need to be taken before surgery?

A 
Bronchoscopy
Mediastinoscopy/EBUS
CT scan of brain
CT scan of thorax
PET scan
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12
Q

what would you look for in a pre-op bronchosopy?

A

Vocal cord palsy
proximal to carina
cell type

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13
Q

what would you look for in a pre-op Mediastinoscopy/EBUS?

A

Lymph nodes

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14
Q

what would you look for in a pre-op CT of brain?

A

Metastases

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15
Q

what would you look for in a pre-op thorax CT?

A

Tumour size
lymph nodes
metastases
local invasion

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16
Q

what would you look for in a pre-op PET scan?

A

Metastases

17
Q

What are some surgeries for lung cancer?

A

Pneumonectomy/lobectomy
Thoracotomy
Minimal access VATS

18
Q

What is a thoracotomy?

A

A long incision around the length of the sixth rib to gain access to lung

19
Q

what is VATS?

A

Video assisted thoracic surgery- key hole

20
Q

What do you need to know before chemotherapy?

A

What cell type the cancer is- Bronchoscopy
Tumour size, local iinvasion, nodes, metastases- CT
Performance status ECOG score

21
Q

what performance status are considered for chemo?

A

0, 1 or 2

22
Q

What does chemotherapy involve?

A 
Longer survival
Better response in small cell cancer
Major side effects
IV infusions every 3-4 weeks
outpatient visits
Imaging
23
Q

what does chemotherapy target?

A

whole body

Rapidly dividing cells

24
Q

What are some chemotherapy side effects?

A 
Nausia
Tiredness
Bone marrow suppression
Hair loss
Pulmonary fibrosis
25
Q

What are common genetic mutation targets?

A

EGFR

ALK1

26
Q

what are some targets for immune therapy?

A

PD-L1

27
Q

What is radiotherapy?

A

ionising beams, targeted against a localised point

28
Q

What are the main uses of radiotherapy?

A

Curative

Paliative

29
Q

What are the side effects of radiotherapy?

A

Collateral damage- spinal cord/ oesophagus/ adjacent lung tissue

30
Q

what is a common side effect of radiotherapy for lung cancer?

A

Temporary oesophagitis

31
Q

What is SABR?

A

Stereotactic ablative radiotherapy

lots of small beams- higher radiation on tumour, less on surrounding tissues

32
Q

what is required for SABR?

A

4D scanning

33
Q

What are some types of endobronchial therapy?

A

Stent inserion for stridor
Photodynamic therapy
Laser therapies

34
Q

What determines the treatment of lung cancer?

A

Cell type
Extent of the disease
Co-morbidity
THE PATIENT’S WISHES

35
Q

What are some big factors stopping someone being able to receive treatment?

A

COPD
emphysema
ischaemic heart disease

36
Q

What are the main things to tackle with palliative care?

A 
Pain
Breathlessness
Cough
Anxiety
Poor mobility
37
Q

What are the main causes of lung cancer?

A

Tobacco smoking
Asbestos
Radon

Respiratory (19 decks)

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