Lung Cancers Flashcards
Define lung cancer
tumors that originate from the epithelium of the respiratory tract
lung cancer/tumors aka
bronchogenic carcinoma
T/F: lung cancer is the most common fatal neoplasia in both sexes age 50-65
true
ethnicity and sex with largest lung cancer incidence
black males
race with lowest rates of lung cancer
Hispanics (male and female)
T/F female lung cancer incidence between blacks and whites is the same
true
WHO Classification of lung cancers is based on what
cell type
WHO Classification of lung cancers (4)
- Epidermoid (squamous) carcinoma (17%)
- Small cell carcinoma (oat cells) (25%)
- Adenocarcinoma (40%)
- large cell carcinoma (15%)
another classification of lung tumors (2)
- small cell lung cancer (SCLC) 20%
2. non-small cell lung cancer (NSCLC) 80%
name the 3 types of lung tumors classified as non-small cell lung cancers
- squamous cell carcinomas
- adenocarcinomas
- large cell carcinomas
Squamous cell carcinomas are closely correlated to what
smoking
Squamous cell carcinomas are usually located where
centrally located near hilus of lung, projecting to bronchi
how do Squamous cell carcinomas spread?
by direct extension
when does metastasis occur in Squamous cell carcinomas
late
S/S of Squamous cell carcinomas
SOB (because the tumor is located in the main bronchi region)
Adenocarcinoma located where
more peripheral, smaller lesions
Adenocarcinoma info
- not strongly associated with smoking
- if a non-smoker develops lung cancer it is most likely to be an adenocarcinoma
Adenocarcinomas invade where, causing what?
invade blood and lymph vessels leading to early metastasis
if a non-smoker develops lung cancer it is most likely to be what type ?
adenocarcinoma
Large cell carcnioma look like what?
highly undifferentiated and anaplastic, meaning the cell is hard to classify as a certain type of cell
Large cell carcniomas develop where
in the periphery
Large cell carcniomas grow at what rate? do they spread?
grow rapidly and spread early and extensively
incidence of these tumors has decreased due to improved detection
Small cell carcinomas are located where
centrally
Small cell carcinomas look like what?
oat seeds, aka also called oat cell carcinoma
Small cell carcinomas rate of spread and prognosis
fastest doubling time and worst prognosis of all bronchiogenic carcinomas
early metastasis to adjacent tissues as well as distal spread occurs very early
some of worst lung tumors to have
small cell carcinomas
Pancoast tumor located where
apex of lungs, often spreads to ribs and vertebrae
Pancoast tumor info
1-3% of all lung tumors
mostly squamous or adenocarcinomas (NSCLC)
tends to be diagnosed late
Pancoast tumor s/s
- 1st s/s is thoracic and scapular pain
- can also present with s/s of brachial plexus compression (ulnar nerve distribution) or thoracic outlet syndrome
- horner’s syndrome
What is horner’s syndrome
sympathetic nerve disorder
3 s/s of Horner’s syndrome
- miosis (constricted pupil)
- partial ptosis (eyelid weakness)
- loss of hemifacial sweating (anhidrosis) causing dry skin
considered uncommon
Metastatic lung cancers
- much more common than primary cancers
- most common place for other cancers to spread is to the lungs
most common primary cancers to metastasize to lungs:
#1 = breast cancer GI, female genital tract, kidneys, melanomas, male genital tract
Diagnosis of lung tumors
- s/s
- cytology, sputum, bronchial brushings
- biopsy
- radiology, CT scan, MRI
treatment for non-small cell lung cancer
- Surgery (for stage 1,2, or 3)
- radiation and chemo
- surgery is most effective with centrally-located tumors that metastasize late
- radiation can cause tissue fibrosis 6-12 months after radiation (decreased ROM and mobility)
prognosis for non-small cell lung cancer (5yr survival)
30% if resectable
6% if not resectable. median survival of less than a year
treatment for small cell lung cancer
chemo!! Radiation can be used to limit cerebral metastasis or pain
too small to be treated with surgery
prognosis for small cell lung cancer
40-70 weeks with treatment
6-17 weeks wthout treatment
Paraneoplastic syndrome
- remote effects of neoplasm
- occurs in 20%
- often appears before primary tumor has been diagnosed
- common in small cell lung tumors
- cushing syndrome
- primary sign = LE weakness
Cushing syndrome
changes in BF, edema, infection, changes in skin quality
cancer and POC
- scheduling
- monitor labs
- pain meds
- nutrition
- pulmonary issues
- energy conservation!!!!
