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MODHIII - Unit 3 > Lung Carcinoma > Flashcards

Lung Carcinoma Flashcards

1
Q

Early stage (local) disease survival at 5 years

A

80%

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2
Q

Late stage (distant metastasis) survival at 5 years

A
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3
Q

Median survival time of patients w/ late stage disease

A

1 year

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4
Q

Top three cancers for number of new cases per year: men

A
  1. prostate:26%
  2. lung/bronchus: 14 %
  3. colon/rectum: 8%
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5
Q

Top three cancers for new cases per year: women

A
  1. breast: 29%
  2. lung/bronchus: 13%
  3. colon/rectum: 8%
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6
Q

Top three cancers for annual deaths: men

A
  1. lung/bronchus: 28%
  2. prostate: 9%
  3. colon/rectum: 8%
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7
Q

Top three cancers for annual deaths: women

A
  1. lung/bronchus: 26%
  2. breast: 15%
  3. colon/rectum: 9%
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8
Q

Number of deaths per year from lung cancer

A

~155,000

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9
Q

Where would lung cancer rank among leading causes of death in the US

A

3, behind heart disease and other cancers

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10
Q

US lung cancer screen recommendations: age, smoking history, modality

A
  • age: 55-74
  • tobacco 33 pack years
  • actively smoking or quit w/ in 15 years
  • modality: low-dose CT chest
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11
Q

Why is there an age limit on screening recommendations

A
  • with increasing age comes decreasing chance that the lung cancer, if it were to be found, would be treatable
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12
Q

Risk factors for lung cancer

A
  • increasing age, tobacco, radon, occupational, genetic

- men more at risk than women

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13
Q

Tobacco and risk of lung cancer

A
  • both primary, active, and secondary are related to lung cancer
  • more you smoke the greater the risk
  • appears as though any amount of smoking leads to increased risk
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14
Q

Occupational risk factors for lung cancer: metals

A
  • indoor combustion cook stoves (coal): affects women
  • asbestos
  • metals: chromium, nickel, zinc, cadmium
  • miners, pipe-fitters, welders, metal fabrication
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15
Q

Genetic risk of lung cancer

A
  • 1.51 fold increase in risk after adjustment for smoking in first degree relatives
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16
Q

Women more likely to get what type of lung cancer

A

adenocarcinoma

17
Q

Difference b/w smoking and non-smoking lung cancer

A
  • smoking lung cancer more likely squamous cell carcinoma

- non smoking lung cancer more likely adenocarcinoma

18
Q

Thoracic symptoms of lung cancer

A
  • cough, dyspnea, chest pain, hemoptysis, voice changes, dysphagia
19
Q

Extra-thoracic symptoms of lung cancer

A
  • bone pain (back pain), headache, seizures, neurologic deficits, abdominal swelling, shoulder pain
20
Q

Common sites of lung cancer metastasis

A
  • bone, brain, adrenal glands, liver, pleura
21
Q

Systemic symptoms of lung cancer (paraneoplastic symptoms)

A
  • anorexia, weight loss, clubbing of nails
22
Q

Most popular staging at diagnosis & survival rate

A

> 50% are distant: which has the worst 5 year survival rate (~5%)

23
Q

Systems focused on when doing a physical exam of patient w/ suspected lung cancer

A
  • weight & weight history

- pulmonary, heart/vascular, lymph nodes, neurologic

24
Q

Lab tests for patients w/ suspected lung cancer & what they indicate

A
  • blood count, electrolytes, liver function, serum proteins

- indicate nutritional status, metastatic disease

25
Q

Radiographs for patient w/ suspected lung cancer and their importance

A
  • CT chest w/ contrast: categorize primary lesion & lymph nodes
  • positron emission tomography (PET): search for metastasis (staging)
26
Q

Functional status assessment for patients with lung cancer & purpose

A
  • assess ability of patient to withstand and benefit from treatment
  • rate global functional status
  • measure pulmonary functional status
27
Q

Pulmonary functional status assessment tests

A
  • exercise capacity formal: measure VO2
  • exercise capacity informal: walk 2 flights of stairs
  • measure total lung capacity: FVC, FEV1
28
Q

Global functional status assessment test & meaning

A
  • Karnofsky Scale
  • 0-100: with 100 being best
  • high number means can use treatment
  • lower number means palliative care
29
Q

Diagnosing lung cancer

A
  • all suspected lung cancers require biopsy for confirmation of diagnosis
30
Q

Types of biopsy used in lung cancer

A
  • CT-guided FNA
  • ultrasound tip bronchoscope
  • thoracentesis
31
Q

Thoracentesis use in lung cancer

A
  • used for pleural effusion
  • fluid can be examined for malignant cells
  • malignant pleural effusion is assigned M1 status in TNM system, which translates into Stage IV*
32
Q

Surgical options for removal of lung masses

A
  • wedge resection
  • segmentectomy
  • lobectomy
  • pneumonectomy
33
Q

TMN staging general meaning

A
  • T factor: size based; tells you if you can get it out w/ surgery (T1-T4)
  • N factor: lymph node involvement; ipsilateral, mediastinum, contralateral (N0-N3)
  • M factor: metastasis; yes or no (M0 & M1)
34
Q

Stage IV & TMN stagin

A

Stage IV = and T, any N, with M1

35
Q

Treatment-Stage approach

A
  • early stage (no metastasis): surgery
  • advance stage (limited to chest): chemo + radiation w/ curative intent
  • advanced stage w/ metastasis: palliative care (may include chemo & radiation)
36
Q

Role of palliative care in lung cancer

A
  • for patients with distant disease, focusing on early palliative care improves both survival and quality of life
37
Q

Overall survival of patients diagnosed with lung cancer at 5 years

A

14%

MODHIII - Unit 3 (20 decks)

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