Lung Tumours

Question 1

Describe an x-ray showing a lung tumour

Answer 1

Shadow in the lung - ether cancer or TB

Can either have a visible mass if tumour is peripheral or if it is more central, it blocks the bronchus

Question 2

What happens if a lung tumour blocks the bronchus

Answer 2

It allows secretions and infection to build up causing pneumonia and complete occlusion of a whole lobe of the lung

Question 3

What are the causes of lung cancer (7)

Answer 3

Smoking
Radon
Workplace chemicals
Air pollution
Genetics
Radiation therapy 
Other lung disease

Question 4

What is the most common cause of lung cancer

Answer 4

Smoking

Question 5

What are the different types of lung cancer

Answer 5

Small cell - 25%

Non-small cell 75%

Question 6

What are the different types of non-small cell lung cancer

Answer 6

Squamous cell carcinoma - 40%
Large cell - 20%
Adenocarcinoma

Question 7

Describe a lung squamous cell carcinoma

Answer 7

Most common
Centrally located
Smoking related

Question 8

What are the common signs and symptoms of lung cancer

Answer 8

Often none until late in the disease
Cough
Haemoptysis 
Pneumonia - occlusion of one of the main bronchi to a lung lobe
Metastasis - bone, liver, brain

Question 9

Describe other signs of lung cancer

Answer 9

Dysphagia - central tumour can compress the oesophagus
SVC obstruction - compression from a tumour in the mediastinum
Recurrent laryngeal nerve palsy (hoarse)

Question 10

Why do lung tumours often have a poor survival rate

Answer 10

Metastases will often happen before the tumour is detectable by normal tests or before the patient has any symptoms

Question 11

Describe stage 1 of lung cancer

Answer 11

Solitary lesion

Question 12

Describe stage 2 of lung cancer

Answer 12

Multiple lesions only on one side of the thorax

Question 13

Describe stage 3 of lung cancer

Answer 13

Lesions on both sides of the thorax

Question 14

Describe stage 4 of lung cancer

Answer 14

Metastatic lesions throughout the lung and also symptoms of oedema or fluid or pneumonia at presentation

Question 15

At what stage do patients most often present with lung cancer

Answer 15

Stage 3 or 4

Question 16

What is the most common treatment for lung cancer and why

Answer 16

Chemotherapy to maximise life expectancy rather than eliminate the disease

Question 17

How may solitary lesions be treated

Answer 17

Removal of the lung lobe - limited number of cases

Question 18

What are biomarkers and why are they useful

Answer 18

Allow to look at the tumour to see what genetic mutations it has so the most suitable method of treatment can be selected for each patient

Question 19

What can a dentist do for patients before they are diagnosed with lung cancer

Answer 19

Ask and record smoking status
Advise on the best way of quitting
Act on patient’s responses - they are more likely to quit with NHS support