Lung Tumours And Sleep Apnoea

Question 1

What percentage of lung cancers are caused by smoking?

Answer 1

83%

Question 2

What are the 2 main groups of lung tumours?

Answer 2

1.Small cell - 25%

2. Non small cell
   - squamous cell carcinoma - 40%
   - large cell - 20%
   - adenocarcinoma - 15%

Question 3

Where are squamous cell carcinomas most commonly located in the lung?

What is a major clause of squamous cell carcinoma?

Answer 3

Located centrally

Smoking

Question 4

What are the signs and symptoms of lung tumours?

Answer 4

1. Cough
2. Haemoptysis (blood stained sputum)
3. Pneumonia
4. Metastasis - bone, liver, brain
5. Other
   - dysphasia
   - svc (superior vena cavo)obstruction
   - recurrent laryngeal nerve palsy (hoarse)

Question 5

Why is the outcome for lung cancer often so poor?

Answer 5

There is a delay in diagnoses due to the tumour being able to double its volume multiple times and spread before it is detectable

Question 6

Briefly describe a stage 1 lung cancer lesion

Answer 6

Solitary lesion

Question 7

Briefly describe a stage 2 lung cancer lesion

Answer 7

Multiple lesions but only on 1 side of the thorax

Question 8

Briefly describe a stage 3 lung cancer lesion

Answer 8

Lesions on both sides of the thorax

Question 9

Briefly describe stage 4 lung cancer tumours

Answer 9

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

Question 10

What is the role of the dentist in treating lung cancer?

Answer 10

1. Very brief advice on smoking

- advice on the best way of quitting (medication and specialist support)

Question 11

What is sleep apnoea?

Answer 11

1. Airway obstruction while asleep
   - 10secs or more duration
   - airway muscle tone drops
2. May snore - may not
3. Drowsiness during the day
   - fall asleep driving
4. Increased risk of MI (low oxygen)
   - treat to improve survival

Question 12

What is the most common type of sleep apnoea?

Answer 12

OSA (obstructive sleep apnoea) is most common

Question 13

How is sleep apnoea measured?

Answer 13

1. AHI (apnoea/hypotonia index)
   - score <10 few problems

There are multisystem health effects

Question 14

What are treatment options for sleep apnoea?

Answer 14

1. Mandibular advancement appliance
   - moves the tongue away from the back of the pharynx by positioning the mandible further forward
2. CPAP - continuous positive airway pressure
   - mask placed over the face which keeps a certain amount of pressure within the airways at all times, blowing apart the tongue and the pharynx which keeps the airway patent
3. Positional therapy
   - devices used to prevent patients from lying on their back