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F2 E3 Shea > Neoplasms 2 > Flashcards

Neoplasms 2 Flashcards

1
Q

A tissue biopsy is needed for dx of lung cancer.

What are the 3 methods?

A
  • Bronchoscopy w/ fluoroscopy
  • CT guided transthoracic needle biopsy
  • Thoracotomy
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2
Q

What is completed as a pre-op assessment?

A

Spirometry

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3
Q

What are the 4 things you need to know when treating lung cancer?

A
  • Whether it is Non-small or Small
  • Stage
  • Pts performance status
  • Resectability / operability
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4
Q

What is the tx for Non-small cell lung cancer in the early stage?

A
  • Pulmonary resection w/ complete MLN evaluation
  • Chemotherapy (consult thoracic oncologist)
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5
Q

What is the tx for Non-surgical candidates with Non-small cell lung cancer?

A
  • Definitive chemo
  • Stereotactic body radiation (single high dose radiation therapy)
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6
Q

What % of lung cancers for Small Cell Lung Cancers are limited?

(disease is limited to the unilateral hemithorax including contralateral mediastinal lobes)

A

30%

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7
Q

What % of lung cancers for Small Cell Lung Cancers are extensive?

(tumor extends beyond the hemithorax including pleural effusion)

A

70%

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8
Q

Tx for limited Small Cell Lung Cancer

A

Chemo & Radiation

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9
Q

Tx for extensive Small Cell Lung Cancer

A

Chemo along as initial tx

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10
Q

Which lung cancer has the worst prognosis?

A

Extensive Small Cell Lung Cancer

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11
Q

Post tx surveillance of lung cancers

  • A majority of recurrences are at proximal or distal sites?
  • How often should pt have H&P and Chest CT?
A
  • Distant sites
  • Every 6 months for 2 years and annually thereafter for up to 5 years.
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12
Q
  • A patient is considered a survivor of cancer if they have not had the diseaes for how many years?
  • Past that point, there are no definitive guidelines on continued imaging.
  • If any imaging, pt will get what after this amount of time?
A
  • 5 years
  • Low dose CT at follow up
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13
Q

What is a common “post treatment” complication that you should watch out for in patients w/ lung cancer?

A

Psychiatric issues

(more common in lung cancer pts than others, bc most of the time they feel blamed for getting cancer from smoking)

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14
Q

Pendunculated or sessile growths in central bronchi

A

Bronchial carcinoid (neuroendocrine) tumors

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15
Q
  • Bronchial Carcinoid Tumors are derived from what cells?
  • Common in what age?
  • Male or female predominance?
A
  • Neuroendocrine cells
  • Less than 60 yrs
  • Equal male : female
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16
Q

Which cancer?

  • Hemoptysis
  • Cough
  • Focal wheezing
  • Recurrent PNA
  • Peripherally located asymptomatic SPNs
A

Bronchial Carcinoid Tumors

17
Q

Bronchial Carcinoid Tumors

  • Fast or slow growing?
  • Where do they metastasize to?
A
  • Slow
  • GI system. BUT, they rarely metastasize
18
Q

What are 4 common sxs of Carcinoid Syndrome?

A
  • Flushing
  • Diarrhea
  • Wheezing
  • Hypotension
19
Q

What imaging would you order to see if a Bronchial Carcinoid Tumor is central or peripheral?

A

CXR

Central: Pneumonitis, atelectasis, bronchiectasis, collapse

Peripheral: solitary pulmonary nodule (slightly lobulated)

20
Q

What imaging would you order for Bronchial Carcinoid Tumors to:

  • evaluate for endobronchial lesions and metastasis?
A

CT

21
Q

What imaging would you order for Bronchial Carcinoid Tumors to localize the tumor?

A

Octreotide Scintigraphy

22
Q

Which cancer is most resistant to radiation and chemo?

A

Bronchial carcinoid tumors

23
Q

Bronchial Carcinoid Tumors

  • Diagnosis is done by:
  • Tx is?
  • Prognosis?
A
  • Biopsy
  • Surgical excision w/ mediastinal lymph node sampling or dissection
  • Excellent prognosis after resection
24
Q

Where does the primary tumor of Mesothelioma arise from?

A

Surface lining of pleura (80%)

25
Q
  • If Mesothelioma is diffuse it is ____.
  • If Mesothelioma is localized it is ____.
  • Is diffuse or localized more common?
A
  • Diffuse: Malignant
  • Localized: Benign
  • Diffuse (75%)
26
Q
  • Mesothelioma is linked to _____ exposure

(60 - 80% of pts w/ this report exposure)

  • Is Mesothelioma more common in men or women?
A
  • Asbestos (smoking + asbestos increases chance of getting Mesothelioma by a ton)
  • Men > Women 3:1
27
Q

Shipyard work

Textiles

Paints

Mining

A

MESOTHELIOMA

28
Q

Mesothelioma

  • Latent period is ____ years
  • Median age of onset is __ - __ yrs old
A
  • 20-40 latent period till sxs onset from time of exposure
  • 72-74 yrs
29
Q

What is needed to dx Mesothelioma?

A

VATS biopsy

30
Q

Tx of Mesothelioma?

A

CHEMO!

31
Q

Prognosis of Mesothelioma?

A

not great.

  • Resp failure
  • complications of local extension
  • Median survival from dx is only 7 to 17 months
  • Fiver yr survival is only 10%
32
Q

lung cancers in general

  • Usually disant or localized?
  • What are % of each?
A
  • Distant 57%
  • Localized 16%

(5 yr survival rate is higher w/ localized cancers bc they have lower stage)

33
Q
  • What decreases lung cancer deaths by 20% in high risk subjects?
  • What is a grade B recommendation by USPSTF?
A
  • Screening w/ low dose helical CT
  • Screening w/ low dose CT
34
Q

USPSTF lung cancer screening recommendations

  • Ages __ - ___
  • Current smokers who quit within the past ___ years w/ a ___ pack-year hx or greater
  • Annual low dose CT screening for at least __ years ( a grade __ recommendation)
A
  • 55-89
  • quit past 15 yrs
  • 30 pack yr hx or greater
  • at least 3 years
  • grade B
35
Q

LDCT or CXR screening better at reducing mortality from lung cancer?

A

LDCT

F2 E3 Shea (16 decks)

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