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Respiratory system SA > Non operative management of Lung cancer > Flashcards

Non operative management of Lung cancer Flashcards

1
Q

What is combined with surgery treatment of lung cancer

A

adjuvant/neoadjuvant therapy

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2
Q

What is the aim of adjuvant treatment

A

Increase chance of cure, applied after surgical treatment to make sure all tumour cells are removed

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3
Q

What is neo- adjuvant treatment in Lung cancer

A

Pre -operative chemotherapy

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4
Q

What is the main effects of radiotherapy

A

Inflammation and fibrosis

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5
Q

What do you need to check with the patient before starting radiotherapy and how do you check this

A

Patient can withstand the toxics effects of radiotherapy

Pulmonary function tests

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6
Q

What is the best systemic treatment

A

Chemoradiotherapy

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7
Q

What is the treatment plan based for in the diagnosis of stage 4 lung cancer

A

palliative care with radiotherapy and chemotherapy

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8
Q

How much can you reduce symptoms in stage 4 Lung cancer with radiotherapy

A

Up to 70%

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9
Q

What does radiotherapy aid in stage 4 lung cancer

A

Help breathlessness if the lung has collapsed,
eases pain
Gets ride of heamoptysis

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10
Q

What is given as palliative treatment to bone metasisis

A

radiotherapy

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11
Q

What is the new treatment for adenocarcinomas if patient has EGFR mutation

A

Tryosine kinase inhibitors

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12
Q

What is the different adenocarcincoma biomarkers

A

EGFR - mutation
ALK - translocation
BRAF - mutation
ROS - alteration

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13
Q

Why is it important to figure out the molecular biology of the patients tumour

A

To figure out what targeted drug therapy is needed to that a potential mutation

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14
Q

If you cant figure out the molecular biology of the patients tumour what is the treatment plan

A

Chemotherapy

Immunotherapy treatments

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15
Q

What is the problem of small cell lung cancer

A

practically untreatable

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16
Q

What is the treatment plan for small cell lung cancer

A

a combination of drugs – this is a palliative form of care rather than curative

17
Q

How much does chemotherapy prolong survival in small cell lung cancer

A

8 weeks till 8 months

18
Q

What is the two histological subtypes of lung cancers

A

small cell lung cancer - 15%

Non small cell lung cancer - 85%

19
Q

What cancers fall are classed as non small cancer

A

adenocarcinoma

squamous

20
Q

What is the different therapeutic options for Lung cancer

A

¡ Surgery
¡ Radiotherapy - curative (radical) or palliative ¡ Chemotherapy
¡ Combination of above
¡ Targeted therapies

21
Q

What does therapeutic optics depend upon

A 
Tumour type; 
stage; 
ECOG performance status; 
patient wishes and options; 
aims of therapy (curative or palliative)
Co- morbidity status
22
Q

What stage is adjuvant therapy most important

A

stage I and II;

23
Q

What is the characteristics of stage 3 and stage 4 in non small cell lung cancer

A

metastases

24
Q

what is the treatment plan for stage 3 non small cell lung cancer

A

Combine radiotherapy and chemotherapy, with an increased toxicity

25
Q

What are the two advancing symptoms of stage 3- 4 lung cancer that can affect your quality of life

A

Painful bone metastases

Brain metastases

26
Q

How is brain metastases managed in lung cancer

A

resection,
Radiotherapy
steroids

27
Q

What is the characteristic of bone metastasis

A 
affects any site 
worse at night 
Bad pain radiating down front of the leg
sore to pee
constipation 
cord compression 
leads to paraplegia
28
Q

What is the chemotherapy drug for adenocarcinoma

A

Pemetrexed + Cisplatin

29
Q

What is an example of a immunotherapy drug and its mechanism

A

Nivolumab BMS - check point inhibitor

blocks PDL1 the signal that prevent T cells attacking cancer cells, therefore allowing T cell activation to clear cancer

30
Q

How long does its take small cell Lung cancer to double

A

29 days

31
Q

What is the difference in the treatment plan for small cell lung cancer - as more advanced disease

A

Chemotherapy - essential and best choice
Need a combination of drugs
Need early thoracic radiotherapy
Prophylactic cranial radiation - prevent brain metastases

32
Q

What is he combination of chemotherapy drug used in the treatment of small cell lung cancer

A

cisplatin+ etoposide

33
Q

What has no effect or advantage on the treatment of small cell lung cancer

A

— High dose chemo/— Alternating chemo/— Maintenance chemo/— Chemo ‘on demand’

These literally have no clinical advantage, better to use a more efficient dose as will have the same outcome without causing all the unneeded side effects

Respiratory system SA (37 decks)

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