Non operative management of Lung cancer Flashcards
What is combined with surgery treatment of lung cancer
adjuvant/neoadjuvant therapy
What is the aim of adjuvant treatment
Increase chance of cure, applied after surgical treatment to make sure all tumour cells are removed
What is neo- adjuvant treatment in Lung cancer
Pre -operative chemotherapy
What is the main effects of radiotherapy
Inflammation and fibrosis
What do you need to check with the patient before starting radiotherapy and how do you check this
Patient can withstand the toxics effects of radiotherapy
Pulmonary function tests
What is the best systemic treatment
Chemoradiotherapy
What is the treatment plan based for in the diagnosis of stage 4 lung cancer
palliative care with radiotherapy and chemotherapy
How much can you reduce symptoms in stage 4 Lung cancer with radiotherapy
Up to 70%
What does radiotherapy aid in stage 4 lung cancer
Help breathlessness if the lung has collapsed,
eases pain
Gets ride of heamoptysis
What is given as palliative treatment to bone metasisis
radiotherapy
What is the new treatment for adenocarcinomas if patient has EGFR mutation
Tryosine kinase inhibitors
What is the different adenocarcincoma biomarkers
EGFR - mutation
ALK - translocation
BRAF - mutation
ROS - alteration
Why is it important to figure out the molecular biology of the patients tumour
To figure out what targeted drug therapy is needed to that a potential mutation
If you cant figure out the molecular biology of the patients tumour what is the treatment plan
Chemotherapy
Immunotherapy treatments
What is the problem of small cell lung cancer
practically untreatable
What is the treatment plan for small cell lung cancer
a combination of drugs – this is a palliative form of care rather than curative
How much does chemotherapy prolong survival in small cell lung cancer
8 weeks till 8 months
What is the two histological subtypes of lung cancers
small cell lung cancer - 15%
Non small cell lung cancer - 85%
What cancers fall are classed as non small cancer
adenocarcinoma
squamous
What is the different therapeutic options for Lung cancer
¡ Surgery
¡ Radiotherapy - curative (radical) or palliative ¡ Chemotherapy
¡ Combination of above
¡ Targeted therapies
What does therapeutic optics depend upon
Tumour type; stage; ECOG performance status; patient wishes and options; aims of therapy (curative or palliative) Co- morbidity status
What stage is adjuvant therapy most important
stage I and II;
What is the characteristics of stage 3 and stage 4 in non small cell lung cancer
metastases
what is the treatment plan for stage 3 non small cell lung cancer
Combine radiotherapy and chemotherapy, with an increased toxicity
What are the two advancing symptoms of stage 3- 4 lung cancer that can affect your quality of life
Painful bone metastases
Brain metastases
How is brain metastases managed in lung cancer
resection,
Radiotherapy
steroids
What is the characteristic of bone metastasis
affects any site worse at night Bad pain radiating down front of the leg sore to pee constipation cord compression leads to paraplegia
What is the chemotherapy drug for adenocarcinoma
Pemetrexed + Cisplatin
What is an example of a immunotherapy drug and its mechanism
Nivolumab BMS - check point inhibitor
blocks PDL1 the signal that prevent T cells attacking cancer cells, therefore allowing T cell activation to clear cancer
How long does its take small cell Lung cancer to double
29 days
What is the difference in the treatment plan for small cell lung cancer - as more advanced disease
Chemotherapy - essential and best choice
Need a combination of drugs
Need early thoracic radiotherapy
Prophylactic cranial radiation - prevent brain metastases
What is he combination of chemotherapy drug used in the treatment of small cell lung cancer
cisplatin+ etoposide
What has no effect or advantage on the treatment of small cell lung cancer
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
