P2 TH6 LUNG CANCER Flashcards
2 MAJOR TYPES OF LUNG CANCER BASED ON HISTOLOGICAL TX + PROGNOSIS
SMALL CELL LUNG CANCER
NON SMALL CELL LUNG CANCER
WHAT IS SMALL CELL LUNG CANCER?
MALIGNANT (CX) CELLS FORM IN THE TISSUE OF THE LUNG
WHAT IS NON SMALL CELL LUNG CANCER?
ANY TYPE OF EPITHELIAL LUNG CANCER OTHER THAN SMALL CELL LUNG CANCER
MOST COMMON TYPE:
squamous cell carcinoma
large cell carcinoma
adenocarcinoma
WHICH MAJOR TYPE LUNG CANCER IS MOST COMMON?
NON SMALL CELL LUNG CANCER
80% OF LUNG MALIGNANCIES
WHICH TYPE LUNG CANCER IS MOST AGGRESSIVE?
SMALL CELL LUNG CANCER
- usually spreads systemically by the time of DX
- malignancy characterised by proliferation of small anapaestic cells
- due to tendency of early metastasis > surgical resection not useful
- MORE RESPONSIVE TO CHEMO
HISTOPATHOLOGICAL SUB TYPES OF NON SMALL CELL LUNG CANCER?
SQUAMOUS CELL CARCINOMA
ADENOCARCINOMA
LARGE CELL CARCINOMA
MOST COMMON SYMPTOM OF LOCAL DISEASE IN LUNG CANCER?
COUGH HEMOPTYSIS CHEST PAIN DYSPNEA WHEEZING PNEUMONIA
MOST COMMON SYMPS OF LOCALLY ADVANCED LUNG CANCER?
HOARSENESS PHRENIC NERVE PARALYSIS DYSPHAGIA STRIDOR SUPERIOR VENA CAVA SYNDROME PLEURAL EFFUSION PERICARDIAL EFFUSION PAN COAST SYNDROME
WHAT DOES PANCOAST SYNDROME INCLUDE?
> DUE: BRONCHOGENIC CARCINOMA IN SUPERIOR PULMONARY SULCUS
SUPERIOR SUCLUS TUMORS > INVASE BRACHIAL PLEXUS + STELLATE GANGLION
> IPSILATERAL HORNERS SYNDROME
NEURITIC PAIN
MUSCULAR ATROPHY IN ARM + HAND
WHAT IS SUPERIOR SUCLUS TUMOR?
PERIPHERALIS LUNG CANCER > localised in superior pulmonary sulcus
> anatomy
- pulmonary sulcus comprise costovertebral gutter extending from first rib to diaphragm
- super pulomary sulcus lies at uppermost extent of this recess
WHAT IS SUPERIOR VENA CAVA SYNDROME?
> group of problems caused when blood flow in superior vena cava is slowed down
extrinsic/ extrinsic obstruction of SVC
CONGESTION OF VENOUS FLOW FROM HEAD, NECK + UPPER EXTREMITIES
CONGESTION > INCREASED VENOUS PRESSURE
MOST COMMON BENING LESION OF LUNG?
HAMARTOMA
- bening tumour like malformation made up of abnormal cells + tissue found in areas of where cell growth takes place
PARANEOPLASTIC SYNDROME
> group of rare disorders triggered by abnormal immune response to cancerous tumor (neoplasm)
COMPLEX OF SYMPTOMS THAT ARE RELATED TO PRIMARY TUMOR OR ITS METASTASIS BY HORMONAL INTERMEDIATES
> EXAMPLE - LUNG CANCER
SYSTEM USED FOR STAGING OF NON SMALL CELL LUNG CANCER?
TUDOR NODE METASTASIS SYSTEM (TNM)
SURGICAL GOAL IN TX FOR NON SMALL CELL LUNG CANCER?
COMPLETE RESECTION OF LOCALISED TUMOURS = DEFINITIVE PRIMARY THERAPY
> completely remove tumor + all intrapulmonary lymphatic drainage
STANDARD PROCEDURE FOR NON SMALL CELL LUNG CANCER RESECTION?
ANATOMIC LOBECTOMY SLEEVE RESECTION BILOBECTOMY PNEUMONECTOMY
THREE INDICATIONS FOR PALLIATIVE RESECTION OF LUNG CANCER
> UNRESOLVING LUNG ABSCESS
MASSIVE HEMOPTYSIS
PAINFUL INVASION OF CHEST WALL
TWO STAGES OF SMALL CELL LUNG CANCER
- LIMITED
- EXTENSIVE
TRADITIONAL TNM CLASSIFICATION SYSTEM = LESS HELPFUL > MOST PX HAVE STAGE 3 OR 4 AT DIAGNOSIS + SURGERY MOSTLY PERFORMED
WHAT IS THE LIMITED STAGE OF SMALL CELL LUNG CANCER COMPROMISE OF?
RESTRICTED TO ONE HEMITHORAX WITH IPSILATERAL REGIONAL + SUPRACLAVICULAR LYMPH NODE INVOLVEMENT
> PRIMARY TUMOUR + NODES = can be treated + totally encompassed in radiation port
WHAT IS THE EXTENSIVE STAGE OF SMALL CELL LUNG CANCER?
METASTASIS OUTSIDE THE HEMITHORAX
> IN 60% OF CASES
STANDARD THERAPY FOR SMALL CELL LUNG CANCER LIMITED STAGE?
COMBINATION OF CHEMO + EARLY CONCURRENT THORACIC RADIOTHERAPY FOLLOWED BY PROPHYLACTIC CRANIAL IRRADIATION (in responding patients)
STANDARD THERAPY FOR SMALL CELL LUNG CANCER IN EXTENSIVE STAGE?
CHEMOTHERAPY
WHAT IS PULMONARY METASTAECTOMY MEAN?
SURGICAL RESECTION OF PULMONARY METASTASIS
> CURATIVE SURGICAL PROCEDURE
MOST IMPORTANT RF IN DEVELOPMENT OF LUNG CANCER?
SMOKING
MOST FREQUENT HISTOLOGICAL TYPE OF LUNG CANCER?
ADENOCARCINOMA
WHICH TYPE OF LUNG CANCER HAS:
> aggressive tendency to metastasise
> often spreads to mediastinal lymph nodes + distant site
> chemoradiotherpay treatment
SMALL CELL LUNG CARCINOMA
WHICH IS MOST COMMON SYMPTOM OF LUNG CANCER WHICH IS OVERLOOKED BOTH BY PX + PHYS?
COUGH
SYMPTOMS OF PANCOAST SYNDROME?
FACIAL ANHYDROSIS
MIOSIS
PTOSIS
WHICH IS THE MOST INTRUIGING SYMPTOMS OF LUNG CANCER AS A RESULT OF PARANEOPLASTIC SYNDROME?
SUPERIOR VENA CAVA SYNDROME
