Pathology of Lung Cancers Part 2 Flashcards
Where can distant metastases of lung cancer occur
Liver Adrenals Brain Bone Skin
What secondary effects can occur due to lung cancer
Secondary effects to neural and vascular structures
What other effects can lung cancer cause
Non-metastatic effects
What will most patients with lung cancer present with
Systemic metastatic disease
What kind of skeletal non-metastatic paraneoplastic effects can lung cancer have
Clubbing
HPOA
What kind of cardiac non-metastatic paraneoplastic effects can lung cancer have
Thrombophlebitis migrans
What kind of endocrine non-metastatic paraneoplastic effects can lung cancer have
ACTH, siADH, PTH
Carcinoid syndrome
Gynecomastia
Where is ACTH and siADH seen
Small cell carcinoma
Where is PTH seem
Squamous carcinoma
It produces hormone similar to PTH which produces calcium in the blood
What is HPOA
Hypertrophic Pulmonary
Osteoarthropathy
What type of investigations can be done
Chest X-Ray Sputum Cytology rarely used Bronchoscopy Trans-thoracic Fine Needle Aspiration Trans-thoracic Core Biopsy Pleural effusion Advanced Imaging Techniques
What type of bronchoscopy can be done
Bronchial biopsy
Bronchial brushings and Washings
Endobronchial US-guided aspiration (EBUS)
What type of advances imaging techniques are there
CT scanning
MRI
PET
Other imaging
What prognostic factors can be used in lung cancer
STAGE of disease CLASSIFICATION: Type of disease Markers/Oncogenes /Gene expression profiles Growth Rate Cell Proliferation DNA Aneuploidy Immune Cell Infiltration
What can be used to select patients for adjuvant therapy
Prognostic markers
What is the 5 year survival rate for people with lung cancer in Scotland and USA
Scotland - Under 9.8%
USA - Over 15%
What is the 5 year survival rate for people with stage 1 operable lung cancer
Over 60%
What is the 5 year survival rate for people with stage 2 operable lung cancer
35%
How many patients with lung cancer in Scotland receive surgical treatment
10-12%
What is the 5 year survival rate for non-small cell carcinomas
Anywhere between 10-25%
Some cell types do badly
What is the 5 year survival rate for small cell carcinomas
4%
Median survival is 9 months
What can be used to help select patients therapy
Predictive biomarkers
What are the key biomarkers for patients with adenocarcinomas
EGFR KRAS HER2 BRAF mutations ALK translocations ROS1 translocations
How much effective molecular targeted therapy is there for squamous cell carcinomas
Very little
What has immunotherapy been found to be helpful in
Advanced stage 4 NSCLC
What is the PDL1/PD-L1 axis immune checkpoint useful for in NSCLC
It is an important biomarker
Important therapeutic target
Drugs which are effective against what are gaining increased use in lung cancers
PD1, PD-L1 and CTLA4 checkpoints
