RESP 145 - Lung Cancer Flashcards
What is the most common malignant tumour worldwide?
Bronchial Carcinoma
What are the main risk factors for Bronchial CA?
Smoking
Environment: Urban living, radiation, occupation exposures
Pre-existing lung disease - Fibrosis, COPD
HIV
Genetics
What are the two main classifications that lung ca can be divided into?
Non-small cell and small-cell carcinomas
Where do small cell carcinomas arise from?
Neuroendocrine cells
Which of the two (NSCCor SCC) lung cancers are more aggressive?
Small cell carcinoma - arise centrally and metastasize early
What is currently the most common NSCLC?
Squamous cell carcinoma
What cells do squamous cell carcinomas arise from?
Epithelial cells
Which NSCLC can cavitate?
Squamous cell carcinoma
What NSCLC arises from glandular cells?
Adenocarcinoma
Which NSCLC is most common in non-smokers?
Adenocarcinoma
What duration of cough merits a CXR?
3 weeks
Why may a lung cancer present with breathlessness and haemoptysis?
Breathlessness - underlying respiratory disease and central tumours can occlude large airways and also can result in lung/lobar collapse
big hairy cocks
Haemoptysis - tumour bleeding into airway
Why may there be chest pain and wheeze in lung cancer?
Peripheral tumours can invade the chest wall or pleura - well innervated
Partial airway obstruction (monophonic wheeze)
What nerves can be affected in lung cancer and what symptom/signs may it produce?
Recurrent laryngeal - hoarse voice
Pancoast tumours of lung apex - Brachial plexus C8/T1= small muscle wasting and weakness and pain down arm
Sympathetic chain - Horners syndrome
Phrenic nerve - Direct invasion by BCA = ipsilateral hemidiaphragm paralysis
How does horners syndrome present?
Miosis, Ptosis, Anhidrosis
What complication could arise from an obstructive tumour in the lung?
A post obstructive infection e.g. pneumonia
What are the main 4 areas that lung cancers metastasize to?
Liver
Brain
Adrenals
Bone
How do you stage SCLC’s and name the management for each stage?
TNM staging
Stage 1/2 = surgery and radiotherapy
Stage 3 = radiotherapy
Stage 4 = chemotherapy
What are the two stages of NSCLC’s? What is the treatment for both?
Limited and extensive
Chemotherapy and radiotherapy
