Resp: Cancer Flashcards

1
Q

Describe the incidence of lung cancer

A
  • 35 000 cases a year. Most deaths per year
  • Higher among lower socioeconomic groups
  • Higher with older people
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2
Q

What are the aetiological factors of lung cancer?

A
  • Smoking
  • Passive smoking
  • Asbestos
  • Radon (Cornwall)
  • Occupational carcinogens (chromium, nickel, arsenic)
  • Genetic/familial factors
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3
Q

Describe the symptoms of primary lung tumour

A
  • Asymptomatic
  • Persistent cough
  • Dyspnoea
  • Wheezing
  • Haemoptysis
  • Lung infection
  • Chest/shoulder pain
  • Weight loss
  • Lethargy/Malaise
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4
Q

What are the symptoms of a regional metastases?

A
  • Bloated face
  • Hoarseness
  • Dyspnoea
  • Dysphagia
  • Chest pain
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5
Q

What are the symptoms of distant metastases?

A
  • Bone pain/fracture

- CNS symptoms (headache, double vision, confusion)

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6
Q

What are signs of lung cancer?

A
  • Cachexia
  • Pale conjunctiva
  • Cervical lymphadenopathy
  • Horner’s syndrome
  • Consolidation
  • Sign of pleural effusion
  • Muffled heart sounds
  • Liver enlargement
  • Skin metastases
  • Neurological long tract signs
  • Asymptomatic
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7
Q

Give an overview of the T stage in lung cancer.

A
  • Describes size of tumour
  • The location of the tumour
  • Multiple tumours (number)
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8
Q

Give an overview of the N stage in lung cancer.

A

Describes the locationof the metastasis to the node. Same side is N1-N2. Contralateral side is contralateral side is N3

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9
Q

Give an overview of the M stage in lung cancer.

A

How far it has spread outside the region or in the region. M3 is sprading outside the region to many

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10
Q

What are the implications of staging on the treatment in lung cancer?

A

2B and below can be operable with radical treatment

3A – Non operable. Can sometime be cured with non adjuvant treatment

3B and above – considered for palliative care

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11
Q

What are the methods of biopsy in lung cancer?

A
  • Bronchoscopy
  • Cervical lymph node fine needle aspiration (FNA)
  • Pleural fluid aspiration (thoracentesis)
  • USS – Neck node. Node can give you an idea of the staging if positive
  • CT biopsy
  • Thoroscopy
  • Surgical
  • Adrenal biopsy
  • Skin, Bone, Brain Biopsy
  • Lymph node biopsieis
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12
Q

What are the imaging techniques used in all investigations of lung cancer?

A
  • Chest X-ray
  • CT scan

For some:
(PET scan, MRI, USS, Bone Scan, ECHO. The test depend on the stage)

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13
Q

What is the most common histological type in lung cancer?

A

Non-Small cell lung cancer (80%)

  • Squamous cell carcinoma (40%)
  • Adenocarcinoma (35%)
  • Large cell carcinoma (5%)
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14
Q

What are the other type of histological types in lung carcinoma?

A
  • Small cell carcinoma

- Rare tumours (e.g. carcinoid tumours)

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15
Q

What are the common treatment methods used for lung cancer?

A
  • Surgery
  • Radiotherapy
  • Combination chemotherapy
  • Combination therapy
  • Biological therapies
  • Palliative care and other treatments
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16
Q

What are metabolic symptoms of lung cancer?

A

Thirst (hypercalcaemia)
Constipation (hypercalcaemia)
Seizure (hyponatraemia – SIADH, small cell)

17
Q

Describe the principles of radiotherapy treatment used in lung cancer?

A
  • Radical with a curative intent

- Palliative with intent of symptom control

18
Q

What is surgery used to treat in lung cancer?

A

Non small cell carcinoma

20-25% curable

19
Q

Describe the use of combination chemotherapy in the treatment of lung cancer.

A
  • Small cell carcinoma is curative
  • Non-small cell modest survival increase and symptoms control
  • Neo advent therapy before surgery
  • Adjuvant chemotherapy after surgery
20
Q

Describe the principles of combination therapy

A

-Combination chemo-radiotherapy which is potentially curative

21
Q

Describe the principles of biological therapies

A

Based on mutational analysis

22
Q

Describe the principles of palliative care and other treatments.

A

Active symptoms control eg analgesia, radiotherapy, airway stents