Resp: Cancer Flashcards
Describe the incidence of lung cancer
- 35 000 cases a year. Most deaths per year
- Higher among lower socioeconomic groups
- Higher with older people
What are the aetiological factors of lung cancer?
- Smoking
- Passive smoking
- Asbestos
- Radon (Cornwall)
- Occupational carcinogens (chromium, nickel, arsenic)
- Genetic/familial factors
Describe the symptoms of primary lung tumour
- Asymptomatic
- Persistent cough
- Dyspnoea
- Wheezing
- Haemoptysis
- Lung infection
- Chest/shoulder pain
- Weight loss
- Lethargy/Malaise
What are the symptoms of a regional metastases?
- Bloated face
- Hoarseness
- Dyspnoea
- Dysphagia
- Chest pain
What are the symptoms of distant metastases?
- Bone pain/fracture
- CNS symptoms (headache, double vision, confusion)
What are signs of lung cancer?
- 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
Give an overview of the T stage in lung cancer.
- Describes size of tumour
- The location of the tumour
- Multiple tumours (number)
Give an overview of the N stage in lung cancer.
Describes the locationof the metastasis to the node. Same side is N1-N2. Contralateral side is contralateral side is N3
Give an overview of the M stage in lung cancer.
How far it has spread outside the region or in the region. M3 is sprading outside the region to many
What are the implications of staging on the treatment in lung cancer?
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
What are the methods of biopsy in lung cancer?
- 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
What are the imaging techniques used in all investigations of lung cancer?
- Chest X-ray
- CT scan
For some:
(PET scan, MRI, USS, Bone Scan, ECHO. The test depend on the stage)
What is the most common histological type in lung cancer?
Non-Small cell lung cancer (80%)
- Squamous cell carcinoma (40%)
- Adenocarcinoma (35%)
- Large cell carcinoma (5%)
What are the other type of histological types in lung carcinoma?
- Small cell carcinoma
- Rare tumours (e.g. carcinoid tumours)
What are the common treatment methods used for lung cancer?
- Surgery
- Radiotherapy
- Combination chemotherapy
- Combination therapy
- Biological therapies
- Palliative care and other treatments
What are metabolic symptoms of lung cancer?
Thirst (hypercalcaemia)
Constipation (hypercalcaemia)
Seizure (hyponatraemia – SIADH, small cell)
Describe the principles of radiotherapy treatment used in lung cancer?
- Radical with a curative intent
- Palliative with intent of symptom control
What is surgery used to treat in lung cancer?
Non small cell carcinoma
20-25% curable
Describe the use of combination chemotherapy in the treatment of lung cancer.
- Small cell carcinoma is curative
- Non-small cell modest survival increase and symptoms control
- Neo advent therapy before surgery
- Adjuvant chemotherapy after surgery
Describe the principles of combination therapy
-Combination chemo-radiotherapy which is potentially curative
Describe the principles of biological therapies
Based on mutational analysis
Describe the principles of palliative care and other treatments.
Active symptoms control eg analgesia, radiotherapy, airway stents
