Respiratory - Cancer Flashcards
What are lung cancers normally divided into?
Non small cell (60%) Small cell (20%)
What histological types fall under non small cell lung cancer?
Squamous cell
Adenocarcinoma
Large cell
What is the first line treatment for non small cell lung cancer?
Surgery
Lobectomy is first line
Segmentectomy / wedge resection are also options
What symptoms make up the triad for Horner’s syndrome?
Ptosis
Anhidrosis
Miosis
What type of tumour causes Horner’s syndrome?
Pancoast tumour
Presses on the sympathetic ganglion in the pulmonary apex
What is the main first line treatment for small cell lung cancers and why?
Much more aggressive tumour so surgery isn’t often an option therefore 1st line treatment is chemotherapy and radiotherapy.
When might radiotherapy be curative?
In Non small cell lung cancer which is diagnosed early
List some extrapulmonary complications of lung cancers:
Recurrent laryngeal nerve palsy - hoarseness of voice Phrenic nerve palsy - SOB and diaphragm weakness SVC obstruction Horner's syndrome SIADH secretion Cushings Hypercalcaemia Limbic encephalitis Lambert-Eaton syndrome
How is a potential lung cancer initially investigated?
Chest xray first line
Staging CT contrast enhanced
Bronchoscopy with endoscopic ultrasound to allow for US guided biopsy
What form of palliative surgery can be done to relieve bronchial obstructions?
Endobronchial stenting or debulking
What lymph nodes are often first found as a sign of lung cancer?
Supraclavicular
What is Pemberton’s sign?
Raising the hands above the head causes facial congestion and cyanosis and is a medical emergency
Sign of severe SVC obstruction / compression
What is limbic encephalitis?
Paraneoplastic syndrome caused by small cell lung cancer.
The immune system makes antibodies to the tissues in the brain, specifically the limbic system.
Anti - Hu antibodies
What are some symptoms of limbic encephalitis:
Hallucinations
Seizures
Short term Memory impairment
Confusion
What do the antibodies in Lambert Eaton syndrome act on?
Voltage - gated calcium channels in the presynaptic terminals in motor neurones
