Respiratory System - Lung Cancer

Question 1

Which type of lung cancer makes up 80% of cases?

Answer 1

Non-small cell lung carcinomas -
Adenocarcinomas
Squamous cell carcinomas

Question 2

Which type of lung cancer makes up 20% of cases?

Answer 2

Small cell lung carcinomas

Question 3

Why are the lungs a common site of metastasis?

Answer 3

Due to their dual blood supply (haematogenous route)

Question 4

Why is there often a poor prognosis regarding lung cancer?

Answer 4

Usually picked up very late

No pain associated until and unless there is involvement with the pluera and bones

Question 5

Name 7 symptoms arising from local tumour effects?

Answer 5

Persistent cough/change to normal cough
Haemoptysis
Chest pain - only with pluera/bone involvement
Wheeze (unilateral)/stridor
Shoulder pain (referred from diaphragm)
Hoarse voice/bovine cough (RLN involvement)
Dysphagia

Question 6

What is clinically significant about a pan-coast tumour?

Answer 6

• Horner’s syndrome - Sympathetic chain compression =
  1. Meiosis
  2. Anhydrosis
  3. Partial Ptosis
• Also RLN compression (bovine cough + hoarseness)
• Arm and hand wasting

Question 7

Which lymph nodes are common metastasis areas from lung tumours?

Answer 7

Cervical

Supraclavicular

Question 8

Name 6 clinical signs regarding lung cancer?

Answer 8

Finger clubbing
Pancoast syndrome
SVCO signs - fullness in face/breathlessness/headache
Weightloss
Lethargy
Lymph node enlargement