Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Lung Cancer > Revision > Flashcards

Revision Flashcards

1
Q

What are the clinical signs of lung cancer?

A 
Lymphadenopathy 
Finger clubbing 
Cyanosis 
Hyperinflation 
Horners syndrome - tumour invades the cervical sympathetic nerves which results in a smaller pupil on one side and a dropping top eye lid. 
Hepatomegally 
Dullness on auscultation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the symptoms of lung cancer?

A 
Haemoptysis 
SOB 
Cough 
Malaise 
Weight loss 
Chest pain 
Fatigue 
Recurrent infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a paraneoplastic syndrome?

A

A paraneoplastic syndrome is a disease or symptom that is the consequence of cancer in the body but, unlike mass effect, is not due to the local presence of cancer cells. These phenomena are mediated by humoral factors (by hormones or cytokines) excreted by tumor cells or by an immune response against the tumor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

State some affects of paraneoplastic syndromes

A

Hyponatraemia - low sodium in blood

Anaemia - low RBCs in blood

Hypercalceamia - High calcium in the blood
o symptoms - abdominal pain, constipation, confusion
o causes - parathyroid hormone related protein, bone metastasis

Dermatomyositis/ Polymyositis
- proximal muscle weakness

Eaton-Lambert Syndrome
- Upper limb weakness

Cerebellar ataxia - cerebellum becomes inflamed or damaged. The cerebellum is the area of the brain responsible for controlling gait and muscle coordination

Sensorimotor neuropathy

Endocrine effects

  • ACTH, SIADH -> small cell
  • DTH -> NSCLC (squamous)

Pan coast tumour
-invasion of brachial plexus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the consequence that can occur when cancer cells migrate and metastasis else where in the body?

A

Bone pain

  • about 50% of cancer patients will have a bone metastasis
  • often worse at night
  • pathological fracture will give symptoms
  • bone metastasis in the vertebrae can compress the spinal cord

Spinal cord compression

  • limb weakness
  • paraesthesia {abnormal sensation, typically tingling or pricking ‘pins and needles’}
  • bladder/bowel dysfunction

Cerebral metastases

  • head ache
  • vomiting
  • dizziness
  • ataxia
  • focal weakness

Thrombosis - clotting of blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the two main types of lung cancer? and what are the percentage of prevalence of both?

A

Small cell lung cancer (SCLC) - 15%

Non small cell lung cancer (NSCLC) - 85%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the three main types of NSCLC? and what are their percentages of prevalence?

A

squamous - 30% (hard to treat)
adenocarcinoma - 55%
large cell undifferentiated - 5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the main aetilogical cause for squamous non small cell lung cancer?

A

smoking!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is NSCLC staged?

A

By TNM.
Tumour - size
Nodes - any lymph nodes involved
Metastasis - local or distant metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How long does it take NSCLC and SCLC to double in size?

A

NSCLC - 129 days

SCLC - 29 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is neoadjuvant therapy used for?

A

Used before surgery to decrease the size of a tumour to make it more operable.
It has be proven to be very beneficial in stage III

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is adjuvant therapy used for?

A

Used post operatively to increase the chances of a cure.

DRUGS - cisplatin + vinoreloine

Thought to be detrimental in stage I and II.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Staging:

What does TX stand for ?

A

Primary tumour cannot be assessed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Staging:

What does TO stand for?

A

There is no evidence of a primary tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Staging:

What does Tis stand for?

A

carcinoma in situ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What other observational staging can be done for a cancer patient?

A

Performance status

0 (well) -> 4 (bed bound)

17
Q

What percentage of cancer patients have advanced disease (stage III/IV)?

A

80%

18
Q

What can be done to treat stage III cancer (locally advanced) - 30% ?

A

Chemo + radio therapy

Radical therapy:

  • High dose (~55 Gy+)
  • Optimal number of fractions should be given (not too less as there would be not affect on the tumour but not too many as too many have been shown not to give therapeutic benefit and would just give a lot more side effects)

ChemoRadio therapy:

  • increased survival compared to RT on its own
  • will kill cancer cells that have not been detected yet as it travels in the blood stream.
19
Q

What can be done to treat Stage IV (distant metastasis) - 60% ?

A

Systemic therapy

Palliative care as the cancer is incurable

  • RT given to primary tumour to give symptomatic relieve
  • Chemo gives symptomatic benefit and increases survival
20
Q

Name a drug used for maintenance chemotherapy and what benefits it gives?

A

Pemetrexed

improves survival by 3-5 months

21
Q

When are targeted drugs used?

A

Targeted drugs are used when a cancer patient has a recognised mutation which is causing the cancer.
These drugs should only be used in patients that have the specific mutation.

These drugs have been proven to work very effectively even when the cancer has been very progressed.

22
Q

What do targeted drugs inhibit?

A

Tyrosine kinase inhibitors

23
Q

Name four mutations that can b treated by targeted drugs?

A

EGFR (15%)
ALK (5%)
BRAF (2%)
ROS (1%)

24
Q

Name a drug that is used for immunotherapy.

A

Nivolumab BMS

25
Q

How does Nivolumab BMS work?

A

Blocks the binding of PD-1 to PD-L1 and PD-L2
which prevents the inactivation of T cells allowing the T cells to be activated and allow the immune system to destroy the cancer cells.
This treatment is very expensive but significantly increases survival and survival even continues to do well and better than other drugs at 2 years.

26
Q

How is SCLC staged?

A

Limited disease

Extensive disease

27
Q

How is limited disease SCLC treated?

A

Chemo (cisplatin + etoposide)

28
Q

What techniques have been proven to have no benefit when treating SCLC limited disease ?

A
  • high dose chemo
  • alternative chemo
  • maintenance chemo
  • maintenance interferon
  • chemo “on demand”
  • targeted therapies
  • MMPI
29
Q

What are the average time periods of survival with and without treatment

A

WITHOUT: 8 months
WITH: 16 months

30
Q

What percentage of people respond and completely recover from SCLC limited disease?

A

Response rate: 90%

Complete remission: 60%

31
Q

How is SCLC extensive disease treated?

A

If the patient is fit enough then only 4 cycles of chemo should be given
If patient is not fit enough then RT should be given to palliate

32
Q

How should brain metastasis be treated?

A

RT and steroids should be done to treat brain metastasis

33
Q

What are the average time periods of survival with and without treatment

A

WITHOUT: 8 weeks
WITH: 8 months

34
Q

What is the average response and remission percentages?

A

Response: 80%
Remission: 30%

35
Q

Name common places for cancer to spread to

A 
Brain 
Liver 
Pancreas 
Lung 
Lymph nodes 
Bone 
Adrenal glands
36
Q

What is the definition of a nodule and a mass?

A

Nodule: opacity 3cm

37
Q

State some local effects of tumours in the lungs.

A

bronchial obstruction

  • lobar collapse
  • infection
  • bronchiectasis
  • endogenous lipid pneumonia
38
Q

State some sources of opacity on a CXR

A 
Lung cancer 
Metastasis 
Benign lung neoplasm 
Infection 
Vascular haematoma 
- arteriovenous malformation (an abnormal connection between arteries and veins)

Lung Cancer (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions