S12 Lung Cancer Flashcards
What are the risk factors for lung cancer?
Smoking, Asbestos, Radon
Occupational carcinogens e.g. chromium, nickel
Genetic factors
Describe the staging of lung cancer
T=size, location and number of tumours
N=number of lymph nodes
M=metastasis
What staging tests are used for lung cancer?
Imaging: CXR, CT, USS
Tissue sampling to confirm diagnosis: bronchoscopy, USS for neck LN/chest wall mass
Describe the symptoms of a primary lung tumour
Most common no symptoms.
Can have cough, dyspnoea (compressing vessels/VQ reduced), wheezing, haemoptysis, chest pain
What are the symptoms of regional lung metastasis?
Bloated face (SVC obstruction)
Hoarseness (LRLN palsy)
Dyspnoea (anaemia, pleural/pericardial effusion)
Dysphagia (oesophageal compression)
What are the symptoms of distant lung metastasis?
Bone pain, headache, double vision, confusion
What are the metabolic symptoms of lung cancers?
Hypercalcaemia and hyponatraemia
What is a paraneoplastic syndrome?
A disease caused by substances released from the tumour.
Give some examples of paraneoplastic syndromes caused by lung cancers
Endocrine (hypercalcaemia, Cushing’s syndrome, SIADH),
Neurological (peripheral neuropathy, Pancoast syndrome),
Haematological (anaemia, thrombocytosis),
Describe the different types of non-small cell carcinoma
On the lung so better prognosis
Squamous cell carcinoma (~40%) (can cause hypercalcaemia due to PTHrp acting on PTH receptors)
Adenocarcinoma (~35%)
Large cell carcinoma (~5%)
Describe the features of small cell carcinoma
On the chest, can cause SVC obstruction and therefore oedema of face, neck and chest
What is the management for lung cancer?
Surgery – mostly for non-small cell, best chance of cure
Radiotherapy – curative intent or palliative
Combination chemotherapy – potentially curative in small cell minority, NSC for symptom control.
