Session 12 - Lung Cancer Flashcards
What is the biggest risk factor for lung cancer?
Smoking
Other than smoking, what are the risk factors for lung cancer?
Asbestos
Radon
Other occupational carcinogens (chromium, nickel, arsenic)
Genetic factors
What symptoms of lung cancer are caused by the primary tumour?
Cough Dyspnoea Wheezing Haemoptysis Lung infection Chest/shoulder pain Weight loss Lethargy/malaise
PATIENT MAY HAVE NO SYMPTOMS
What symptoms may be caused by regional metastases of lung cancer.
Bloated face (SVC obstruction)
Hoarseness (left recurrent laryngeal nerve palsy)
Dyspnoea (anaemia, pleural or pericardial effusions)
Dysphagia (oesophageal compression)
Chest pain (parietal pleural involvement)
What are the signs of lung cancer?
Finger clubbing Superior vena cava obstruction Cachexia Pale conjunctiva Cervical lymphadenopathy Horner’s syndrome Consolidation Signs of pleural effusion Muffled heart sounds Liver enlargement Skin metastases Neurological long tract signs NO SIGNS
What is Horner’s syndrome?
Interruption of sympathetic nerve supply to to eye, characterised by the classic triad of:
- miosis (constricted pupil)
- partial ptosis
- facial anhydrosis
Caused by tumours (Pancoast) or infection of the lung apex. Affects one side of the face.
What is a paraneoplastic syndrome?
A paraneoplastic syndrome is a syndrome that is the consequence of cancer in the body, but unlike mass effect is not due to the local presence of cancer cells.
What endocrine paraneoplastic syndromes can occur in lung cancer?
Hypercalcaemia
Cushing’s syndrome
Inappropriate Antidiuretic Hormone Secretion (SIADH)
What neurological paraneoplastic syndromes can occur in lung cancer?
Encephalopathy
Peripheral neuropathy
Eaton-Lambert syndrome
Pancoast syndrome
What haematological paraneoplastic syndromes can occur in lung cancer?
Anaemia
Thrombocytosis
Where does lung cancer commonly spread to?
Draining lymph nodes Other parts of the lung Pleura Pericardium Liver Adrenals Brain Bone
What are the main types of lung cancer?
Non-small cell carcinoma:
- squamous cell carcinoma (~40%)
- adenocarcinoma (~35%)
- large cell carcinoma (~5%)
Small cell carcinoma (~12%)
Rare tumours (e.g. carcinoid) (~5%)
Surgery is most commonly used for which type of lung cancer?
Non-small cell carcinomas
What is the cause of hoarseness of voice in lung cancer?
Impingement of left recurrent laryngeal nerve
Does small cell carcinoma or non-small cell carcinoma proliferate and spread at a faster rate?
Small cell carcinoma grows and metastasises faster
