Session 12 - lung cancer Flashcards
- Risk factors for lung cancer
- Commonest lung cancer?
- There are different types of primary lung cancer and they are divided into 2 main groups:
- Pancoast tumour present?
- State another type of cancer of the lung which can be found in the upper airways
- Most common cause of mesothelioma?
- Tobacco (more than 8/10 lung cancers caused by smoking but only 15% of those who smoke will get lung cancer)
radon,
workplace (asbestos, silicia)
Pollution
family history
immunosupression
- non small cell lung cancer
- small cell lung cancer (SCLC)
non small cell lung cancer (NSCLC) 12%
Rare tumours (e.g. carcinoid) ~ 5%
- Adenocarcinoma (most common, starts in the mucus making gland cells in the lining of your airways)
Squamous cell cancer ( PTH - hypercalcaemia) tends to grow near the centre of the lung.
Large cell carcinoma (The cancer cells appear large and round under the microscope)
- Pancoast:
Horners: sympathetic chain impingement no sweating on half face
Thenar atrophy
sympathetic chain ptosis- LPS 10% and tarsal muscle
cnstricted pupil unopposed parasympathetic
- Asbestos
How do we grade the tumours in terms of size?
Staging tests
CXR to see if it is cancer
CT scan - to check spread to other organs
What are the symptoms if the cancer is primary, regional metastases, distant metastases & metabolic ?
Paraneoplastic syndromes: symptoms due to altered immune system response to a neoplasm
What are the standard imaging we must do?
PET- CT picks up changes than the CT
PET scan covers the whole body down to feet not really for the brain
Might find malignancies in the bowel, rectum, bone -> additional 5% metastases will be the difference between oferreing radical treatment with surgery or not
What biopsies must/ can we do?
- What are the molecular markers?
- What do we mean by performance status?
- EGFR mutations
ALK mutation
KRAS mutations
PD1 mutations -> Goodpastures
PDL1mutations
2.
- Treatment
