Session 7 - Lung Cancer Flashcards
Describe incidence of lung cancer in men
- Commonest male cancer
- Mortality around 100 per 100,000
- Incidence falling slowly due to reduction in smoking
Describe incidence of lung cancer in females
- Exceeds breast cancer as a cause of death in women
- Mortality rate around 40 per 100,000
- Incidence rising
How does incidence of lung cancer vary according to socioeconomic group?
- Wide variation
* Rate three times higher in lowest compared with highest
What is the main risk factor for lung cancer?
- Smoking
- 90% lung cancers in men
80% lung cancer in women
Give four aeitological factors which influence lung cancer
- Asbestos exposure
- Radon exposure
- Genetic factors
- Dietary factors
What are the main signs and symptoms of lung cancer?
• Relatively non-specific
What are the main symptoms of a primary lung cancer tumour?
- Cough
- Dyspnoea
- Wheezing
- Haemoptysis
- Chest pain
- Post-obstructive pneumonia
- Weight loss
- Lethargy/malaise
What are the main four symptoms of regional mestastases?
- Superior vena cava obstruction
- Hoarseness (left recurrent laryngeal nerve palsy)
- Dypnoea (phrenic nerve palsy)
- Dysphagia
What are the main two symptoms of distant metastases
- Bone pain/fractures
* CNS symptoms (headache, double vision, confusion)
What is paraneoplastic syndrome?
• Presence of a symptom or a disease due to the presence of cancer in the body, but not due to the local presence of cancer cells
What are the symptoms of paraneoplastic syndrome mediated by?
• Humoral factors (hormones and cytokines) secreted by tumour cells, or the immune response against tumour cells
What are the four main categories of paraneoplastic syndrome?
- Endocrine
- Neurological
- Skeletal
- Haematological
Give two diseases which occur as an endocrine result of paraneoplastic syndrome
- Hypercalcaemia
* Cushing’s syndrome
Give two disease which occur as a neurological result of paraneoplastic syndrome
- Encephalopathy
* Peripheral neuropathy
Give a skeletal disease which occurs as a result of paraneoplastic syndrome
• Finger clubbing
Give three diseases which occur as a a haemotolofical result of paraneoplastic syndrome
- Anaemia
- Throbocytopenia
- Disseminated Intravascular Coagulation
What are two other diseases which can come about as a result of paraneoplastic syndrome?
- Nephrotic syndrome
* Anorexia or Cachexia
What occurs when lung cancer is first suspected in a patient in terms of investigations
○ Plain chest x-ray
What are three scans used for diagnosis and staging
- CT scan
- PET scan
- Isotope bone scan
What are the two staging systems for lung cancer?
• Number
TMN
What is a stage 1 cancer?
• Small cancer, localised to one area of the lung
What is a stage 2 and 3 cancer?
• Larger cancer, may have grown into surrounding tissues
What is stage 4 cancer?
Cancer has metastasised
What is the TMN staging system (Outline T, M and N) ?
- T - Size and position of tumour
- N - Lymph node involvement
- M - Metastases
