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Heme / Onc > SM_277b: Lung Cancer > Flashcards

SM_277b: Lung Cancer Flashcards

1
Q

___ has worst survival of major cancers because ___

A

Lung cancer has worst survival of major cancers because most aptients present with advanced disease

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2
Q

___ is main risk factor for lung cancer

A

Tobacco is main risk factor for lung cancer

  • However, not all lung cancer patients are smokers
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3
Q

Describe presentation of early stage lung cancer

A

Early stage lung cancer

  • Often asymptomatic: found incidentally or through lung cancer screening
  • May cause cough, hemoptysis, or dyspnea
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4
Q

Superior vena cava syndrome due to lung cancer presents with ___, ___, ___, and ___

A

Superior vena cava syndrome due to lung cancer presents with facial plethora, dilated collateral veins along chest, extremity edema, and headaches

  • Vessel obstruction
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5
Q

Pancoast tumor due to lung cancer can present with ___, ___, and ___

A

Pancoast tumor due to lung cancer can present with shoulder pain, brachial plexus, or Horner’s syndrome

  • Nerve impingement - symptoms depend on site of involvement
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6
Q

Horner’s syndrome is ____, ____, and ____

A

Horner’s syndrome is constricted pupil (miosis), drooping of the upper eyelid (ptosis), and absence of sweating of the face (anhidrosis)

  • Due to pancoast tumor (lung cancer)
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7
Q

Lung cancer can cause ___

A

Lung cancer can cause hoarseness due to impingement of laryngeal nerves

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8
Q

Most common sites of lung cancer metastasis are ___, ___, ___, ___, and ___

A

Most common sites of lung cancer metastasis are pleura, brain, bone, adrenal, and liver

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9
Q

Describe SVC syndrome

A

SVC syndrome

  1. Obstruction of SVC
  2. Facial plethora, dilated collateral veins along chest, extremity edema, headaches
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10
Q

Lung cancer is associated with ___

A

Lung cancer is associated with paraneoplastic syndromes

  • Ectopic production of hormone
    • ADH (SIADH): hyponatremia
    • ACTH: Cushing’s syndrome
    • PTHrP: hypercalcemia, hypophosphatemia
  • Development of antibodies
    • Lamberton-Eaton: antibodies that block presynaptic Ca channels in synapse to block ACh release, muscle weakness
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11
Q

Paraneoplastic syndromes are most commonly associated with ____

A

Paraneoplastic syndromes are most commonly associated with small cell lung carcinoma

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12
Q

Describe SIADH

A

SIADH

  • Ectopic production of ADh
  • Euvolemic hyponatremia
  • Low serum osmolality
  • High urine osmolality
  • Usually associated with small cell lung cancer
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13
Q

Cushing’s syndrome can result from ___

A

Cushing’s syndrome can result from ectopic production of ACTH from tumor

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14
Q

Hypercalcemia presents with ___, ___, ___, and ___

A

Hypercalcemia presents with stones, bones, groans, and overtones

  • Bone metastases: bone destruction and Ca release into blood
  • Paraneoplastic: production of PTHrP: elevated Ca, low P, most commonly seen in squamous cell lung cancer
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15
Q

Describe Lamberton Eaton

A

Lamberton Eaton

  • Antibody against presynaptic Ca channels of NMJ -> less ACh release -> proximal muscle weakness
  • Improves with repeated stimulation
  • Associated with small cell lung cancer
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16
Q

PHTrP is most often seen with ___

A

PHTrP is most often seen with NSCLC (squamous cell carcinoma)

17
Q

Describe types of lung cancer

A

Lung cancer

  • Small cell lung cancer
  • Non small cell lung cancer: adenocarcinoma, squamous cell carcinoma, large cell carcinoma
18
Q

Describe adenocarcinoma

A

Adenocarcinoma

  • Derived from gland cells
  • Bx: glandular structures
  • Central or peripheral tumors
  • Seen in non-smokers as well
19
Q

Describe squamous cell carcinoma of lung

A

Squamous cell carcinoma of lung

  • Occurs in smokers
  • Central tumors near hilum, cavitary lesions
  • Paraneoplastic syndrome: PTHrP -> hypercalcemia
  • Bx: keratin pearls
20
Q

Describe small cell lung cancer

A

Small cell lung cancer

  • Aggressive (poor prognosis)
  • Neuroendocrine tumor
  • Smokers
  • Central tumors
  • Bx: small, densely packed blue cells
  • Associated with paraneoplastic syndromes
21
Q

Describe central and peripheral tumors

A

Lung cancer

  • Central: squamous cell, small cell
  • Peripheral: adenocarcinoma, large cell
22
Q

Describe lung cancer biopsy

A

Lung cancer biopsy

  • Give info regarding histology (cell type), molecular analysis (what is driving cell to grow), and interaction between tumor and immune system
  • Biopsies prove stage of disease
23
Q

Describe treatment for NSCLC

A

NSCLC treatment

* Stage I (curative intent): surgery
 Stage II (curative intent): surgery + chemo
* Stage III (curative intent where possible): combo treatment
* Stage IIIC/IV (palliative): personalized
24
Q

Describe systemic treatment for stage IV NSCLC

A

Systemic treatment for stage IV NSCLC

  • Chemo: rapidly growing cells (normal and malignant)
  • Targeted therapy: specific molecular targets
  • Immunotherapy: does not allow tumors to hide from immune system, can also further stimulate a patient’s immune system to attack cancer cells
25
Q

____ or ____ are other treatments for NSCLC

A

EGFR tyrosine kinase inhibitors and PD1/PDL1 inhibitors are other treatments for NSCLC

26
Q

Describe small cell lung cancer

A

Small cell lung cancer

  • 15% of all
  • Smokers
  • Rapid growth, aggressive disease
  • Paraneoplastic syndromes
27
Q

Describe staging of small cell lung cancer

A

Staging of small cell lung cancer

  • Limited: confined to a single hemithorax and all disease encompassed in single radiation port
  • Extensive stage: exents beyond single hemithorax, cannot fit into one radiation field so cannot be cured
28
Q

Describe treatment for small cell lung cancer

A

Small cell lung cancer treatment

  • Limited stage (curative intent): combo chemo and radiation
  • Extensive stage (cannot be cured, palliative intent): chemo and immunotherapy
29
Q

Describe carcinoid tumor

A

Carcinoid tumor

  • Typical: well differentiated
  • Atypical: intermediate grade
  • Can overproduce serotonin -> carcinoid syndrome -> flushing, diarrhea
30
Q

Mesothelioma is ____ often resulting from ____

A

Mesothelioma is disease of pleura often resulting from asbestos

31
Q

Prevent lung cancer through ___

A

Prevent lung cancer through smoking cessation

32
Q

Screening for lung cancer via ___ can reduce mortality

A

Screening for lung cancer via low dose CT can reduce mortality

Heme / Onc (41 decks)

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