Surgical Management of Lung Cancer Flashcards
Where does lung cancer commonly metastasise
Other lung Adrenal glands Bones Brain Liver
Common history
Pain - bony pain
Headaches, neurological symptoms
Blood in urine
Common examination findings
Laryngeal nerve and brachial plexus palsy Superior vena cava obstruction Chest wall masses Pleural/pericardial effusion Enlarged liver
Which carcinoma is treated surgically
Small cell carcinoma
Chest x-ray findings
Pleural effusion
Chest wall invasion
Phrenic nerve palsy
Collapsed lobe or lung
Blood test findings
Anaemia
Abnormal liver function test
Abnormal bone profile
Findings in CT scan
Size of tumour Enlargement of mediastinal nodes (>1cm) Metastatic disease Proximity to mediastinal structures Pleaural/pericardial effusion Diaphragmatic involvement
PET scan useful in
Detecting nodule activity within mediastinum
MRI useful in
Determining degree of vascular and neurological involvement in pancoast (apex) tumour
Bone scan good test for
Chest wall invasion and for bony metastases
ECHO will demonstrate
Presence or absence of significant pericardial effusion
Surgery in staging
Bronchoscopy
Mediastinoscopy
Respiratory function testing
Spirometry
Diffusion studies
Arterial blood gas on air
Fractionated V/Q scan
Broad categories to consider in fitness for surgery
Cardiovascular
Respiratory
Psychology
Examples of fitness for surgery factors
Heart problems, smoking, asthmatic, COPD, stroke, pulmonary hypertension, mental illness, rheumatoid arthritis, social background
