Treatment of Lung Cancer (DISEASE MECHANISMS) Flashcards
What is treatment of choice for small cell lung cancer?
Cytotoxic chemotherapy, often back with radiotherapy
Why is SCLC suitable for chemotherapy?
Very rapid cell growth makes it susceptible
Why is surgery rarely an option for SCLC?
Early metastases
What are the curative treatment options for NSCLC?
Surgery or radical radiotherapy
What does “radical” mean in terms of cancer treatment?
With the intent to cure
What are the different treatment options for bronchial carcinoma?
Surgery
Radiotherapy
Chemotherapy
Palliative care
Surgery significantly ______ the median survival rates
increases
What tools are used to stage for surgery?
Bronchoscopy
Mediastinoscopy
CT scan of brain/thorax
PET scan
How far from the carina must the tumour be to be operable?
> 2 cm
What is a pneumonectomy?
Surgical removal of a lung / part of a lung
What is a lung lobectomy?
Surgical removal of a lung lobe
Which surgical methods can be used to remove lung cancer?
Thoracotomy (very invasive)
Minimal access VATS (Video-assisted thoracic surgery)
What must be considered when debating surgery as a treatment option?
Peri-operative mortality and post-operative morbidity
What methods can be used to stage for chemotherapy?
Bronchoscopy / Tissue sampling
CT scan (size/local invasion/nodes/metastases)
Performance status ECOG score
What do the different ECOG scores represent?
0 = no symptoms 1 = some symptoms but no affect on daily life 2 = >50% out of bed/chair 3 = <50% out of bed/chair 4 = housebound
Where is chemotherapy most responsive?
Small cell lung cancer
What side effects are associated with chemotherapy?
Nausea and Vomiting Tiredness Bone marrow suppression (possibility of neutropenic sepsis) Hair loss Pulmonary fibrosis
Radiotherapy is usually _______ treatment
palliative
What are the issues with radiotherapy as a treatment option?
Maximum cumulative dose Collateral damage (spinal cord / oesophagus / adjacent ling tissue) Only has local effects (doesn't work for subclinical metastases except cranial irradiation)
What are the different options for endobronchial therapy?
Stent insertion for stridor
Photodynamic therapy
Outer-laser therapy
Radioactive pellets
What does photodynamic therapy involve?
Photo-sensitising drug –> exposure of tumour to certain light frequency –> tumour attacked by photo-sensitive drugs
Endobronchial therapies are ______ treatment
palliative
What determined the treatment of lung cancer?
Cell type
Extent of disease
Co-morbitidy
Patient’s wishes
What is meant by co-morbidity in terms of lung cancer treatment?
Other smoking related diseases such as COPD or IHD
Palliative care addresses (5)
Pain Breathlessness Cough Anxiety Poor mobility
