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PHAM02 > Wk 14: Lung cancer in practice > Flashcards

Wk 14: Lung cancer in practice Flashcards

1
Q

What are the risk factors of lung cancer?

A
  • Smoking/passive
  • Asbestos
  • Ionising radiation
  • Air pollution
  • Genetic
  • Previous malignancies
  • Old age
  • Poor diet
  • Physical inactivity
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2
Q

Which types of lung is strongly linked to smoking?

A
  • Small cell lung cancer
  • Squamous cell carcinoma
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3
Q

What are examples of smoking cessation strategies?

A

12 wk programme:

  • NRT
  • Champix (1-2 wks before stopping)
  • CO readings
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4
Q

What are the problems associated with lung cancer screening?

A
  • Lack of sensitive tests
  • X-ray exposes patient to radiation
  • Costs too high
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5
Q

What are the signs of lung cancer?

A
  • Cough won’t go away
  • Coloured mucus
  • SOB
  • Haemoptysis
  • Pain in chest/shoulder
  • Loss of appetite
  • Ongoing chest infection
  • Red breath sounds, crackles + unilateral wheeze
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6
Q

What are the types of lung cancer?

A
  • Non small cell lung cancer (most common)
  • Small cell lung cancer
  • Mesothelioma
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7
Q

What are the types of non small cell lung cancer?

A
  • Adenocarcinoma
  • Squamous cell carcinoma
  • Large cell lung cancer
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8
Q

What is the rate at which non-small cell lung cancer grows at?

A

Slow rate

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9
Q

What rate does small cell lung cancer grow at?

A
  • Most aggressive
  • Metastasised by time of diagnosis (high risk of brain metastisis)
  • Located: central airway
  • Tumours smaller
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10
Q

What rate does mesothelioma grow at?

A
  • Aggressive
  • Caused by asbestos exposure (industry linked)
  • Specialist needed
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11
Q

What is the treatment of non small cell lung cancer?

A
  • Surgery: stage I-II
  • Radical radiotherapy: continuous hyperfractionated accelerated radiotherapy (CHART)
  • Radical chemoradiotherapy
  • Neoadjuvant chemoradiotherapy + surgery
  • Palliative chemotherapy
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12
Q

Describe the chemotherapy regime for non small cell lung cancer

A
  • Before surgery: easier to remove
  • Early stage, after surgery: lower risk of remission
  • Before/after radiotherapy: get rid of early stage who can’t get surgery
  • Combine radio + chemo: fit
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13
Q

What drugs are used for chemotherapy in non small cell lung cancer?

A

Cisplatin or carboplatin w/:

  • Gemcitabine
  • Etoposide
  • Docetaxel
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14
Q

What is included during diagnosis in terms of cancer related receptors?

A

Mutation in epidermal growth factor receptor (EGFR)

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15
Q

What is used to treat epidermal growth factor receptors?

A
  • Erlotinib (tarceva)
  • Gefitinib (Iressa)
  • Afatinib (Giotrif)
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16
Q

What are the adverse effects of EGFR treatment?

A
  • Acneiform rash, dry skin or itching
  • Use steroids, topical/oral antibiotics or topical retinol
17
Q

What is the MHRA advice on EGFR inhibitors?

A
  • Risk of keratitis + ulcerative keratitis
  • Causes: corneal perforation + blindness
  • Worsening: refer to opthamologist
  • Treatment discontinued if ulcerative keratitis
18
Q

What is palliative chemotherapy?

A
  • Stage 3B/4 cancer
  • Docetaxel/gemcitabine w/ carboplatin/cisplatin
  • Radiotherapy if persistent symptomatic disease
19
Q

What is limited stage disease of SCLC?

A
  • Cancer contained single area
  • Chemo followed by radio or chemoradio
20
Q

What is extensive stage disease of SCLC?

A

Cancer spread (advanced)

21
Q

What is the first line chemotherapy for limited stage disease in SCLC?

A
  • Carboplatin/cisplatin + etoposide
  • 4-6 cycles
  • Concurrent chemo radio if respond to radio
  • Sequential radio if unfit for concurrent but respond to chemo
22
Q

What is the second line chemotherapy for SCLC?

A
  • Carboplatin/cisplatin
  • CAV (cyclophosphamide, doxorubicin, vincristine)
  • Topotecan capsules
23
Q

What are the changes for people living with lung cancer?

A
  • Coping w/ breathlessness
  • Tiredness
  • Smoker guilt
  • Fear
24
Q

What are the issues of palliative care?

A
  • Endobronchial obstruction
  • Superior vena cava obstruction
  • Breathlessness
  • Cough
  • Brain metastases
  • Hypercalcaemia

PHAM02 (35 decks)

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