10.2 Lung Cancer Flashcards
(38 cards)
What is the commonest cause of cancer in males and females?
Lung cancer
What are risk factors for lung cancer?
SMOKING - proportional to the duration of the habit and the number of cigarettes smoked.
Exposure to asbestos (electricians/builders)
Exposure to radon (miners)
Genetic factors
Dietary factors
Lower socioeconomic group
How is lung cancer diagnosed?
Bronchoscope and needle biopsy of the lung or pleura used to obtain tissue sample for microscopy
Why is histological diagnosis essential for lung cancer patients?
Confirmation of lung cancer
Decide the cell type
Determine prognosis and treatment
Why is imaging of lung cancer useful?
Useful for:
Diagnosis
Staging (Assessment of the extent of the disease)
Determining the treatment and prognosis
When is surgery considered to treat lung cancer?
Non-small cell (20-25% operable)
Localised tumour
What is radical radiotherapy?
Radiotherapy done with curative intent (includes stereotactic RT)
What is palliative radiotherapy?
Radiotherapy done for symptom control
How is chemotherapy used to treat lung cancers? (4 ways)
– Small Cell - potentially curative in a minority
– Non-Small Cell - modest survival increase, symptom control
– ‘Neoadjuvant’ therapy- chemo before surgery (to ‘downstage’ the tumour to allow subsequent surgery))
– ‘Adjuvant’- chemo after surgery (no benefit if < stage 2)
What is combination therapy?
A combination of chemotherapy and radiotherapy. Potentially curative
What palliative care treatment is given to lung cancer patients?
Active symptom control eg analgesia, radiotherapy, airway stents, anxiolytics, nutritional support, patient support groups.
Treatment of tobacco addiction, coronary heart disease & other conditions
What 6 broad treatments are considered for lung cancer?
Surgery Radiotherapy Combination chemotherapy Combined therapy Biological (targeted) therapies Palliative care and other treatments
What cancer has the highest cancer related deaths world wide?
Lung cancer
What is the 1 year survival rate of stage 1 lung cancer after diagnosis?
83%
What is the median age to diagnose with lung cancer?
70 years
What criteria must be fulfilled to have a screening process?
• Disease with serious consequences
• High prevalence of detectable disease
• Test detects little pseudo-disease (overdiagnosis)
• Test detects disease before the critical point
• Test causes little morbidity
• Test affordable and available
• Treatment exists
• Treatment more effective when applied before symptomatic detection
• Treatment not too risky or toxic
Screening must lead to a decrease in disease specific mortality
What is the secondary prevention for lung cancer?
National lung cancer screening trail - Low dose chest CT.
Is currently in trails, involve screening high risk patients (smokers/COPD/older)
Mass media campaigns - ‘be clear on cancer’
What tests can be done to stage lung cancers?
Imaging - CXR, CT scan, Pet Scan, MRI, USS, Bone scan, ECHO
Tissue sampling - bronchoscopy, uss, Ct biopsy, thorocoscopy, surgical
What are symptoms of a primary lung tumour?
- Cough
- Dyspnoea
- Wheezing
- Haemoptysis
- Lung infection
- Chest / shoulder pain
- Weight Loss
- Lethargy/Malaise
- NO SYMPTOMS
What are symptoms of regional Metastases of a lung cancer?
- Bloated face (SVC obstruction)
- Hoarseness (left recurrent laryngeal nerve palsy)
- Dyspnoea (anaemia, pleural or pericardial effusions) • Dysphagia (oesophageal compression)
- Chest pain (parietal pleural involvement)
What are symptoms of distant Metastases of a lung cancer?
- Bone pain/fractures
* CNS symptoms (headache, double vision, confusion etc.)
What are metabolic symptoms caused by lung cancers?
- Thirst (hypercalcaemia)
- Constipation (hypercalcaemia)
- Seizures (hyponatraemia – SIADH, small cell)
What clinical signs might a patient with lung cancer present with?
- Cachexia
- Pale conjunctiva
- Cervical lymphadenopathy
- Horners Syndrome
- Finger clubbing
- Superior vena cava obstruction
- Consolidation
- Signs of pleural effusion
- Muffled heart sounds
- Liver enlargement
- Skin metastases
- Neurological long tract signs
- NO SIGNS
What is meant by staging of cancer?
Spread of cancer
Cell type
