Bronchial carcinoma

Question 1

Prevalence

Answer 1

Lung cancer accounts for 28% of cancer deaths in men

and 24% of cancer deaths in women (rapidly rising) in the US

Question 2

Causes

Answer 2

Cigarette smoking being the most common cause of lung cancer in both sexes.

Question 3

It is classified simply as:

Answer 3

1. Small cell cancer (deadly with poor prognosis)

2. Non-small cell cancer NSCLC:

• where curative resection is possible
  e. g.
• SCC
• adenocarcinoma

Question 4

Clinical features

Answer 4

Most present at 50–70 yrs

Only 10–25% asymptomatic at time of diagnosis

If symptomatic—usually advanced and not resectable

Question 5

Local symptoms

Answer 5

• Cough (42%)
• Chest pain (22%)
• Wheezing (15%)
• Haemoptysis (7%)
• Dyspnoea (5%)

General:

• anorexia
• malaise
• weight loss (unexplained)

Others:

• unresolved chest infection
• hoarseness
• symptoms from metastases

Question 6

Investigations

Answer 6

Chest X-ray

Computerised tomography

Fibre-optic ± fluorescence bronchoscopy

PET scanning (to exclude metastatic disease)

No proven benefit of screening for asymptomatic people.

Question 7

Management

Answer 7

Staging of cancer is pivotal to management.

Refer for possible surgical resection (NSCLC).