Diagnosis and management of lung cancer Flashcards
What is the first line investigation for lung cancer?
Chest x-ray
What might you see on a chest x-ray of someone with lung cancer?
Hilar lymphadenopathy
“Peripheral opacity” – a visible lesion in the lung field
Pleural effusion – usually unilateral in cancer
Collapse
What is the investigation of choice for suspected lung cancer?
Contrast-enhanced CT
What should the CT include?
Adrenals and liver to look for sites of metastases.
What can be used to allow samples to be taken in suspected lung cancer?
Bronchoscopy and EBUS
What might you find in the blood of someone with lung cancer?
Thrombocytosis- elevated platelets
When might you carry out in a PET scan in someone with suspected lung cancer?
Non-small cell lung cancer to establish eligibility for curative treatment
What nerve palsy’s can occur in someone with lung cancer?
Recurrent laryngeal nerve plasy- hoarse voice
Phrenic nerve palsy- shortness of breath
What is a complication of lung cancer?
Superior vena cava obstruction
What is Superior vena cava obstruction due to?
Direct compression of the tumour on the superior vena cava
How can superior vena cana obstruction present?
Facial swelling
Difficulty breathing
Distended veins in the neck and upper chest.
What sign can be used to diagnose superior vena cava obstruction?
“Pemberton’s sign” - raising hands over head causes facial congestion and cyanosis.
What is the first line management of non-small cell lung cancer?
Lobectomy
What is offered for stages 1-3 of lung cancer?
Curative radiotherapy
What can be offered to stages 3 and above lung cancer?
Chemotherapy to control the disease and improve quality of life.
