Treatment of Lung Cancer

Question 1

What are the characteristics of Small cell lung cancer in how it progresses?

Answer 1

Rapidly progressive disease
Early metastases
Rarely suitable for surgery
Good initial response to chemotherapy. Slide 5

Question 2

What are the characteristics of non small cell lung cancer in how it progresses?

Answer 2

Curative options of surgery or radical radiotherapy or palliative chemotherapy and new targeted treatments. Slide 6

Question 3

What are the 4 treatment choices for lung cancer?

Answer 3

Surgery, chemotherapy, radiotherapy and palliative care. Slide 9

Question 4

What preparation do you have to do before a surgery?

Answer 4

Bronchoscopy
EBUS
CT scan of Brain for metastases
CT scan of thorax
PET scan. Slide 12

Question 5

What does VATS stand for?

Answer 5

Video Assisted Thoracic Surgery. Slide 19

Question 6

What preparation do you have to do before chemotherapy?

Answer 6

Bronchoscopy
CT scan
Performance status on ECOG score (how the disease is progressing). Slide 23

Question 7

What are side effects of chemotherapy?

Answer 7

Nausea and vomiting
Tiredness
Bone marrow suppression (infection)
Hair loss
Pulmonary fibrosis
Slide 26

Question 8

What are more new specific treatments?

Answer 8

Genetic mutations e.g. EGFR

Immune Therapy e.g.PD - L1. Slide 27

Question 9

What types of radiotherapy are there?

Answer 9

Ionising (X rays)
Radical (curative intent)
Palliative (delaying tactic)
Slide 28

Question 10

What are the disadvantages of radiotherapy?

Answer 10

Maximum cumulative dose
Collateral damage e.g. spinal cord
Only goes where you point the beam so not good for metastases. Slide 29

Question 11

What does SABR stand for and what does it do?

Answer 11

Stereotactic ablative radiotherapy

More beams and less collateral damage as they are less powerful. It also has 4D scanning. Slide 33

Question 12

What can endobronchial therapy be used for?

Answer 12

Stent insertion for stridor
Photodynamic therapy
Other laser therapy. Slide 35

Question 13

What does the treatment of the lung cancer get determined by?

Answer 13

Cell type
Extend of disease
Co-morbidity
Patients wishes! Slide 38

Question 14

What are examples of co-morbidity?

Answer 14

Smoking related diseases e.g. COPD

Ischaemic Heart disease. Slide 39

Question 15

What is the better option in treating lung cancer?

Answer 15

Prevention e.g. stop smoking. Slide 46