Bronchogenic Cancer Flashcards Preview

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Flashcards in Bronchogenic Cancer Deck (17):
1

What is bronchogenic carcinoma?

- leading cause of preventable death and cancer related death in the U.S.
- leading cause of cancer related deaths in the WORLD.

2

Are lung cancer rates higher or lower in African Americans?

45% HIGHER

3

Has survival rate improved since 1975?

not really :(

4

What are the 3 occupational exposure risks for bronchogenic carcinoma?

- crystalline silica
- asbestos
- nuclear plant workers

5

What are the protective factors against bronchogenic carcinoma?

- moderate exercise
- vitamin C and E

6

What are the SYMPTOMS (what pt complains about) with bronchogenic carcinoma?

- endobronchial= cough, hemoptysis, post obstructive pneumonia.
- pleural= chest pain, dyspnea, cough
- mediastinal= dyspnea, palpitations, hoarseness, dysphagia, stridor
- metastatic= weight loss, seizures, ataxia, headache, altered mental status

7

What are the SIGNS of bronchogenic carcinoma?

- asymmetric breath sounds, increased work of breathing
- evidence of a pleural effusion
- rales (suggesting a pneumonitis)
- adenopathy
- clubbing
- dilated neck veins, upper extremity and facial edema, facial cyanosis (SVC syndrome)

8

What is a paraneoplastic syndrome?

a syndrome that is the consequence of cancer in the body but that is not due to the local presence of cancer cells.

9

What are some paraneoplastic syndromes?

- Eaton-Lambert syndrome= proximal muscle weakness, which improves with repetition; worse in the AM (opposite of myasthenia gravis).
- Hypercalcemia
- Syndrome of Inappropriate ADH
- Hypertrophic Osteoarthropathy= painful swollen joints
- Migratory thrombophlebitis

10

Since not all spots on a CXR are cancers, what must you do to confirm your suspicion of a cancer?

biopsy via:
- fine needle aspiration (FNA)
- bronchoscopy (great for proximal lesions)
- mediastinoscopy
- video assisted thorascopic surgery (VATS)
- open thoracotomy (tend not to do this one)

11

**** What is the number one cell type for bronchogenic carcinoma? (test question)

adenocarcinoma

12

**** What is the second most common cell type for bronchogenic carcinoma?

squamous cell carcinoma

13

How do brocnhoalveolar cells grow?

along the walls (presents like a pneumonia), opposed to all other cell types, which grow circumferentially as they increase in diameter (like a ping pong ball).

14

Is small cell carcinoma aggressive?

YES. It metastasizes early.

15

What are the 2 stages of small cell carcinoma?

1. limited= restricted to ipsilateral hemithorax (18 month survival)
2. extensive= metastatic disease (9 month survival)

16

**** What is the difference between resectability and operability? (test question)

- resectability= lung stage based on TNM (1A, 1B, 2A, 2B, 3A). You are NOT resectable if you are 3B or 4.
- operability= major thoracic surgery based on general medical health.
*You need a YES for both resectability and operability for a pt to undergo surgery.

17

How do we divide tumors of the mediastinum?

- anterior= 4 Ts (teratoma, thymoma, thyroid, and terrible lymphoma).
- middle= anything (adeno, sqamous...)
- posterior= neurogenic tumors