Clinical features and staging of lung cancer Flashcards Preview

Respiratory system 2017 > Clinical features and staging of lung cancer > Flashcards

Flashcards in Clinical features and staging of lung cancer Deck (25)
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1
Q

How many cancer deaths are due to lung cancer?

A

1 in 5, most common cancer in both sexes

2
Q

What % of lung cancers are associated with smoking?

A

85%

3
Q

What are the risk factors for lung cancer?

A

Smoking
Passive smoking
Asbestos
Genetics

4
Q

What are the symptoms of lung cancer?

A
Cough >3 weeks
Haemoptysis
Wheeze
Chest and bone pain
Weight loss
Chest infections
Difficulty swallowing
Paraesthesia in upper limbs
Raspy hoarse voice
SOB
Nail clubbing
5
Q

What are some symptoms of advanced metastatis lung cancer?

A
Bone pain
Weakness of the limbs 
Paraesthesia
Bladder/bowel dysfunction
Headache
Vomiting
Dizziness
Ataxia
Vocal weakness
Thrombosis
6
Q

What are some paraneoplastic symptoms of advanced lung cancer?

A
Hyponaetraemia - SIADH
Anaemia
Hypercalcaemia
Dermatomyositis/polymyositis
Eaton-Lambert syndrome 
Cerebral ataxia
Sensorimotor neuropathy
7
Q

What is SIADH?

A

Syndrome of inappropriate ADH secretion, leading hyponatraemia, hypoosmolality and impaired water secretion

8
Q

What is Eaton-Lambert syndrome?

A

Weakness of upper limbs

9
Q

What are the clinical signs of lung cancer?

A
Clubbing
Chest signs
Lymphadenopathy
Horners syndrome
Pancoast tumours
Superior vena cava obstruction
Hepatomegaly
Skin nodules
10
Q

What is Horners syndrome?

A

Signs and symptoms of disruption of nerve pathway, particularly the sympathetic ganglion, from the brain to the face and eye on one side, leading to decreased pupil size, decreased sweating on the side of the face affected

11
Q

What is a pancoast tumour?

A

Found in pulmonary apex, usually in NSCLC, which can cause compression of brachiocephalic vein, recurrent laryngeal nerves, vagus nerves or the sympathetic ganglion (leading to Horners syndrome)

12
Q

What investigations are used for lung cancer?

A
CXR
CT
FBC - anaemia common in cancer
Renal and liver function tests
Calcium levels
Clotting screen - clotting normal = not PE
Spirometry - patient fitness
Bronchoscopy
Endobronchial ultrasound
Image guided lung and liver biopsy
Fine needle aspiration of neck nodes or skin
Excision of cerebral metastases
Bone biopsy
Mediastinoscopy/otomy
Surgical excision biopsy
13
Q

What are the 4 types of lung cancer, their origin and their relative frequencies?

A

Squamous - 30%, epithelial cells
Adenocarcinoma - 27-40%, glands
Large cell - 10-15%, poorly differentiated
Small cell - 15-20%, neuroendocrine cels

14
Q

How do you stage tumours?

A

TNM classification
T - size of primary tumour and its invasion
N - lymph node involvement
M - distant metastasis

15
Q

How many people with stage I lung cancer are alive at the end of year 1?

A

90%

16
Q

How many people with stage II lung cancer are alive at the end of year 1?

A

85%

17
Q

How many people with stage III lung cancer are alive at the end of year 1?

A

50%

18
Q

How many people with stage IV lung cancer are alive at the end of year 1?

A

24%

19
Q

At what stage can we offer curative treatments?

A

stage 1 and 2

20
Q

What type of lung cancer usually has better prognoses?

A

Adenocarcinoma

21
Q

What type of lung cancer usually has the worst prognoses?

A

Small cell

22
Q

What imaging techniques are useful in investigations and staging?

A

CXR
CT/MRI
PET scans and glucose analogs

23
Q

How do we rank performance status from 0-4?

A
0 -active
1 - symptoms but ambulatory 
2 - up and about >50%, unable to work
3 - up and bout <50%, limited self care
4 - bed or chair bound
24
Q

What % of patients undergo surgery?

A

18%

25
Q

Describe palliative treatment for lung cancer

A
Chemo/radio
Opiates or other analgesics
Bisphosphonates (prevents bone loss)
Anti-emetics
Treat hypercalcaemia, dehydration etc