Lung Cancer Flashcards
What are the two main types oof lung cancer?
- Small-cell (neuroendocrine) lung cancers (SCLC) → tend to disseminate early in their development
- Non-small-cell lung cancers (NSCLC) → which are more likely to be diagnosed in a localised form
How is non-small lung cancer defined?
The vast majority (85 percent) of lung cancers fall into the category called non-small cell lung cancer.
NSCLCs are carcinomas, which are cancers of the cells lining the surface of the lung airways. These include the bronchi, bronchioles, and alveoli.
40 percent of NSCLCs will have spread beyond the lungs by the time it is diagnosed
What causes non-small lung cancer?
Mainly cigarette smoking
Other risk factors include second-hand smoke, exposure to workplace carcinogens, radiation exposure, environmental pollution, family history of lung cancer and previous infection of HIV
What are the three types of non-small lung cancer?
- Adenocarcinoma
- Squamous cell carcinoma
- Large cell carcinoma
What is the key information regarding non-small cell adenocarcinoma?
Represents 40 percent of all NSCLC diagnoses
Adenocarcinoma affects both smokers and nonsmokers.
Adenocarcinoma tends to grow more slowly than other types of lung cancer, which can help lead to a better prognosis.
What is the key information regarding non-small cell squamous cell carcinoma?
Also called epidermoid carcinoma, is the second most common type of NSCLC, representing 25 to 30 percent of all NSCLC diagnoses
These cancers are more likely to spread to other areas of the body, making them more difficult to treat
Squamous cell carcinoma is more closely associated with smoking than any other type of lung cancer
What is the key information regarding non-small cell large cell carcinoma?
A rare form of NSCLC, accounting for only 10 to 15 percent of all diagnoses.
It can occur anywhere in the lung and tends to be aggressive.
What is the typical clinical presentation for non-small cell lung cancer?
- A cough that doesn’t go away or gets worse over time
- Coughing up blood
- Chest pain or discomfort
- Trouble breathing
- Wheezing
- Hoarseness
- Loss of appetite
- Weight loss for no reason
- Fatigue
- Trouble swallowing
- Swelling in the face and/or veins in the neck
How is non-small cell carcinoma diagnosed?
MRI, CT or PET can confirm diagnosis
NSCLC and other lung cancers can be difficult to diagnose because, often, these cancers have symptoms that are mistaken for common illnesses or the effects of long-term smoking.
80 percent of people diagnosed with NSCLC have already progressed to advanced stages at diagnosis
What lymph nodes does lung cancer often spread to in the earliest stages?
Ipsilateral peribronchial nodes
Hilar nodes
Intrapulmonary nodes
What lymph nodes does lung cancer often spread to in the more advanced stages?
Ipsilateral mediastinal nodes
Subcarinal nodoes
What lymph nodes does lung cancer often spread to in the most severe stages?
Contralateral mediastinal or hilar nodes
Supraclavilacular nodes
Nodes beyond
How would you manage non-small cell lung cancer?
Surgery can be curative in non-small-cell lung cancer but only 5–10% of all cases are suitable for resection; about 70% of these survive for 5 years.
Trial data suggest that neoadjuvant chemotherapy may downstage tumours to render them operable and may also improve 5-year survival in patients whose tumours are operable at presentation
In what cancer stages is surgery curative for non-small cell lung cancer?
T1, N0, M0
If surgery is not appropriate, how would you manage non-small cell lung cancer?
In patients who are fit and who have a stage 1 NSCLC, high-dose radiotherapy (65 Gy or 6500 rads) can result in a 27-month median survival and a 22% 5-year survival.
Poor lung function is a contraindication
