Lung Cancer Flashcards
(27 cards)
Lung cancer
Leading cause of death in US and accounts for 27% of. cancer death.
1/4 DO NOT have symptoms at diagnosis.
Cough with blood rest Color sputum
Diagnosis
CRX
Cough w/ bloody rusty sputum
4 major types
Squamous
Small-cell
Large-cell
Adenocarcinoma (MOST PREVALENT IN BOTH SEXES)
Epidemiology
86% die within 5 year
Death peaks in ages 55 to 65
men death rate is higher
African American men have higher risk
Causes
Smoking
Environmental factors.
Pathology
Carcinogenic agents , tobacco smoke absorbed in these areas.
Repeated carcinogenic bronchial epithelium may causes increase risk of cellular replication.
Small cell lung cancer
Accounts 15% of lung cancers More responsive with chemotherapy More rapid growth white gray growth,develop the main bronchus Grows around other structures 3 types: Oat cell - soft
Non-small-cell
85% of all lung cancer
Tumor suppressor gene p53-60%
Squamous-cell carcinoma
2nd most common lung cancer
Common in men
3 subtypes :well-differentiated, moderately , poorly
Metastasis are initially to the hilar and mediastinal lymph nodes , liver, bones and brain
Adenocarcinoma
35%-40%
Area of metastasis brain, liver, bone and adrenal glands
HX: chronic lung disease, Ra, recurring pulmonary-infections
*most common , NONSMOKERS
Large-cell carcinoma
Aka:undifferentiated carcinoma Least common Large Highly malign Found in later stages
Clinical presentation
Smoking HX
Location of tumor
Higher in Pt with first degree relative ‘
Intrathroacic or local regional signs and symptoms
Cough Sputum SOB (26-60% of pt have) CP Pain is dull Wheezing Facial edema
Nonspecific systematic S/S
Weakness
Fatigue
Anorexia (1/2 of pt)
Anemia
S\S extrathoracic
Spreads to lymph nodes, brain, bones, liver and supearenal glands
Neurological - hemiplegia, epilepsy, personality changes
ABD
pain unilateral
Janice and ascites
Bone pain
Paraneoplastic syndrome
Small cell- more frequently associated Endocrine Neurological Cardiovascular Skeletal Weakness Wt loss Hypercalcemia Eaton-lambert myastrenic syndrome- auto immune disorder
Diagnostic testing
CBC,NA,.K,Ca, liver, PTT CXR Tumor module 2-3 mm CT sputum sample (early morning) Needle aspiration
Management
Annual screening 55-80
30 pack year hx
Discontinue once person has not smoked in 15 years
Surgery
Resection Pneumonectomy. Lobotomy Sleeve resection Lesion resection
Non small cell chemotherapy
Widely used Stage II and IIIA
Improve survival rate 3months -5 years
Small cell chemotherapy
Most effective 80-100%
Remission 6-8 months
If cancer reoccurs survive is 3-4 months
non-smallcell radiation
Used when cancer not spread beyond thorax
Malignant plural effusion is not appropriate for definitive
Small cell radiation
Chemo and radiation increase rate by 5 years.
Thoracic irradiation is local tumor control .
. Quite sensitive
Follow-up
H&P every 3 months during 2 years , every 6 months for 5 years then yearly
Yearly CXR
CT ABD, bronchoscopy, CBC, liver test
