Lung Cancer Flashcards

1
Q

How many deaths a year are there from lung cancer?

A

35000

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2
Q

What is the 5 year survival rate of those diagnosed with lung cancer?

A

8%

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3
Q

What is the most common cause of lung cancer?

A

Smoking

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4
Q

Is the risk of lung cancer proportional to the amount smoked?

A

Yes

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5
Q

Genetically at a cellular level how does smoking lead to lung cancer?

A

Carcinogens in smoke cause multiple mutation in epithelial cell DNA which accumulate
Multiple hits eventually leads to cell cycle regulation loss
The mutated cells being dividing uncontrollably

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6
Q

What are the key symptoms of lung cancer?

A
Cough 
Haemoptysis 
Chest pain 
Breathlessness 
Weight loss (key sign) 
Hoarseness of voice 
Wheeze 
Swollen face
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7
Q

What are the metastatic symptoms of lung cancer?

A

Bone pain
Headaches-neurological fits
Jaundice

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8
Q

What is the most aggressive form of lung cancer?

A

Small cell carcinoma

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9
Q

What are the characteristics of small cell carcinoma of the lungs?

A

Large tumours
Quick growing
Often metastasised before diagnosis

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10
Q

What are the 3 types of non small cell lung cancer?

A

Large cell carcinoma
Adenocarcinoma
Squamous cell carcinoma

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11
Q

What are common sites of metastasis of lung cancer?

A
Liver 
Bone 
Brain 
Adrenal glands 
Skin
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12
Q

What 3 zones is the lung divided into?

A

Upper
Middle
Lower

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13
Q

What is a pulmonary mass?

A

Opacity in lung over 3cm with no mediastinal adenopathy or atelectasis

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14
Q

What is a pulmonary nodule?

A

Opacity in lung up to 3cm with no mediastinal adenopathy or atelectasis

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15
Q

What does a tissue sample of mass in lung allow?

A

Histology to help stage the sample and diagnose the type of lung cancer

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16
Q

What does the identification of the stage of the cancer allow?

A

A prognosis and treatment to be outlined

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17
Q

What does TNM stand for?

A

Tumour size and position
Nodes
Metastases (has the tumour spread anywhere else in the body)

18
Q

How is T in TNM classified??

A

T1-4

19
Q

How is N in TNM classified?

A

N1-3

20
Q

How is M in TNM classified?

A

M0-1

21
Q

What are some of the other causes of lung cancer?

A

Asbestos

Occupational

22
Q

What % of smokers get lung cancer?

A

10%

23
Q

What is small cell carcinoma usually called by?

A

Smoking

24
Q

Why is lung cancer called ‘clinically silent’?

A

Because there are no symptoms for ages

25
Q

Why does lung cancer have such a bad prognosis?

A

Because by the time the symptoms normally appear the cancer is in too late a stage and the patient will normally die

26
Q

What is a PET-CT?

A

Radiolabelled glucose is injected into the body.
Rapidly dividing cells (tumour cells) will use the most glucose
This allows us to see distant metastasis

27
Q

What are the signs of lung cancer?

A
Finger clubbing 
Stridor 
Signs of consolidation 
Pleura effusion 
Cervical lymphadenopathy
28
Q

What is the most preventable form of lung cancer?

A

Lung cancer

29
Q

What initial investigations are done for suspected lung cancer?

A
CXR
FBC
Renal, liver functions and calcium 
Clotting screen 
Spirometry
30
Q

What does N0 mean?

A

No regional node involvement

31
Q

What does M0 mean?

A

Distant metastasis absent

32
Q

What does M1 mean?

A

Distant metastasis present

33
Q

What treatment options are available for lung cancer patients?

A

Surgery
Radiotherapy
Chemotherapy
Palliative care

34
Q

What does palliative management involve?

A

Symptom control
Quality of life
Community support
Decisions and planning, resuscitation status, end of life care
Multidisciplinary team including lung cancer nurse and hospice

35
Q

Is lung cancer easy to treat?

A

No it is very difficult

36
Q

Where does the cancer have to start in order to be a primary lung cancer?

A

In the lung

37
Q

Give examples of inherited oncogene mutations which increase the likelihood of lung cancer

A

KRAs
EGRF
BRAF
HER2

38
Q

What % of lung cancers are large cell?

A

10%

39
Q

What % of lung cancers are adenocarcinoma?

A

27%

40
Q

What % of lung cancers are squamous cell carcinoma?

A

35%

41
Q

What CXR signs may indicate lung cancer?

A
Hilar vascular structure defined?
Is the costophrenic angle sharp?
Is the trachea central?
No widening mediastinium
Lesions?
Pleural effusion?
Are the lungs inflated? Or is there pneumothorax present