Lung Cancer Flashcards
(40 cards)
What is lung cancer?
Primary malignancy arising from lung parenchyma or bronchi
How common is lung cancer in the UK
3rd most common cancer in the UK
How is lung cancer classified?
Non small cell - most common
Small cell - less common
What are the types of non-small cell lung cancer?
Which one is the most common?
Adenocarcinoma (most common)
Squamous cell carcinoma
Large cell carcinoma
Which type of cells does adenocarcinoma arise?
alveolar type 2 epithelial cells
Which type of cells does squamous cell carcinomas arise?
basal epithelial cells
Which type of cells does large cell carcinomas arise
Various types of epithelial cell
Which type of cells does small cell cancer arise
Neuroendocrine cells of the lung
What paraneoplastic syndromes does lung cancer create?
SIADH
Cushing syndrome
Lambert Eaton syndrome
SVC obstruction
Acanthosis nigricans
Humoural hypercalcaemia of malignancy
Hypertrophic pulmonary osteoarthropy
Which cancer is strongly associated with asbestos inhalation?
Which cells does this cancer affect?
What is the latency period between exposure to asbestos and the development of the cancer?
Mesothelioma
Mesothelial cells of pleura
up to 45 years
Signs and symptoms of lung cancer?
SOB
cough
Haemoptysis
Clubbing
Recurrent pneumonia
Weight loss
Lymphadenopathy (supraclavicular or cervical)
Malignant pleural effusion
How does SIADH in lung cancer present?
Which type of lung cancer causes this
Hyponatraemia
Small cell
- How does Lambert Eaton syndrome present in lung cancer?
- What is the cause of it?
- Which lung cancer causes this?
- Proximal weakness improved on movement
Dry mouth
Lightheadedness
Erectile dysfunction - Autoantibodies to calcium channel receptors
- Small cell
Which lung cancer may cause Cushings syndrome?
Small cell
Which lung cancer may cause
humoural hypercalcaemia of malignancy?
Squamous cell carcinoma
What is hypertrophic pulmonary osteoarthropy?
Which lung cancer causes it?
Increased growth of periosteum leading to clubbing and arthritis of wrists and ankles
Adenocarcinoma
When should you refer on a 2ww pathway suspecting lung cancer in primary care?
Aged 40+ with unexplained haemoptysis
CXR findings suspicious of lung cancer
When should you order an urgent CXR for patients with suspected lung cancer?
1 of the following symptoms if 40+ and smoked, or 2 symptoms if 40+ and never smoked:
- Cough
- Fatigue
- Shortness of breath
- Chest pain
- Weight loss
- Anorexia
- Persistent/recurrent chest infection
- Finger clubbing
- Supraclavicular or persistent cervical lymphadenopathy
- Thrombocytosis
- Chest signs consistent with lung cancer (e.g. reduced breath sounds, dullness to percussion)
What x ray findings do you get with lung cancer?
Lung mass - rounded, spiculated, SCC will be cavitating
Consolidation
Bulky hilum
Lobar collapse
Pleural effusion
Which lung cancer is usually associated with a bulky hilum finding on chest x ray?
Squamous cell carcinoma
Investigations for lung cancer?
Sputum cytology - for pts who don’t want/can’t have biopsy
Diagnostic thoracocentesis - only if pleural effusion present
FBC, U&Es, LFTs (liver mets), bone profile, CRP, clotting (if surgery planned)
CT chest with contrast AFTER x ray
for staging and better view of mass
Endobronchial US (EBUS) - detailed assessment and US guided biopsy
Biopsy
(percutaneous/bronchoscopy) - confirms diagnosis and cancer subtype
Investigations after lung cancer diagnosis?
Spirometry to assess lung function and determine surgical suitability
CT TAP for staging
PET-CT for staging (more sensitive)
Head CT/MRI - intercranial metastases
Indications for chemotherapy for patients with lung cancer?
Small cell lung cancer
Stage 3-4 non-small cell lung cancer
What immunotherapies are offered to patients and usually for which lung cancer is it offered to?
Pembrolizumab, atezolizumab.
Offered in advanced non-small cell lung cancer
