Lung Cancer Flashcards
(21 cards)
Does small cell cause clubbing ?
No
What is the main RF for SCLC?
Smoking - almost all patients are smokers
What are poor prognostic markers of SCLC?
Extensive diseases Poor ECOG Hyponatraemia Elevated ALP and LDH
What is limited stage SCLC?
One hemithorax - e.g. hilar, mediastonal and subclavicular LN
What is extensive stage SCLC?
Spread beyond hemithorax - ipsilateral effusion or mets
Treatment of limited SCLC?
Concurrent chemo/radio
Treatment of extensive SCLC?
Chemo - carbo/etop
What are the 2 main RF for mesothelioma?
Asbestos and Tabacco
Treatment of mesothelioma?
Resect - uncommonly done due to high mortality procedure Chemo with cisplatin and permetrexed - Poor prognosis
What investigations are done for staging of NSCLC?
- WBBS - CT brain, chest, abdo, pelvis - PET ( often pick up mets and upstages cancer)
What are types of lung cancer?
Adenocarcinoma Squamous Small Cell Large cell Bronchoalveolar
What is stage 1 NSCLC?
under 5 cm
What is stage 2 NSCLC?
Local spread, can be to pleura or chest wall, can have local LN
What is stage 3 NSCLC?
LN in mediastinum or ipsilateral lung nodules
What is stage 4 NSCLC?
Mets or malignant effusion
How do you manage stage 1 NSCLC?
Resect
How do you manage stage 2 NSCLC?
Resect Adjuvant chemo - cisplatin + vinorebline
How do you manage stage 3 NSCLC?
- Resect 2. If unresectable - neoadjuvant chemo to downsize 3. Combined chemo radiotherapy
How do you manage stage 4 NSCLC?
- ALK + EGFR + ROS-1 Mutation
If positive
- eGFR - erlotinib, gefetonib
- ALK - crizotonib
- ROS-1 Crizotonib
If negative
- chemo (cis/carbo-platin + any of vinorebline/paclitaxal, gemcitabine)
2. Pembro/Nivo 2nd line
What diver mutations are associated with NSCLC?
eGFR, ALK, ROS-1
What phenotype gets eGFR mutations?
young, asian, female, never smoker with adenocarcinoma
