Lung Cancer

Question 1

Lung cancer

Answer 1

forms from epithelial cell in the respiratory tract

Question 2

Risk factors for lung cancer

Answer 2

1. Tobacco smoking
2. Exposure to Radon gas
3. Asbestos
4. Air pollution
5. Medical radiation

Question 3

Types of lung cancer

Answer 3

1. Small cell carcinoma -
   • origin from small immature endocrine cells
2. Non small carcinoma
   • make up most of lung cancers

Question 4

Types of non small cell cancers

Answer 4

1. Adenocarcinomas
• Glandular structures form
• Generate mucin
2. Squamous cell
• Square shaped
• produce keratin
3. Carcinoid tumor
• mature endocrine cells
4. Large cell carcinoma
• lack glandular and squamous differentiation

Question 5

Small cell carcinoma

Answer 5

1. Neuroendocrine tumors
most malignant !
2. Assoc w smoking
3. Develops near main bronchus
4. Grows fast and rapidly metastasises 

5. Paraneoplastic syndrome -

Question 6

Small cell carcinoma - paraneoplastic syndrome

Answer 6

• tumor releases ACTH which stimulates cortisol release and causes Cushing’s syndrome
• Tumor releases ADH causing increase in blood pressure and water retention
• Tumor release antibodies
• > destroy neurons causing Lambert - Eaton Myasthenic syndrome

Question 7

Squamous cell carcinoma

Answer 7

• Centrally located
• Assoc with smoking
• Pancoast tumors can form
• Neoplastic syndrome - excess parathyroid hormone release causing depletion in calcium in bone causing brittle bones and hypercalcaemia

Question 8

Adenocaricnomas

Answer 8

• Peripheral
• Not linked to smoking
• Least malignant
• Pancoast tumors can form

Question 9

Bronchial carcinoid tumors

Answer 9

• Tumors can occur through out

* Can release serotonin - increased peristalsis, diarrhea and bronchoconstriction causing asthma

Question 10

TNM staging - T

Answer 10

T - size of the tumor
T0 - no tumor
T1 - 1 - 3 cm tumor in lung
( T1a, T1b, T1c)
T2 - 3-5cm, visceral pleura and main airway
T3 - 5 - 7 cm ( chestwall, ribs, diaphragm)
T4 - 7cm> ( both lobes)

Question 11

TNM staging - N

Answer 11

N - spread to nearby lymphnodes
N1
N2
N3

Question 12

TNM staging - M

Answer 12

M- Metastasis
M1 - metastasis within lung
M2 - spread to opposite lobe
M3 - metastasis within lung but only one
M4 - everywhere

Question 13

Symptoms

Answer 13

depends on size, location, hormone
• Weighloss
• Fever
• Night sweats

2. If tumor obstructs airway
   - cough, shortness of breath, pneumonia
   • Hypertrophic pulmonary osteoarthropy - inflammation of joints and bone
3. Compresses nerve
   • Horner’s syndrome
   • Recurrent laryngeal nerve - change in voice
   • Phrenic nerve - difficulty breathing
4. Compresses blood vessels
   • superior vena cava obstructed thus cannot drain
   - Face swelling
   - Shortness of breath
5. Dysphagia - squeezes oesophagus thus difficulty swallowing
   • Pleural/Pericardial effusion

Question 14

Diagnosis

Answer 14

1. Chest X ray

Question 15

Resp symptoms

Answer 15

•Breathlessness
• Cough
• Chest pain
• Wheeze
 Clubbing