Lung Cancer

Question 1

What is the common age range affected by lung cancer sufferers?

Answer 1

85-89

Question 2

Give 4 risk factors for lung cancer.

Answer 2

Smoking
Asbestos
Occupational carcinogens (Cr, nickel and arsenic)

Question 3

Where are some local areas of lung cancer metastasis?

Answer 3

Lymph nodes
Pericardium
Pleura
Contralateral lung

Question 4

What are some sites of distant metastasis?

Answer 4

Liver
Brain
Adrenals
Bone

Question 5

Give some signs of lung cancer.

Answer 5

Cachexia
Clubbing
Horner’s syndrome 
Ipsilateral diaphragm elevation 
SVC syndrome 
Consolidation on CXR
Muffled heart sounds
Hepatomegaly 
Skin metastasis 
Paraesthesia on ulnar side of arm and hand muscle weakness

Question 6

Why might someone with lung cancers get seizures?

Answer 6

Due to dilutional hyponatremia from SIADH due to ectopic ADH release (small cell lung cancer)

Question 7

Why might someone with lung cancer be thirst and constipated?

Answer 7

Hypercalcaemia due to bone metastasis or PTH-Protein ectopic release

Question 8

Name some neurological syndromes that can arise due to lung cancer.

Answer 8

Encephalopathy
Peripheral neuropathy (brachial plexus compression)
Eaton lambert syndrome
Pancoast syndrome

Question 9

What is a cutaneous paraneoplastic syndrome that can occur due to lung cancer?

Answer 9

Dermatomyositis

Question 10

What when should a biopsy not be done and why?

Answer 10

Metastasis present - will make no difference to prognosis - risk of PT and cardiac arrest

Question 11

What are top 3 most common types of lung cancer?

Answer 11

SCC
AC
SC
Large cell carcinoma
Rare tumours (carcinoid)

Question 12

Mutations in what can predispose?

Answer 12

EGFR
ALK
KRAS
PD1
PDL1