Lung cancer Flashcards
What are the main types of bronchial carcinoma and how common are they?
Non small cell cancer is more common - squamous, adenocarcinoma, large cell
Small cell is less common (20%) - arise from endocrine cells and cause paraneoplastic syndromes from secretion
Which lung cancer has the worst prognosis?
Small cell as 70% are disseminated at presentation
What are the symptoms of lung cancer?
Dyspnoea, cough, haemoptysis, weight loss, lethargy, anorexia, chest pain, recurrent pneumonia
What are the signs of lung cancer?
Cachexia, anaemia, clubbing, consolidation, pleural effusion
mets - bone tenderness, hepatomegaly, confusion
What are some of the local and systemic complications of lung cancer?
Recurrent larangeal nerve palsy, phrenic nerve palsy, Horner’s syndrome
Systemic - hypercalcaemia, addisons
What is mesothelioma?
A tumour of mesothelial cells that usually occurs in the pleura - associated with asbestos exposure
What are the clinical features of mesothelioma?
Chest pain, weight loss, clubbing dyspnoea, signs of mets - lymphadenopathy, hepatomegaly, bone pain
What are the tests for mesothelioma?
Chest XR/CT shows pleural thickening/effusion. Bloody pleural fluid
How is mesothelioma diagnosed?
Histology of sample from thoracoscopy, often only ade at post mortem
What is the management of mesothelioma?
Pemetrexed + cisplatin chemo
Surgery has mixed results
Prognosis is poor
How do squamous cell lung cancers cause hypercalcaemia?
They excrete PTH which causes increased bone breakdown
How do you treat malignancy associated hypercalcaemia?
Aggressive rehydration, bisphosphonates e.g. zolendronic acid IV, Calcitonin can produce a more rapid response (2hr) but has a short term effect
Need to control the underlying malignancy
Which cancers cause SIADH and which cause hypercalcaemia?
SIADH is small cell
Squamous cell carcinomas cause hypercalcaemia
