Lung cancer Flashcards
(52 cards)
What percentage of lung cancers are caused by smoking
85%
What percentage of smokers get lung cancer
10%
What are the causative agents of lung cancer
Asbestos
Radon
Air Pollution
Diesel Exhaust
Is there more lung cancer in males or females
Males but females are more succepitable
What are the presenting symptoms of lung cancer (x9)
Chronic cough (>3 weeks) Haemoptosis Wheeze Chest and Bone pain Difficulty swallowing Raspy hoarse voice S.O.B Nail Clubbing Unexplained weight loss
What are the clinical signs of lung cancer (x6)
Clubbing of fingers Lymphadenopathy Horners syndrome Pancoast tumour Superior Vena Cava obstruction from lymph glands Hepatomegaly and skin nodules
What is Horners syndrome
Horner’s syndrome is a rare condition characterized by miosis (constriction of the pupil), ptosis (drooping of the upper eyelid), and anhidrosis (absence of sweating of the face). It is caused by damage to the sympathetic nerves of the face.
What are the three indicators of finger nail clubbing
- The base of the nail (nail bed) becomes soft and the skin next to the nail bed becomes shiny. 2. The nails then curve more than normal when looked at from the side (this is called Scarmouth’s sign)
- The ends of the fingers may then get larger (when they are called drumstick fingers)
What is a Pancoast tumour?
A tumour of the pulmonary apex
If you suspect lung cancer then whats the first investigation you should carry out
Chest X-ray
After chest X-ray what further investigations can the GP perform when suspecting lung cancer
Full Blood count Renal and liver functions Calcium Clotting screening Pulmonary function (Spirometry)
What techniques can be used to diagnose a piece of tissue suspected to be lung cancer or metastasis.
Bronchoscopy (just looks)
EBUS (common) - bronchoscopy but sample is taken
Image guided lung biopsy
Image guided liver biopsy (for metastasis)
Fine needle aspiration of neck node or skin metastasis
What do you look for on a chest Xray when diagnosing lung cancer
No widening of the mediastinum The hilar vascular structures are crisply defined (left should be higher) The trachea should be central Pleural effusion phrenic nerve palsy Collapsed lobe/lung Shadowed local opacity Metastatic disease
If a lesion is found by the Xray, what investigations should be done next?
CT scan and tissue sample
How do you stage a lung neoplasm?
TNM staging
What is TNM staging
T - the size of the cancer tumor and whether or not it has grown into nearby tissue (T1–T4)
N - whether cancer is in the lymph nodes N0-N3)
M - if the cancer has metastasised to other organs (Mx-M1)
If the lesion is not Lung cancer, what else could it be?
Pulmonary mass - an opacity in the lung over 3cm with no mediastinal adenopathy or atelectosis
Pulmonary Nodule - less than 3cm with no mediastinal adenopathy or atelectosis
What is a PET scan and what area of the body can you not use it on
A positron emission tomography (PET) scan is an imaging test that helps reveal how your tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to show this activity. This scan can sometimes detect disease before it shows up on other imaging tests.
Cant use for brain metastasis
What are the 4 main types of lung carcinoma and how common are they (%)
Adenocarcinoma 41%
Squamous cell carcinoma 40%
Small cell carcinoma 15%
Large cell carcinoma 4%
What are the two categories of lung cancers and how common is each (in %)
Small Cell lung Cancer (SCLC) 15%
None small cell lung cancer (NSCLC) 85%
What the survival rate for a NSCLC
10-25%
What the survival rate for a SCLC
4%
What lung cancer is most commonly caused by smoking
Squamous cell carcinoma
Why are Squamous cell carcinomas difficult to treat
Very few addictive Oncogenes
