Lung Cancer Treatment Flashcards

(37 cards)

1
Q

What are the 5 steps in treating lung cancer?

A
Giving the diagnosis
Surgery
Radiotherapy
Chemotherapy
Supportive care
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2
Q

What are the steps of giving a diagnosis?

A
Prepare the ground
Bring a relative
Make sure they understand
Prepare for obvious questions
Tell their GP
Arrange follow up
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3
Q

What are the survival rates of lung cancer in scotland?

A

median= 5.8 months

1 year survival = 30%

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4
Q

What are the clinical options of small cell carcinoma?

A
At time of presentation, usually spread beyone primary site- can't operate
12% of lung cancers
Rapidly progressive
Early metastases
Good initial response to chemotherapy
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5
Q

What are the clinical options of non small cell carcinoma?

A

Can be potentially cured with surgery or radical chemotherapy
Paliative chemotherapy
Most of lung cancers are non-small cell

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6
Q

What is the survival rate of non small cell?

A

7.7 months

39% survive a year

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7
Q

What is the survival of small cell?

A

5.9 months

24% survive a year

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8
Q

what is the survival of unknown lung cancers?

A

4.9 months

26% survive a year

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9
Q

What do you consider when thinking of lung cancer surgery?

A

Can it be cut out?
Is it localised?
Will the patient survive the operation?
What willthe residual lung function be?

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10
Q

After surgery, what are the survival rates?

A

42.7 months

81% survive a year

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11
Q

what tests need to be taken before surgery?

A
Bronchoscopy
Mediastinoscopy/EBUS
CT scan of brain
CT scan of thorax
PET scan
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12
Q

what would you look for in a pre-op bronchosopy?

A

Vocal cord palsy
proximal to carina
cell type

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13
Q

what would you look for in a pre-op Mediastinoscopy/EBUS?

A

Lymph nodes

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14
Q

what would you look for in a pre-op CT of brain?

A

Metastases

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15
Q

what would you look for in a pre-op thorax CT?

A

Tumour size
lymph nodes
metastases
local invasion

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16
Q

what would you look for in a pre-op PET scan?

17
Q

What are some surgeries for lung cancer?

A

Pneumonectomy/lobectomy
Thoracotomy
Minimal access VATS

18
Q

What is a thoracotomy?

A

A long incision around the length of the sixth rib to gain access to lung

19
Q

what is VATS?

A

Video assisted thoracic surgery- key hole

20
Q

What do you need to know before chemotherapy?

A

What cell type the cancer is- Bronchoscopy
Tumour size, local iinvasion, nodes, metastases- CT
Performance status ECOG score

21
Q

what performance status are considered for chemo?

22
Q

What does chemotherapy involve?

A
Longer survival
Better response in small cell cancer
Major side effects
IV infusions every 3-4 weeks
outpatient visits
Imaging
23
Q

what does chemotherapy target?

A

whole body

Rapidly dividing cells

24
Q

What are some chemotherapy side effects?

A
Nausia
Tiredness
Bone marrow suppression
Hair loss
Pulmonary fibrosis
25
What are common genetic mutation targets?
EGFR | ALK1
26
what are some targets for immune therapy?
PD-L1
27
What is radiotherapy?
ionising beams, targeted against a localised point
28
What are the main uses of radiotherapy?
Curative | Paliative
29
What are the side effects of radiotherapy?
Collateral damage- spinal cord/ oesophagus/ adjacent lung tissue
30
what is a common side effect of radiotherapy for lung cancer?
Temporary oesophagitis
31
What is SABR?
Stereotactic ablative radiotherapy | lots of small beams- higher radiation on tumour, less on surrounding tissues
32
what is required for SABR?
4D scanning
33
What are some types of endobronchial therapy?
Stent inserion for stridor Photodynamic therapy Laser therapies
34
What determines the treatment of lung cancer?
Cell type Extent of the disease Co-morbidity THE PATIENT'S WISHES
35
What are some big factors stopping someone being able to receive treatment?
COPD emphysema ischaemic heart disease
36
What are the main things to tackle with palliative care?
``` Pain Breathlessness Cough Anxiety Poor mobility ```
37
What are the main causes of lung cancer?
Tobacco smoking Asbestos Radon