Lung Cancers

Question 1

Define lung cancer

Answer 1

tumors that originate from the epithelium of the respiratory tract

Question 2

lung cancer/tumors aka

Answer 2

bronchogenic carcinoma

Question 3

T/F: lung cancer is the most common fatal neoplasia in both sexes age 50-65

Answer 3

true

Question 4

ethnicity and sex with largest lung cancer incidence

Answer 4

black males

Question 5

race with lowest rates of lung cancer

Answer 5

Hispanics (male and female)

Question 6

T/F female lung cancer incidence between blacks and whites is the same

Answer 6

true

Question 7

WHO Classification of lung cancers is based on what

Answer 7

cell type

Question 8

WHO Classification of lung cancers (4)

Answer 8

1. Epidermoid (squamous) carcinoma (17%)
2. Small cell carcinoma (oat cells) (25%)
3. Adenocarcinoma (40%)
4. large cell carcinoma (15%)

Question 9

another classification of lung tumors (2)

Answer 9

1. small cell lung cancer (SCLC) 20%

2. non-small cell lung cancer (NSCLC) 80%

Question 10

name the 3 types of lung tumors classified as non-small cell lung cancers

Answer 10

1. squamous cell carcinomas
2. adenocarcinomas
3. large cell carcinomas

Question 11

Squamous cell carcinomas are closely correlated to what

Answer 11

smoking

Question 12

Squamous cell carcinomas are usually located where

Answer 12

centrally located near hilus of lung, projecting to bronchi

Question 13

how do Squamous cell carcinomas spread?

Answer 13

by direct extension

Question 14

when does metastasis occur in Squamous cell carcinomas

Answer 14

late

Question 15

S/S of Squamous cell carcinomas

Answer 15

SOB (because the tumor is located in the main bronchi region)

Question 16

Adenocarcinoma located where

Answer 16

more peripheral, smaller lesions

Question 17

Adenocarcinoma info

Answer 17

• not strongly associated with smoking

- if a non-smoker develops lung cancer it is most likely to be an adenocarcinoma

Question 18

Adenocarcinomas invade where, causing what?

Answer 18

invade blood and lymph vessels leading to early metastasis

Question 19

if a non-smoker develops lung cancer it is most likely to be what type ?

Answer 19

adenocarcinoma

Question 20

Large cell carcnioma look like what?

Answer 20

highly undifferentiated and anaplastic, meaning the cell is hard to classify as a certain type of cell

Question 21

Large cell carcniomas develop where

Answer 21

in the periphery

Question 22

Large cell carcniomas grow at what rate? do they spread?

Answer 22

grow rapidly and spread early and extensively

incidence of these tumors has decreased due to improved detection

Question 23

Small cell carcinomas are located where

Answer 23

centrally

Question 24

Small cell carcinomas look like what?

Answer 24

oat seeds, aka also called oat cell carcinoma

Question 25

Small cell carcinomas rate of spread and prognosis

Answer 25

fastest doubling time and worst prognosis of all bronchiogenic carcinomas
early metastasis to adjacent tissues as well as distal spread occurs very early

Question 26

some of worst lung tumors to have

Answer 26

small cell carcinomas

Question 27

Pancoast tumor located where

Answer 27

apex of lungs, often spreads to ribs and vertebrae

Question 28

Pancoast tumor info

Answer 28

1-3% of all lung tumors
mostly squamous or adenocarcinomas (NSCLC)
tends to be diagnosed late

Question 29

Pancoast tumor s/s

Answer 29

• 1st s/s is thoracic and scapular pain
• can also present with s/s of brachial plexus compression (ulnar nerve distribution) or thoracic outlet syndrome
• horner’s syndrome

Question 30

What is horner’s syndrome

Answer 30

sympathetic nerve disorder

Question 31

3 s/s of Horner’s syndrome

Answer 31

1. miosis (constricted pupil)
2. partial ptosis (eyelid weakness)
3. loss of hemifacial sweating (anhidrosis) causing dry skin
   considered uncommon

Question 32

Metastatic lung cancers

Answer 32

• much more common than primary cancers

- most common place for other cancers to spread is to the lungs

Question 33

most common primary cancers to metastasize to lungs:

Answer 33

#1 = breast cancer
GI, female genital tract, kidneys, melanomas, male genital tract

Question 34

Diagnosis of lung tumors

Answer 34

• s/s
• cytology, sputum, bronchial brushings
• biopsy
• radiology, CT scan, MRI

Question 35

treatment for non-small cell lung cancer

Answer 35

1. Surgery (for stage 1,2, or 3)
2. radiation and chemo
   - surgery is most effective with centrally-located tumors that metastasize late
   - radiation can cause tissue fibrosis 6-12 months after radiation (decreased ROM and mobility)

Question 36

prognosis for non-small cell lung cancer (5yr survival)

Answer 36

30% if resectable

6% if not resectable. median survival of less than a year

Question 37

treatment for small cell lung cancer

Answer 37

chemo!! Radiation can be used to limit cerebral metastasis or pain
too small to be treated with surgery

Question 38

prognosis for small cell lung cancer

Answer 38

40-70 weeks with treatment

6-17 weeks wthout treatment

Question 39

Paraneoplastic syndrome

Answer 39

• remote effects of neoplasm
• occurs in 20%
• often appears before primary tumor has been diagnosed
• common in small cell lung tumors
• cushing syndrome
• primary sign = LE weakness

Question 40

Cushing syndrome

Answer 40

changes in BF, edema, infection, changes in skin quality

Question 41

cancer and POC

Answer 41

• scheduling
• monitor labs
• pain meds
• nutrition
• pulmonary issues
• energy conservation!!!!