Lung Carcinoma Flashcards Preview

MODHIII - Unit 3 > Lung Carcinoma > Flashcards

Flashcards in Lung Carcinoma Deck (37)
Loading flashcards...
1

Early stage (local) disease survival at 5 years

80%

2

Late stage (distant metastasis) survival at 5 years

3

Median survival time of patients w/ late stage disease

1 year

4

Top three cancers for number of new cases per year: men

1. prostate:26%
2. lung/bronchus: 14 %
3. colon/rectum: 8%

5

Top three cancers for new cases per year: women

1. breast: 29%
2. lung/bronchus: 13%
3. colon/rectum: 8%

6

Top three cancers for annual deaths: men

1. lung/bronchus: 28%
2. prostate: 9%
3. colon/rectum: 8%

7

Top three cancers for annual deaths: women

1. lung/bronchus: 26%
2. breast: 15%
3. colon/rectum: 9%

8

Number of deaths per year from lung cancer

~155,000

9

Where would lung cancer rank among leading causes of death in the US

3, behind heart disease and other cancers

10

US lung cancer screen recommendations: age, smoking history, modality

- age: 55-74
- tobacco 33 pack years
- actively smoking or quit w/ in 15 years
- modality: low-dose CT chest

11

Why is there an age limit on screening recommendations

- with increasing age comes decreasing chance that the lung cancer, if it were to be found, would be treatable

12

Risk factors for lung cancer

- increasing age, tobacco, radon, occupational, genetic
- men more at risk than women

13

Tobacco and risk of lung cancer

- both primary, active, and secondary are related to lung cancer
- more you smoke the greater the risk
- appears as though any amount of smoking leads to increased risk

14

Occupational risk factors for lung cancer: metals

- indoor combustion cook stoves (coal): affects women
- asbestos
- metals: chromium, nickel, zinc, cadmium
- miners, pipe-fitters, welders, metal fabrication

15

Genetic risk of lung cancer

- 1.51 fold increase in risk after adjustment for smoking in first degree relatives

16

Women more likely to get what type of lung cancer

adenocarcinoma

17

Difference b/w smoking and non-smoking lung cancer

- smoking lung cancer more likely squamous cell carcinoma
- non smoking lung cancer more likely adenocarcinoma

18

Thoracic symptoms of lung cancer

- cough, dyspnea, chest pain, hemoptysis, voice changes, dysphagia

19

Extra-thoracic symptoms of lung cancer

- bone pain (back pain), headache, seizures, neurologic deficits, abdominal swelling, shoulder pain

20

Common sites of lung cancer metastasis

- bone, brain, adrenal glands, liver, pleura

21

Systemic symptoms of lung cancer (paraneoplastic symptoms)

- anorexia, weight loss, clubbing of nails

22

Most popular staging at diagnosis & survival rate

>50% are distant: which has the worst 5 year survival rate (~5%)

23

Systems focused on when doing a physical exam of patient w/ suspected lung cancer

- weight & weight history
- pulmonary, heart/vascular, lymph nodes, neurologic

24

Lab tests for patients w/ suspected lung cancer & what they indicate

- blood count, electrolytes, liver function, serum proteins
- indicate nutritional status, metastatic disease

25

Radiographs for patient w/ suspected lung cancer and their importance

- CT chest w/ contrast: categorize primary lesion & lymph nodes
- positron emission tomography (PET): search for metastasis (staging)

26

Functional status assessment for patients with lung cancer & purpose

- assess ability of patient to withstand and benefit from treatment
- rate global functional status
- measure pulmonary functional status

27

Pulmonary functional status assessment tests

- exercise capacity formal: measure VO2
- exercise capacity informal: walk 2 flights of stairs
- measure total lung capacity: FVC, FEV1

28

Global functional status assessment test & meaning

- Karnofsky Scale
- 0-100: with 100 being best
- high number means can use treatment
- lower number means palliative care

29

Diagnosing lung cancer

- all suspected lung cancers require biopsy for confirmation of diagnosis

30

Types of biopsy used in lung cancer

- CT-guided FNA
- ultrasound tip bronchoscope
- thoracentesis

31

Thoracentesis use in lung cancer

- used for pleural effusion
- fluid can be examined for malignant cells
***malignant pleural effusion is assigned M1 status in TNM system, which translates into Stage IV***

32

Surgical options for removal of lung masses

- wedge resection
- segmentectomy
- lobectomy
- pneumonectomy

33

TMN staging general meaning

- T factor: size based; tells you if you can get it out w/ surgery (T1-T4)
- N factor: lymph node involvement; ipsilateral, mediastinum, contralateral (N0-N3)
- M factor: metastasis; yes or no (M0 & M1)

34

Stage IV & TMN stagin

Stage IV = and T, any N, with M1

35

Treatment-Stage approach

- early stage (no metastasis): surgery
- advance stage (limited to chest): chemo + radiation w/ curative intent
- advanced stage w/ metastasis: palliative care (may include chemo & radiation)

36

Role of palliative care in lung cancer

- for patients with distant disease, focusing on early palliative care improves both survival and quality of life

37

Overall survival of patients diagnosed with lung cancer at 5 years

14%