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Flashcards in Respiratory: Lung Cancer Deck (20)
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1
Q

What is the epidemiology of lung cancer?

A

Has the highest cancer related deaths in the world - also the most prevalent cancer. 20% 5yr survival rate
35,000 deaths per year in the UK

2
Q

How does the incidence of lung cancer differ between socioeconomic groups?

A

Higher incidence in lower socioeconomic groups due to higher incidence of smoking, and less likely to access healthcare.

3
Q

What is the most common age of presentation of lung cancer?

A

60-80 yrs

4
Q

What are the risk factors for lung cancer other than smoking?

A
  • asbestos
  • radon from rocks
  • occupational carcinogens
  • genetic factors
5
Q

Why is there not screening for lung cancer?

A

Doesn’t lead to a decrease in disease specific mortality so screening does not fulfil criteria

6
Q

Why is it important to stage lung cancer?

A

To look at prognosis and what treatments are suitable

7
Q

What does lung cancer have such a poor prognosis?

A

80% of pts present non inoperable

Lots of pts have other co-morbidities caused by smoking which limits treatment options

8
Q

What are the common sites for lung cancer to spread to?

A

Local spread: draining lymph nodes, pericardium, pleura
Distant spread: brain, liver, adrenals, bone

In the rapid access lung clinic all pts have CT from head to adrenals

9
Q

What imaging techniques are used for diagnosis and staging of the disease?

A

Chest xray
CT scan - shows only physical presence
PET scan - shows increased activity in tissues which is important in lymph nodes. Often picks up metastasis that CT doesnt

10
Q

What are the common methods used to obtain material for histological diagnosis?

A

Bronchoscopy
USS guided liver biopsy
CT biopsy - of lung and pleura
Pleural fluid aspiration

11
Q

What are some of the symptoms of lung cancer?

A

Primary tumour: cough, dyspnoea, wheezing, haemoptysis, lung infection, malaise, weight loss, asymptomatic most common
Regional metastases: hoarseness, dysphagia, chest pain
Distant metastases: bone pain, headache

12
Q

What are the different types of lung cancer?

A

Non small cell carcinoma (80%)
Includes squamous cell, large cell and adenocarcinoma which is most common in non smokers

Small cell carcinoma (15%)
Others (5%)

13
Q

How does small cell carcinoma present and what is the prognosis?

A

60% present when already metastasised
Tumours tend to be located around the hilium
Involve neuroendocrine cells which produce hormones

Poor prognosis

14
Q

How does non small cell carcinoma present?

A

Adenocarcinoma make up half of all non small cell carcinomas - Located near the periphery of the lung and involve glands
Squamous cell located near the main bronchus and can compress the airways
Large cell grow rapidly

15
Q

What is performance status?

A

A measure of the activity level of the individual - the cut off for radical treatment is 2 which means the pt is symptomatic but it is in a bed or chair for less than half a day.

16
Q

What is the best chance of cure for lung cancer?

A

Surgery, This is mostly used for non small cell carcinomas (20% when operable)

17
Q

What are the uses of radiotherapy?

A

Radical radiotherapy has curative intent and may cure small cell carcinomas
Low dose radiotherapy can be used palliatively for symptomatic control

18
Q

What is neoadjuvant and adjuvant chemotherapy?

A

Neoadjuvant chemotherapy is before surgery to downstage the tumour and size
Adjuvent chemotherapy is after surgery

19
Q

What is the role of chemotherapy?

A

Generally slows cancer rather than cures

  • potentially curative for small cell in the minority
  • modest survival increase with non small cell
20
Q

What are biological therapies?

A

Based on mutational analysis - potential game changer in the future

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