Surgical management of cancer Flashcards
Why wouldn’t people be suitable for surgery?
If tumour has spread (many metastases)
If tumour attached to main structures
If they aren’t fit enough other health wise e.g. smokers have increased risk of ischemic heart disease/COPD
Of those that undergo surgery, how many are cured?
Where are hila lymph nodes?
Within the lung, located in the area where the bronchus enters the lung.
Can lymph node involvement be responsible for phrenic nerve palsy and recurrent laryngeal nerve palsy?
What does the left recurrent larryngeal nerve hook around? What does it innvervate?
Ligamentum arteriosum - within the aorto-pulmonary window which links between arch of aorta and left pulmonary artery. Innervates the left vocal chord.
Common metastases locations
Brain, bones, liver, adrenals, controlateral lung
Are metastases painful? Can you get a personality change?
Yes, they can be v painful, esp brain and bones. You can get personality change if metastases in the brain.
What is Pancost syndrome?
Tumour invades brachial plexus, leading to weakness/numbness down one arm.
Chances of permanent cure for surgical removal metastases?
Low, about 25%
If there is plural effusion what are your concerns? Would you perform surgery?
Is it malignant? If so surgery would not get rid of disease.
Chest wall invasion resected reconstructed with?
Is phrenic nerve palsy operable? Why?
No, because it means that there is extensive invasion of mediastinum
Careful of what re collapsed lung?
What extent the tumour is - PET scanning can help with this.
Bone marrow involvement signs?
Altered bone profile
What goesup when there is liver met or bone met?