Week 6 Lecture 1 Flashcards
(103 cards)
1
Q
What are the main types of primary lung cancer?
A
Non-small cell lung cancer, small cell lung cancer, carcinoid, mesothelioma
Mesothelioma specifically affects the pleura.
2
Q
What is the most common cause of cancer death in both men and women?
A
Lung cancer
3
Q
What age range has the peak incidence of lung cancer?
A
60 to 70 years
4
Q
What percentage of lung cancers are classified as non-small cell lung cancer?
A
80%
5
Q
List the three main subtypes of non-small cell lung cancer.
A
- Adenocarcinoma
- Squamous cell carcinoma
- Large cell carcinoma
6
Q
What are Pancoast tumors?
A
Primary lung cancers that develop in the apex of the lung, usually non-small cell cancers
7
Q
What is the most common subtype of lung cancer in North America?
A
Adenocarcinoma
8
Q
What is the prognosis for adenocarcinoma in terms of 5-year survival?
A
13%
9
Q
Which type of lung cancer is most strongly associated with smoking?
A
Squamous cell carcinoma
10
Q
What is the characteristic histological feature of squamous cell carcinoma?
A
Presence of keratin pearls
11
Q
What is the prognosis for large cell carcinoma in terms of 5-year survival?
A
10%
12
Q
What percentage of lung cancers does small cell lung cancer account for?
A
13.8%
13
Q
What is the prognosis for small cell lung cancer in terms of 5-year survival?
A
5%
14
Q
What staging system is used for lung carcinoma?
A
TNM scoring system
15
Q
What does ‘T’ represent in the TNM staging system?
A
Tumor size and extent of local and/or regional spread
16
Q
What does ‘N’ represent in the TNM staging system?
A
Spread of tumor to regional or distant lymph nodes
17
Q
What does ‘M’ represent in the TNM staging system?
A
Presence of distant metastases
18
Q
What is the most common presenting symptom of lung cancer?
A
Cough
19
Q
What clinical feature is common due to central tumors in lung cancer?
A
Hemoptysis
20
Q
What is Horner’s syndrome?
A
Drooping of the upper eyelid, constriction of the pupil, absence of sweating
21
Q
What is the primary cause of paraneoplastic syndromes in lung cancer?
A
Production of physiologically active substances by cancer
22
Q
What is the lifetime risk of developing lung cancer in smokers?
A
12-17%
23
Q
What are the two most common causes of paraneoplastic syndromes?
A
- Production of active substances by cancer
- Altered immune response
24
Q
What type of lung cancer is most commonly associated with hypercalcemia?
A
Squamous cell carcinoma
25
What are common mutations involved in the molecular pathogenesis of lung cancers?
* K-ras mutations
* EGFR mutations
* EML4-ALK translocations
26
What is the most common occupational risk factor for lung cancer?
Exposure to asbestos
27
What are carcinoid tumors and where do they most often appear?
Tumors that develop in neuroendocrine cells, most often in the gastrointestinal tract
28
What percentage of lung cancers do carcinoid tumors account for?
2-3%
29
What are the two subtypes of lung carcinoid tumors?
* Typical carcinoid
* Atypical carcinoid
30
What are lung carcinoids and their prevalence in lung cancers?
Lung carcinoids are very rare, accounting for 2-3% of all lung cancers.
31
Where do lung carcinoids develop?
Lung carcinoids develop in neuroendocrine cells of the normal bronchial epithelium.
32
What are the two subtypes of lung carcinoids?
The two subtypes are typical carcinoid and atypical carcinoid.
33
Are lung carcinoids more common in men or women?
Lung carcinoids are equally common in men and women.
34
Are lung carcinoids related to smoking?
No, lung carcinoids are not related to smoking.
35
How do lung carcinoids compare in growth rate to other lung cancers?
Lung carcinoids tend to grow slower than other types of lung cancers.
36
Do most lung carcinoids cause endocrine paraneoplastic syndromes?
Most lung carcinoids do not cause endocrine paraneoplastic syndromes.
37
What is the 5-year survival rate after surgery for typical carcinoids?
The 5-year survival rate for typical carcinoids is 90% after surgery.
38
What is the 5-year survival rate after surgery for atypical carcinoids?
The 5-year survival rate for atypical carcinoids is 60% after surgery.
39
What is mesothelioma?
Mesothelioma is a cancer of the pleural lining.
40
What percentage of lung cancers does mesothelioma account for?
Mesothelioma accounts for about 5% of all lung cancers.
41
What is the primary cause of mesothelioma?
Mesothelioma is most often caused by asbestos exposure.
42
How long does it typically take for mesothelioma to develop after asbestos exposure?
It typically takes 30 to 50 years between exposure to asbestos and diagnosis.
43
What are common initial symptoms of mesothelioma?
Common initial symptoms include pleural effusion, pleural mass, chest pain, weight loss, and malaise.
44
How does pleural mesothelioma typically spread?
Pleural mesotheliomas tend to spread locally within the chest cavity, invading and compressing major structures.
45
What is the prognosis for mesothelioma patients?
The prognosis is poor, with few patients surviving longer than 18 months after diagnosis.
46
What is metastasized cancer?
Metastasized cancer refers to cancer that has spread to other parts of the body, including the lungs.
47
How do cancers typically spread to the lungs?
Cancers can spread to the lungs via the lymphatic system or the bloodstream.
48
Where do most metastatic cancers develop in the lungs?
Most metastatic cancers develop near the edges of the lungs and in the lower lobes.
49
Can lung metastases cause symptoms initially?
Lung metastases may not cause any symptoms initially.
50
List some cancers that commonly metastasize to the lungs.
* Bladder cancer
* Breast cancer
* Colorectal cancer
* Kidney cancer
* Melanoma
* Sarcomas
* Testicular cancer
51
Fill in the blank: Mesothelioma is primarily caused by _______.
asbestos exposure
52
What is the most common cause of cancer death in both men and women?
Lung cancer
## Footnote
Lung cancer is a leading cause of cancer mortality.
53
What age range has the peak incidence of lung cancer?
60 to 70 years
## Footnote
The risk of developing lung cancer increases with age.
54
What percentage of all lung cancers is accounted for by Non-Small Cell Lung Cancer?
80%
## Footnote
This type is the most prevalent among lung cancer cases.
55
Name the three main subtypes of Non-Small Cell Lung Cancer.
* Adenocarcinoma
* Squamous cell carcinoma
* Large cell carcinoma
## Footnote
These subtypes are grouped due to historically similar treatment approaches.
56
What are Pancoast tumors?
Primary lung cancers that develop in the apex of the lung
## Footnote
They are usually non-small cell cancers, most often squamous cell carcinomas.
57
Which subtype of lung cancer is most common in North America?
Adenocarcinoma
## Footnote
It accounts for 36.4% of all lung cancers.
58
What is the prognosis for adenocarcinoma?
13% 5-year survival
## Footnote
This indicates a relatively poor long-term outcome.
59
What is the most common presenting symptom of lung cancer?
Cough
## Footnote
Cough often presents in advanced stages of lung cancer.
60
True or False: Squamous Cell Carcinoma accounts for 20% of all lung cancers.
True
## Footnote
This type is most common in men and strongly associated with smoking.
61
What is the prognosis for Large Cell Carcinoma?
10% 5-year survival
## Footnote
This subtype tends to grow and spread faster than other types.
62
What is the most common location for Small Cell Lung Cancer?
Centrally or in the hilum
## Footnote
This type develops in the neuroendocrine cells of the lung.
63
What is the single most important predictor of prognosis in lung cancer?
Tumor stage
## Footnote
The TNM scoring system is used to stage lung carcinoma.
64
Fill in the blank: The TNM scoring system stands for Tumor size, ________, and Metastasis.
Node spread
## Footnote
This scoring system helps assess the extent of cancer.
65
What percentage of patients have localized disease at the initial diagnosis of lung cancer?
20%
## Footnote
Most patients present with advanced disease.
66
What are the most common sites of metastasis for lung cancer?
* Regional lymph nodes
* Brain
* Bone
* Liver
* Adrenal glands
## Footnote
These sites are frequently involved in the progression of lung cancer.
67
What is Horner's syndrome?
Drooping of the upper eyelid, constriction of the pupil, absence of sweating
## Footnote
This syndrome can occur due to Pancoast tumors impacting the sympathetic nerve plexus.
68
What are paraneoplastic syndromes?
Clinical syndromes involving nonmetastatic systemic effects that accompany a cancer
## Footnote
They can include symptoms from substances produced by the cancer.
69
What is the most common cause of hypercalcemia in lung cancer patients?
Ectopic production of a parathyroid hormone related peptide
## Footnote
This is most commonly seen in patients with squamous cell carcinomas.
70
What is the primary risk factor for developing lung cancer?
Tobacco smoke
## Footnote
85-90% of lung cancers occur in tobacco smokers.
71
Fill in the blank: Exposure to _______ is associated with 10% of lung cancers.
Radon
## Footnote
Radon is a colorless, odorless gas that can accumulate in homes.
72
What is the lifetime risk of developing lung cancer in smokers?
12-17%
## Footnote
This risk is significantly higher compared to non-smokers.
73
What determines the development of lung cancer?
No single mutation determines the development of lung cancer
74
Which family of oncogenes is most important in lung cancer?
ras family of oncogenes, particularly K-ras
75
What is the role of ras mutations in lung cancer?
Involved with the molecular pathogenesis of Non-small cell lung cancers and contribute to tumor progression
76
What percentage of adenocarcinomas have K-ras gene mutations?
25%
77
K-ras mutations are associated with which lifestyle factor?
Cigarette smoking
78
What is currently available for targeted therapy of K-ras mutations in lung cancer?
No effective targeted molecular therapy available
79
What gene has activating mutations in up to 25% of adenocarcinomas?
Epidermal Growth Factor Receptor (EGFR)
80
In which populations are mutations in EGFR more common?
* Nonsmokers
* People of East Asian descent
* Women
81
What is the significance of EGFR mutations in lung cancer treatment?
These cancers respond very well to tyrosine kinase inhibitor drugs
82
What percentage of adenocarcinomas show EML4-ALK translocations?
5%
83
What is a common occurrence in adenocarcinomas with EML4-ALK translocations?
Brain metastases present at diagnosis in 25% of cases
84
EGFR and EML4-ALK mutations are ________.
mutually exclusive
85
What type of genetic alteration involves ROS1 translocations?
Fusions between ROS1 and various partners occur in 2% of all lung cancers
86
What percentage of small cell lung cancers show overexpression of MYC?
10 – 40%
87
What is the mutation prevalence of TP53 in lung cancers?
Identified in more than 80% of small cell and 50% of non–small cell lung cancers
88
What percentage of small cell and non-small cell cancers have RB mutations?
* >80% of small cell
* 25% of non–small cell
89
What genetic deletion is frequently found in all types of lung cancers?
Deletions in the short arm of chromosome 3 (3p)
90
What does the BCL2 protooncogene encode?
Bcl-2, a protein that inhibits apoptosis
91
What is the mutation prevalence of PTEN in non-small cell lung cancers?
Deficient in many non–small cell lung cancers
92
Amplification of which receptor is found in 20% of squamous cell carcinomas?
FGFR1 (fibroblast growth factor receptor 1)
93
What is a consequence of early and extensive mutations in lung cancers?
Pronounced intratumor heterogeneity
94
What percentage of all lung cancers do carcinoid tumors account for?
2-3%
95
What are the two subtypes of carcinoid tumors?
* Typical carcinoid
* Atypical carcinoid
96
What is the 5-year survival rate after surgery for typical carcinoids?
90%
97
What is the prognosis for atypical carcinoids after surgery?
60% 5-year survival
98
What type of cancer is mesothelioma?
Cancer of the pleural lining
99
What is the common cause of mesothelioma?
Asbestos exposure
100
How long can it take for mesothelioma to develop after asbestos exposure?
30 to 50 years
101
What is the prognosis for patients diagnosed with mesothelioma?
Poor, with few surviving longer than 18 months
102
What is a common site of metastasis for other cancers?
The lungs
103
Which cancers are more common to metastasize to the lungs? List at least three.
* Bladder cancer
* Breast cancer
* Colorectal cancer
