Lung cancer

• What are the most predominant lung cancers in the UK?

  Non-small cell

  Small cell
• What are some risk factors for lung cancer?

  Smoking

  Asbestos

  Arsenic

  Radon

  Nickle

  Chromate

  Cryptogenic fibrosing alveolitis
• What is a factor that is NOT related to lung cancer?

  Coal dust
• What is the most common type of lung cancer?

  Non small cell
• What is the most common lung cancer type in never smokers?

  Adenocardinoma
• What are some tumour types of non small cell lung cancers?

  Squamous cell carcinoma

  Adenocarcinoma

  Large cell carcinoma
• What are some primary tumour-related lung cancer symptoms?

  Cough

  Haemoptysis

  Dyspnoea

  Chest pain

  Wheezing or stridor

  Recurrent chest infections

  Weight loss and anorexia
• What are some symptoms of regional spread of lung cancer?

  Hoarseness - recurrent laryngeal nerve involvement

  Dysphagia - Oesophageal involvement

  Sup vena cava obstruction

  Shoulder pain and Horner's - Pancoast tumour (at the apex of the lung)
• Where are some distant metastasis of lung cancer?

  Bone

  Brain

  Liver

  Adrenal
• What are paraneoplastic syndromes?

  Indirect systemic symptoms caused by biologically active substances produced by the tumour or by an immune response against the tumour
• What are some paraneoplastic syndromes that can occur in lung cancer?

  Hypercalcaemia

  Cushing's

  SIADH

  LEMS

  Clubbing
• What is the initial investigation for suspected lung cancer?

  CXR
• What is done if the CXR is abnormal or there is a high clinical suspicion despite a normal CXR?

  CT thorax
• What are some further investigations for lung cancer?

  PET-CT

  EBUS-TBNA

  Tissue biopsy
• What is the management for non small cell lung cancer?

  Surgical:

  • Lobectomy

  Radiotherapy:

  • First-line for those with stages 1-3 (not suitable for surgery)

  Chemo:

  • Those with stage 3 or 4

  Combination:

  • Adjuvant chemo - complete resection
  • Adjuvant radio - incomplete resection
  • All patients with stages 1-3 who are not suitable for surgery = chemoradio
• When is surgery done for those with small cell lung cancer?

  Early stage 1 and 2
• What is the majority of SCLC patients treated with?

  Chemo + radio
• What is limited stage SCLC defined as?

  Without distant metastasis - T1-4, N0-3, M0
• What is the first line treatment for limited stage SCLC?

  4-6 cycles of Cisplatin combo chemo (+ concurrent or adjunct thoracic radiotherapy if good response to chemo)
• What is extensive stage SCLC defined as?

  With distant metastasis - T1-4, N0-3, M1
• What is the first line treatment for extensive stage SCLC?

  Platinum based combo therapy (+ concurrent or adjunct thoracic radiotherapy if good reponse to chemo)
• What is the treatment for a SCLC relapse?

  Further chemo

  Palliative radiotherapy
• What are some resp complications of lung cancer?

  Pneumonia and abscess formation

  Atelectasis

  Dyspnoea

  Pleural effusion
• What are some circulatory complications of lung cancer?

  PE

  Superior vena cava syndrome
• What are some factors that may affect lung cancer prognosis?

  Age

  Overall health

  Tumour size

  Molecular markers