28. Lung Cancer - Bronchogenic Cancer - Cox

• Lung cancer

  • disrupt genetic reproduction and cellular function
• The most common cause of lung cancer?


  smoking
• Lung Cancer linked with inhaled carcinogens
• Smoking can cause DNA damage - mutation in p53
• Modifiable risk factor of smoking

  • alcohol
  • obesity
  • decrease physical activity
  • diet
• Rapid growth of tumor can lead to = mass effect

  • obstruction atelectasis
  • pneumonia
• Preexisting lung disease can increase risk of cancer

  • COPD
  • diffuse pulmonary fibrosis
• adenocarcinoma arise from bronchial mucosal glands
• Bronchoalveolar carcinoma arise from type II pneumocytes
• SCC manifest as proximal bronchus cavitary lesion
• SCLC will cause superior vena cava obstruction
• SCLC cause paraneoplastic syndrome

  • due to metastases of the diseases
• SCLC

  • arise in peribranchial location - centrally
  • tumor cells may exfoliate into sputum
• To biopsy lung cancer use?

  CT guided biosy
• SVCO - test with pemberton maneuver

  • elevate both arm > 1 minute
  • positive if
  • facial congestion
  • cyanosis
  • respiratory impairment due to decrease venous return