Question | Answer |
Median age of lung cancer? | 71 |
Who has the highest incidence of lung cancer? | african american men |
Causes 85% of all lung cancer cases? | smoking |
Other etiology of lung cancer? | *IR SCARS*
(Idiopathic
Radiation
Silica
COPD
Asbestos
Radon
Secondhand smoke) |
Genetic etiology of lung cancer?
Activation of oncogenes? | k-ras |
Genetic etiology of lung cancer?
inactivated tumor supressor gene? | p21 |
Genetic etiology of lung cancer?
Growth factors? | EGFR (epidermal growth factor receptor)
VEGF (vascular endothelial growth factor)
ALK (anaplastic lymphoma kinase) |
List most aggressive to least aggressive? neuroendocrine spectrum | small cell carcinoma
atypical carcinoid
typical carcinoid |
Pathology: Extremely rapid growth, central location, almost exclusively associated with *smokers*? | small cell |
Pathology: Central location, exfoliates (outgrows blood supply), Aggressive | Squamous cell |
Pathology: Slow growing, peripheral location, "scar" tumor, most common type? | adenocarcinoma |
Common sites of distant metastases? | *CLABB*
(Contralateral lung
Liver
Adrenals
Bone
Brain) |
Lung Cancer diagnostic?
relatively low cost
readily available
insensitive
non-specific if no symptoms | CXR |
Lung Cancer Diagnostic?
More sensitive
Size, shape, invasion
Evaluate lymphadenopathy
High cost | CT |
Lung Cancer diagnostic?
Looks for distant metastases
radiolabeled glucose | PET/CT |
What are the types of ways to get tissue? | Sputum (maybe)
Bronchoscopy
Needle biopsy
surgery (lung biopsy) |
Staging NSCLC? | T (tumor size/invastion)
N (Lymph nodes)
M (matastasis) |
Staging? primary tumor can't be assessed but tumor cells detected in sputum or bronchial washing, no gross tumor detected | Tx |
Staging? No evidence of primary tumor | T0 |
Staging? Carcinoma in situ, treated with surgery, photodynamic therapy, cryosurgery, laser therapy | Tis |
NSCLC Treatment: no lymph node involvement, surgical removal, follow up with CT scans. What stage? | Stage I |
5 year survival (surgical) of stage I disease? | 43-64% |
NSCLC Treatment: Lymph nodes involved or larger tumor or multiple lung tumors. Surgery, radiation, & chemotherapy. What stage? | Stage II and III |
long term survival percantage of inoperable pts? | 5-25% |
SCLC confined to hemithorax, regional nodes? | limited |
SCLC all others? | extensive |
SCLC median survival: limited? | 16-24 months |
SCLC median survival: extensive? | 9-12 months |
SCLC treated with? | chemotherapy
XRT |