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