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Lung Cancer

Clinical Medicine

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
Created by: duanea00