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Lung Cancer
Clinical Medicine
| 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 |
Created by:
duanea00
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