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Lung Cancer


What is the leading cancer killer of women and men? Lung
Most aggressive type of lung cancer. Not surgically treated. Highest rate of mets. Usually systemic disease = Small cell lung ca (16% of lung cancers)
Most common type of lung cancer non-small cell (85%)
Most common types of non-small cell lung cancer Squamous cell (30-35%), adenocarcinoma (30-35%), large cell (3-5%)
Squamous cell lung cancer usually originates where in the lung? central
Adenocarcinoma lung cancer usually originates where in the lung? peripheral
What is the presentation of stage 1 lung cancer? Predominately asymptomatic (while more advanced is symptomatic)
What fraction of patients present to PCP with stage 3-4 lung cancer? 2/3
Most frequent symptoms associated with advanced lung cancer Cough, wt loss, dyspnea, chest pain, hemoptosis, bone pain, lymphadenopathy, hepatomegaly, clubbing, horseness, SVC syndrome
In which population is there an increasing incidence in lung cancer? Young, white, non-smoking females
What is the most common cause of death in lung cancer? distant metastases
Which stages of lung cancer are resectable? stages I-IIIa
Initial imaging modality for suspicion of lung cancer chest x-ray
A __ lesion on chest x-ray is considered malignant until proven otherwise non-calcified
RFs for lung cancer include: smoking, air pollution, ionizing radiation, asbestosis, heavy metals,industrial carcinogens
Most common etiologic factor in lung cancer: smoking (85% of cases overall M>F)
Imaging used to evaluate for mets: PET, brain CT, MRI
Imaging modality considered the standard of care in proper staging of lung tumors Bronchoscopy
Gold standard for lymph node evaluation with lung cancer = cervical mediastinoscopy
Lung cancer type more easily detected early: SCLC (in sputum) - bc it often originates in central bronchi
Tends to be glandular & mucus-producing; associated with pleural effusions = adenocarcinoma
In lung cancer, local mets may cause symptoms associated with what anatomic area? Mediastinal structures (phrenic nerve, SVC, recurrent laryngeal nerve)
Common distant mets sites in lung cancer: bone, brain, adrenals, kidney, liver
Lung cancer is often associated with paraneoplastic syndromes grouped as: endocrine, systemic, neuro, cutaneous, hematologic, renal
Lung ca workup CXR, CT, CBC, LFTs, lytes, Ca. Bronchoscopy; sputum cyto & pleural fluid; LN bx
5 year survival rate for SCLC & NSCLC = NSCLC = 15%. Limited-stage SCLC = 7%; extensive-stage dz = 1%
What % of mediastinal masses, originating in mediastinum, are benign? 75%
Most common anterior mediastinal mass = thymoma
Anterior mediastinal mass DDx Thymoma, lymphoma, thyroid/PT, teratoma (germ cell tumor)
Middle mediastinal mass DDx Hiatal hernia & mets cancer most common; also sarcoid, AAA, pericardial cyst (most common mediastinal cyst), bronchogenic cyst, LAD
Posterior mediastinal mass DDx Neurogenic tumor (20% of all primary mediastinal tumors)
50% of patients with thymoma initially present with: myasthenia gravis
Complications of lung cancer (SPHERE) SVC syndrome, Pancoast tumor, Horner syndrome, Endocrine (carcinoid), Recurrent laryngeal nerve (hoarseness), Effusions
Common endocrine syndrome/effect of SCLC Cushing/SIADH
Common endocrine syndrome/effect of SCC Hypercalcemia/PTH dz
Common endocrine syndrome/effect of large cell lung cancer Gynecomastia
Common endocrine syndrome/effect of adenocarcinoma thrombophlebitis
Created by: Abarnard