Lung Cancer
Definition
Types:
Adenocarcinoma (most common non-smoker; peripheral)
SCC (near bronchi)
Small cell (near bronchi) - 15%
Large cell
Epidemiology
Most common cause of ca death in men + women
Aetiology
Clinical Features
Sx:
Signs:
Investigations
Imaging: CT (local invasion), Bronchoscopy (up to 6th level airways - sub segmental), PET scan
Others: Biopsy (central lesion = bronchoscopy; non-central = percutaneous; none if unhealthy/ old - doesn't change manangement), pleural tap (30% chance TP)
Management
SCLC: chemo
NSCLC: chemo - extend survival for 1 month
Prognosis
Small cell if untreated - 6w
Small cell if treated - 18 mo
NSCLC if untreated - 12 mo
NSCLC if treated - 13mo
Source
Dr Greg Haug
Types:
Adenocarcinoma (most common non-smoker; peripheral)
SCC (near bronchi)
Small cell (near bronchi) - 15%
Large cell
Epidemiology
Most common cause of ca death in men + women
Aetiology
- Smoking (Most common)
- Asbestos
- Radon (watchmakers)
- Radiation
Clinical Features
Sx:
- Persistent cough (usually central lesions) - most common 75%
- Weight loss 40%
- Haemoptysis (usually central lesions) 25-50%
- Chest pain 20%
- Dyspnoea 20%
Signs:
- Clubbing/ HPOA (SCC/ adenocarcinoma)
- Paraneoplastic (hyperCA) (SCC --> PTHrP)
- Subpleura mass/ non smoking --> adenocarcinoma
- Paraneoplastic (SIADH/ Cushing's syndrome) = SCLC
Investigations
Imaging: CT (local invasion), Bronchoscopy (up to 6th level airways - sub segmental), PET scan
Others: Biopsy (central lesion = bronchoscopy; non-central = percutaneous; none if unhealthy/ old - doesn't change manangement), pleural tap (30% chance TP)
Management
SCLC: chemo
NSCLC: chemo - extend survival for 1 month
Prognosis
Small cell if untreated - 6w
Small cell if treated - 18 mo
NSCLC if untreated - 12 mo
NSCLC if treated - 13mo
Source
Dr Greg Haug