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15 Cards in this Set
- Front
- Back
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Risks for Lung Ca
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Tobacco
Radon Gas (uranium miners) Asbestos Metals Pulm. Fribrosis COPD Sarcoidosis |
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Types of Lung CA
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Squamous Cell
Adenocarcinoma Bronchoalveolar Large Cell Small Cell |
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Characteristic of Squamous Cell Lung Ca
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25-35 %
arises from Bronchial epith central location spread locally can cause hemoptysis associated with hilar adenopathy |
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Characteristic of Adeno Ca of Lung
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35-40%
Arise from mucus glands located periphery |
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Characteristic of Large Cell Ca of Lung
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5-10%
can be central or peripheral rapid doubling time aggressive clinically |
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Characteristic of Small Cell Ca of Lung
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15-20%
Bronchiole origin Central location submucosal early blood spread aggressive |
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Paraneoplastic syndrome in Lung Ca
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small cell- SIADH (15%)
squamous cell- hypercalcemia increased ACTH peripheral neuropathy anemia Eaton Lambert myasthenia synd |
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Investigations in Lung Ca
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sputum cytology
thoracocenthesis (50-60% sens) FNAC of lymph node (supraclavicular and cervical) Bronchoscopy Transthoracic needle bx (50-97% sens) VATS |
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Staging of Non small cell lung Ca
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TNM
IA & IB local disease IIA & IIB local disease with or without isolated hilar or peribronchial lymph nodes IIIA orally invasive with ipsilateral mediastinal or subcarinal IIIB contralateral mediastinal or hilar. ipsilateral scalene or supraclavicular T4 pleual effusion IV metastasis T1 less 3cm T2 more than 3cm |
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Staging of small cell lung Ca
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limited (30%)- unilateral hemithorax and supraclavicular lymph nodes
extensive (70%)- beyond hemithoracx and includes effusions |
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Limitation of PET Scan in lung ca
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not good for things less than 1cm or bronchoalveolar
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Low risk criteria for lung resection for lung Ca
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preop FEV1 more than 2lit- low risk
predicted post lung resection FEV1 more than 800lit or more than 40% of predicted FEV1 cardiopulm excercise test showing maximal oxygen uptake (MVO) of more than 15ml/kg/min high risk would be if less than 10ml/kg/min |
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Treatment of non small cell lung ca
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surgical resection Stage I/II(lobectomy or pneumonectomy with dissection of mediastinal lymph nodes)
neoadjuvant chemo before surgery or rt (mainly IIIa or IIIb) adjuvant chemo after surg or rt Stage IV- chemo alone |
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Treatment of Small cell lung Ca
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limited- thoracic radiation and chemo
whole brain radiation (does not affect survival) extensive- chemo alone |
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Prognosis of Lung Ca
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overrall 5yr is 15%
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