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15 Cards in this Set

  • Front
  • Back
Risks for Lung Ca
Tobacco
Radon Gas (uranium miners)
Asbestos
Metals
Pulm. Fribrosis
COPD
Sarcoidosis
Types of Lung CA
Squamous Cell
Adenocarcinoma
Bronchoalveolar
Large Cell
Small Cell
Characteristic of Squamous Cell Lung Ca
25-35 %
arises from Bronchial epith
central location
spread locally
can cause hemoptysis
associated with hilar adenopathy
Characteristic of Adeno Ca of Lung
35-40%
Arise from mucus glands
located periphery
Characteristic of Large Cell Ca of Lung
5-10%
can be central or peripheral
rapid doubling time
aggressive clinically
Characteristic of Small Cell Ca of Lung
15-20%
Bronchiole origin
Central location
submucosal
early blood spread
aggressive
Paraneoplastic syndrome in Lung Ca
small cell- SIADH (15%)
squamous cell- hypercalcemia
increased ACTH
peripheral neuropathy
anemia
Eaton Lambert myasthenia synd
Investigations in Lung Ca
sputum cytology
thoracocenthesis (50-60% sens)
FNAC of lymph node (supraclavicular and cervical)
Bronchoscopy
Transthoracic needle bx (50-97% sens)
VATS
Staging of Non small cell lung Ca
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
Staging of small cell lung Ca
limited (30%)- unilateral hemithorax and supraclavicular lymph nodes
extensive (70%)- beyond hemithoracx and includes effusions
Limitation of PET Scan in lung ca
not good for things less than 1cm or bronchoalveolar
Low risk criteria for lung resection for lung Ca
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
Treatment of non small cell lung ca
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
Treatment of Small cell lung Ca
limited- thoracic radiation and chemo
whole brain radiation (does not affect survival)
extensive- chemo alone
Prognosis of Lung Ca
overrall 5yr is 15%