Lung Cancer Overview and Symptoms
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Questions and Answers

What type of lung cancer is most commonly associated with smoking?

  • Non-small cell lung cancer (NSCLC) (correct)
  • Small cell lung cancer (SCLC)
  • Carcinoid tumor
  • Adenocarcinoma

    • Which type of non-small cell lung cancer is more commonly found peripherally?

  • Large cell carcinoma
  • Squamous cell carcinoma
  • Adenocarcinoma (correct)
  • Mixed cell carcinoma

    • Which symptom is NOT specific to lung cancer?

  • Shortness of breath
  • Haemoptysis
  • Chest pain
  • Fatigue (correct)

    • What is a characteristic that distinguishes small cell lung cancer from non-small cell lung cancer?

    <p>SCLC is often associated with paraneoplastic effects (B)</p> Signup and view all the answers

    In which scenario should a patient be referred for a suspected cancer pathway referral?

    <p>If they present with chest X-ray findings suggesting lung cancer (B)</p> Signup and view all the answers

    Which of the following is NOT a generalized cancer symptom?

    <p>Pancoast symptoms (B)</p> Signup and view all the answers

    What is the most common sign associated with lung cancer?

    <p>Palpable lymph nodes (D)</p> Signup and view all the answers

    What is required for the histological categorization of lung cancer grading?

    <p>Imaging to guide the biopsy (D)</p> Signup and view all the answers

    What does the N in TNM classification stand for?

    <p>Node spread (D)</p> Signup and view all the answers

    Which treatment is primarily used for localized tumors with limited spread?

    <p>Surgery (B)</p> Signup and view all the answers

    What is the purpose of radiotherapy with respect to tumor treatment?

    <p>It applies a high dose to the tumor while minimizing exposure to surrounding tissue. (D)</p> Signup and view all the answers

    Why might immunotherapy require specific testing such as PD-L1 evaluation?

    <p>To identify the presence of cancer cell defenses against immune attack. (B)</p> Signup and view all the answers

    What distinguishes a lower respiratory tract infection (LRTI) from an upper respiratory tract infection (URTI)?

    <p>LRTIs involve the alveoli and airways, while URTIs involve the nasal cavity and larynx. (B)</p> Signup and view all the answers

    What is the classification of pneumonia in terms of respiratory infection types?

    <p>Lower Respiratory Tract Infection (A)</p> Signup and view all the answers

    What is a common screening recommendation for individuals at high risk of lung cancer?

    <p>Low-dose CT scan of the lungs (D)</p> Signup and view all the answers

    What is a key feature of the grading process in tumor evaluation?

    <p>It relies on histological evaluation. (A)</p> Signup and view all the answers

    Flashcards

    TNM staging

    A system for classifying tumors based on size, location, and spread to lymph nodes and distant organs.

    Tumor Grading

    Describes the tumor's aggressiveness based on its microscopic appearance.

    Surgery for Cancer

    Surgical removal of a tumor, often considered for localized tumors with limited spread.

    Radiotherapy for Cancer

    Using high-energy radiation to kill cancer cells. Useful when surgery is not an option.

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    Chemotherapy for Cancer

    Drugs that target rapidly dividing cells, including cancer cells. Can control or cure certain cancers, but can also damage healthy cells.

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    Immunotherapy for Cancer

    Treatments that use the body's own immune system to fight cancer. More specific to tumor types.

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    URTI (Upper Respiratory Tract Infection)

    Infection of the upper respiratory tract, including the larynx, pharynx, tonsils, and nasal cavity. Usually less severe.

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    LRTI (Lower Respiratory Tract Infection)

    Infection of the lower respiratory tract, involving airways and alveoli. Often more severe.

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    Non-small cell lung cancer (NSCLC)

    The most frequent type of lung cancer, commonly linked to smoking. Further classified into subtypes like adenocarcinoma, squamous cell carcinoma, large cell, mixed, and carcinoid (rare).

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    Adenocarcinoma

    A type of NSCLC that tends to develop in the outer regions of the lung. It's the most common type of NSCLC.

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    Squamous cell carcinoma

    A type of NSCLC that's more likely to emerge in the airways of the lungs, often related to smoking.

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    Small cell lung cancer (SCLC)

    A less common type of lung cancer that is not normally treatable with surgery. It's often associated with paraneoplastic effects, causing unusual symptoms in other parts of the body.

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    Paraneoplastic effects

    Unusual symptoms that occur in other parts of the body due to substances released by the cancer. These are commonly seen with SCLC.

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    Haemoptysis

    A symptom of lung cancer that involves coughing up blood.

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    Lung cancer symptoms

    A group of specific signs that can indicate potential lung cancer. These may include coughing, shortness of breath, haemoptysis, non-resolving pneumonia, chest pain, a mass effect (affecting voice), and Pancoast symptoms (rare).

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    General cancer signs

    A group of general signs that suggest cancer, including fatigue, weight loss, pain, various symptoms, and hypocalcaemia.

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    Study Notes

    Lung Cancer

    • Non-small cell lung cancer (NSCLC): Most common, higher association with smoking. Subdivided into adenocarcinoma, squamous cell carcinoma, large cell, and mixed types. Adenocarcinoma is more common peripherally, while squamous cell carcinoma is more common in airways. Carcinoid tumors (rare) secrete chemicals causing various symptoms.
    • Small cell lung cancer (SCLC): Less common, not amenable to surgery. Often associated with paraneoplastic effects, meaning unusual symptoms in other parts of the body due to substances released into the bloodstream.

    Lung Cancer Symptoms (Specific)

    • Cough
    • Shortness of breath
    • Haemoptysis (coughing up blood)
    • Non-resolving pneumonia
    • Chest pain (direct invasion)
    • Mass effect (hoarse voice)
    • Pancoast symptoms (rare)

    Lung Cancer Symptoms (Generalised)

    • Fatigue
    • Unexplained weight loss
    • Pain/symptoms from metastases
    • Paraneoplastic phenomena
    • Hypocalcaemia

    Lung Cancer Signs

    • Palpable lymph nodes
    • Signs of SVC obstruction (swelling of face, neck, arms, upper body)
    • Monophonic wheeze
    • Signs of nerve damage (mass effect)
    • Effusion (unilateral), dull to percussion
    • General cancer signs (cachexia, emaciation)

    Lung Cancer Investigation

    • People referred with suspected lung cancer pathway referral within 2 weeks if they have chest X-ray findings suggestive of lung cancer or are over 40 and have unexplained haemoptysis.
    • Urgent chest X-rays are offered to people over 40 who exhibit two or more unexplained symptoms or a history of smoking with one or more symptoms (cough, fatigue, shortness of breath, chest pain, weight loss, appetite loss, recurrent chest infection, finger clubbing, thrombocytosis, supraclavicular or persistent cervical lymphadenopathy, chest signs consistent with lung cancer)

    Lung Cancer Evaluation

    • Grading: A histological categorization needing a biopsy, possibly needing imaging for guidance.
    • Staging: Anatomical categorization requiring imaging, considering tumor size, location, and presence/position of metastases, using the TNM classification. T1-4 (based on size/structures invaded), N0-3 (based on lymph node spread), M0-1 (based on metastases).

    Lung Cancer Treatment

    • Surgery: Suitable for localized tumors with limited spread
    • Radiotherapy: Used for tumors or regions unsuitable for surgery, with concentrated radiation beams over tumor site to lower surrounding tissue damage.
    • Chemotherapy: To control or sometimes cure certain cancers (toxic, affecting rapidly dividing cells, reduces a patient's immune system), immunotherapy (specific to tumor subtype, needs testing) blocks receptors to allow T-cell immune attack.

    Lung Cancer Screening

    • Individuals between 55-75 who smoke or have smoked will get an invite for a lung cancer assessment (low-dose CT scan if high risk).

    Respiratory Infections

    • URTI (Upper Respiratory Tract Infection): Larynx, pharynx, tonsils, nasal cavity (less likely severe)
    • LRTI (Lower Respiratory Tract Infection): Below larynx, airways, alveoli (more likely severe)
    • Pneumonia: Infection of lung parenchyma, inflamed alveoli walls filled with pus and fluid containing bacteria/blood cells. Can be lobar or bronchopneumonia. Community- or hospital-acquired (CAP/HAP); Antibiotics are used for treatment for bacterial pneumonia, potentially causing sepsis.
    • Epiglottitis: Inflammation of upper airway tissues (life-threatening, usually bacterial); characterized by pyrexia, painful swallowing, and drooling.
    • Bronchitis: Inflammation of bronchial mucosa, mainly viral (self-limiting); causing cough and sputum. May have URTI symptoms.
    • Bronchiolitis: Inflammation of small airways (<2mm), often infective (RSV) in children; causing wheezing, fever, and cough.
    • Mycobacterium TB: Slow-growing bacteria; requiring several antibiotics for months to work. It is hard to isolate and culture via sputum samples.

    Asthma

    • Obstructive ventilatory disorder, characterized by hyper-responsiveness of the bronchi leading to episodic spasm and inflammation.
    • Diagnosed based on FENO (fraction of exhaled nitric oxide) not imaging.
    • Symptoms: increased risk of contrast hypersensitivity, inflammatory mucosa, smooth muscle contraction, and airway mucous secretions, all lead to airway obstruction.
    • Triggers: Allergens, medications, environment (smoke), occupational, and complications (secondary infections like pneumothorax), loss of lung function if left untreated.
    • Treatment: Bronchodilators and corticosteroids (e.g., salbutamol), beta2 agonists, leukotriene receptor antagonists.

    COPD (Chronic Obstructive Pulmonary Disease)

    • Airflow limitation from chronic inflammatory response in airways, leading to lung tissue destruction.
    • Primarily linked with smoking.
    • Components: Chronic bronchitis (inflammation of bronchi) and emphysema (breakdown of alveolar walls; affects upper lobes more).

    Interstitial Lung Disease

    • Characterized by inflammation and scarring, making breathing difficult.
    • Scarring: called pulmonary fibrosis, affecting the interstitium/interlobular septum.
    • Stiffens and loses compliance of the lungs, causing restrictive ventilatory defect.
    • Causes: Autoimmune diseases, occupation lung disease, drugs, idiopathic (no known cause), post-infectious, or radiation.

    Pneumothorax

    • Air in the pleural space (between parietal and visceral pleura).
    • Can be spontaneous (not due to trauma) or secondary (from lung disease).
    • Symptoms: Difficulty breathing, chest pain.
    • Diagnosis via chest X-ray.
    • Treatment depends on size and underlying lung disease.

    Pleural Effusion

    • Excess fluid in the pleural cavity.
    • Exudate: Fluid leakage from blood vessels (e.g., cancer, infection, injury)
    • Transudate: Fluid passing through membranes (e.g., heart/liver/kidney failure).
    • Left pleural effusion: Progressive breathlessness as effusion progresses. Treatment depends on the cause: aspirating fluid, chest drain insertion.

    Pulmonary Embolism (PE)

    • Venous clot lodged in pulmonary vessels.
    • Deep vein thrombosis (DVT): Clots formed in deep veins.
    • Symptoms: Pleuritic chest pain, SOB, hypoxemia, hypotension, cardiac arrest.
    • Diagnosis often uses CXR to check for other cause before definitive PE blood tests like D-dimer.
    • Treatment: Anticoagulation, thrombolytic therapy.

    Other Lung Infections

    • Tracheitis: Inflammation of the trachea; more severe if bacterial (mostly affecting children).
    • Empyema: Pus in pleural fluid.
    • Lung Abscess: Localized collection of pus in the lung.

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    Description

    This quiz explores the key aspects of lung cancer, including its types such as non-small cell lung cancer and small cell lung cancer, along with their distinct symptoms. Participants will learn about specific and generalized symptoms associated with lung cancer, aiding in better understanding and awareness of the disease.

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