Lung Cancer Presentation PDF

Presented by Jonathan Lung Cancer Brack Name, Role Date: 6/12/24  Anatomy of lung cancer Epidemiology and Learning outcomes aetiology of breast cancer Lung cancer signs, symptoms and clinical im...

Presented by Jonathan Lung Cancer Brack Name, Role Date: 6/12/24  Anatomy of lung cancer Epidemiology and Learning outcomes aetiology of breast cancer Lung cancer signs, symptoms and clinical imaging Anatomy revision Aetiology Lung cancer may be caused by:  Smoking (active and passive)  Carcinogens in the workplace (asbestos)  Pollution  Poor nutrition  Viral Lung Cancer risk Factors Epidemiology Survival (over all) 1 year survival = approx 40%, 5Y = 16%, 10Y = 8% Lung cancer is responsible for 1.3 million deaths worldwide annually Overall prognosis is poor, mainly due to late diagnosis??? Median age of incidence of lung cancer = 70 yrs, median age of death by lung cancer = 71 yrs! (National Cancer Institute) Much of the recent research has improved quality of life considerably, but not survival yet. Could screening have an impact in future? Signs, symptoms and imaging In your groups discuss and make a list. Signs, symptoms a cough that doesn’t go away after 2 or 3 weeks a long-standing cough that gets worse chest infections that keep coming back coughing up blood (haemoptysis) an ache or pain when breathing or coughing persistent breathlessness persistent tiredness or lack of energy loss of appetite or unexplained weight loss Less common symptoms of lung cancer include: changes in the appearance of your fingers, such as becoming more curved or their ends becoming larger (this is known as finger clubbing) difficulty swallowing (dysphagia) or pain when swallowing wheezing a hoarse voice swelling of your face or neck persistent chest or shoulder pain How similar are the signs and symptoms of these non-malignant conditions? Emphysema Pneumonia Bronchitis Chronic Obstructive Pulmonary Disease (COPD) Asthma Tuberculosis TNM Staging  Group Task Prepare a presentation on the following, use this link to begin 1. Stage 1 Lung Cancer/limited and extensive small cell 2. Stage 2 lung cancer 3. Stage 3 Lung cancer 4. Stage 4 Lung Cancer 5. Locally advanced, spread and survival related to stage Cancer research uk staging TNM stage So how do we treat lung cancer? Treatment options Radiotherapy 1. Conventional EBRT 2. Stereotactic 3. Internal radiotherapy Surgery 1. Lobectomy 2. Pneumonectomy 3. Wedge resection or segmentwectomy Chemotherapy Surgery  Radiotherapy Radiotherapy is the only treatment modality for which there are indications in all stages of disease and across all categories of patient performance status Modelling shows that 77% of all patients with lung cancer have an evidence- based indication for radiotherapy at some point in their cancer journey At the population level, optimal use of radiotherapy could result in a 5-year local control gain of 8.3% and survival gain of 4%. (3) Radiotherapy with concurrent chemotherapy is the standard of care of the majority of patients with stage III NSCLC STARS and ROSEL trials have suggested that SABR may be an option in operable patients although further studies are required before this becomes standard of care Palliation Very important in both NSCLC and SCLC due to poor prognosis. Palliative radiotherapy Analgesia Oxygen therapy Invasive procedures for obstructive lesions (bronchoscopic laser therapy, brachytherapy, surgical stents) Psychosocial support Home care and hospice support Pancoast Tumour NSCLC arising at apex of lung. Sometimes presents early due to pain from pressure on brachial plexus, but often inoperable due to proximity to cervical and brachial nerves and vessels. Early presentation treated with pre- operative chemo-radiation, followed by complex surgery and brachial arterial graft. For late presentation, palliative radiotherapy is used. Mesothelioma Arises almost exclusively from asbestos exposure Arises in mesothelium (nearly always pleura as asbestos is inhaled, but rare cases in peritoneum or pericardium). Pleural effusion is often a presenting symptom. Poor prognosis. Chemotherapy, radiotherapy, surgery and pleurodesis may all be used with limited success. Chest drain sites are often treated with radiotherapy to prevent tracking of disease out to skin surface. Compensation claims for occupational asbestos exposure are numerous.  Superior Vena Cava Obstruction (SVCO) One of the few radiotherapy emergencies (as well as Stridor). Pressure on the Superior Vena Cava causes swelling and bloating of face, arms and chest. Dilation of blood vessels causes red face, and blue dilated vessels may be apparent on the skin surface. Breathing is severely impaired. Palliative radiotherapy in conjunction with steroids to reduce swelling. Stent may be considered if radiotherapy fails to bring rapid relief of symptoms  Anatomy of the breast revision Epidemiology and aetiology of breast cancer Breast cancer signs, symptoms and Learning clinical imaging outcomes Anatomy of lung cancer Epidemiology and aetiology of breast cancer Lung cancer signs, symptoms and clinical imaging 25 QUESTIONS