Resp History
 

Lung Cancer History

 
 
Bookmark

Overview

    • Ask About

    • Diagnosis - presenting symptoms, type of lung cancer
    • Functional status
    • Risk factors - environmental exposures, chronic scarring
    • Family history of lung cancer
    • Management - surgery, chemotherapy, radiotherapy, targetted therapy
    • Complications - pleural effusion, metastases, local compression, paraneoplastic
    • Risk Factors for Lung Cancer

    • Genetic factors
    • Smoking (active or passive)
    • Air pollution
    • Occupational exposure - asbestosis, silicosis,
    • Chronic scarring - interstitial lung disease, tuberculosis, COPD
    • Alcohol

Diagnosis

    • Types of Lung Cancer

    • Non-Small Cell Lung Cancer - adenocarcinoma, squamous cell carcinoma, large cell carcinoma
    • Small Cell Lung Cancer
    • Potential Presentations

    • Disease-Related

    • Respiratory symptoms - cough, haemoptysis, dyspnoea, pleuritic chest pain
    • Constitutional symptoms - anorexia, weight loss, fatigue
    • Complication-Related

    • SVC obstruction - facial swelling, plethora, upper limb oedema, positive Pemberton’s sign
    • Pancoast tumour - Horner’s syndrome (partial ptosis, miosis, anhydrosis), wasting of the hand
    • Laryngeal nerve involvement - hoarse voice
    • Paraneoplastic - hypercalcaemia, neurologic symptoms, hypertrophic pulmonary osteoarthropathy, Cushing’s syndrome

Complications

    • Complications of Lung Cancer

    • Pleural effusion
    • Metastases - brain, liver, adrenal, bone
    • Local compression - SVC obstruction, sympathetic chain compression (Pancoast tumour) , laryngeal nerve palsy, phrenic nerve palsy, brachial plexopathy
    • Paraneoplastic syndromes - hypercalcaemia, SIADH, Cushing’s, hypertrophic pulmonary osteoarthropathy, neurologic syndromes

Management

    • Non-Small Cell Lung Cancer

      Depends on the stage and the patient's functional status.
    • Non-Metastatic

    • Surgical resection (lobectomy) with or without adjuvant chemotherapy
    • Chemoradiotherapy
    • Metastatic

    • Immunotherapy - pembrolizumab, nivolumab
    • Targetted therapy - EGFR inhibitors, ALK inhibitors
    • Surgical resection
    • Chemotherapy
    • Radiotherapy
    • Small Cell Lung Cancer

      Depends on whether the disease is limited or extensive.
    • Chemoradiotherapy with or without cranial irradiation to prevent brain metastasis
    • Chemotherapy
Last updated on May 1st, 2019
 
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Explore
   
 
 

Read More...

Ainslie G. Assessment of cough. Continuing Medical Education. 2009 Mar 19;27(2):68.
 Antoniou KM, Margaritopoulos GA, Tomassetti S, Bonella F, Costabel U, Poletti V. Interstitial lung disease. European Respiratory Review. 2014 Mar 1;23(131):40-54. Badran M, Ayas N, Laher I. Cardiovascular complications of sleep apnea: role of oxidative stress. Oxidative medicine and cellular longevity. 2014;2014. Beasley R, Semprini A, Mitchell EA. Risk factors for asthma: is prevention possible?. The Lancet. 2015 Sep 12;386(9998):1075-85. Braman SS, Davis SM. Wheezing in the elderly. Asthma and other causes. Clinics in geriatric medicine. 1986 May;2(2):269-83. Cano-Jiménez E, Hernández González F, Peloche G. Comorbidities and Complications in Idiopathic Pulmonary Fibrosis. Medical Sciences. 2018 Sep;6(3):71. Committee on Rating of Mental and Physical Impairment. The Respiratory System. JAMA. 1965 Nov; 194(8): 919-932. Cushman M. Epidemiology and risk factors for venous thrombosis. InSeminars in hematology 2007 Apr 1 (Vol. 44, No. 2, pp. 62-69). WB Saunders. del Giudice MM, Allegorico A, Parisi G, Galdo F, Alterio E, Coronella A, Campana G, Indolfi C, Valenti N, Di Prisco S, Caggiano S. Risk factors for asthma. InItalian journal of pediatrics 2014 Dec (Vol. 40, No. 1, p. A77). BioMed Central. Feierabend R. Hoarseness in adults. Am Fam Physician. 2009;80:363. Gordon BR. Asthma History and Presentation. Otolaryngeal Clin N Am. 2008; 41: 375-385. Harding SM. Complications and consequences of obstructive sleep apnea. Current opinion in pulmonary medicine. 2000 Nov 1;6(6):485-9. Heit JA, Silverstein MD, Mohr DN, Petterson TM, O'fallon WM, Melton LJ. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Archives of internal medicine. 2000 Mar 27;160(6):809-15. Ho WK. Deep vein thrombosis: risks and diagnosis. Australian family physician. 2010 Jul;39(7):468. Holzinger F, Beck S, Dini L, Stöter C, Heintze C. The diagnosis and treatment of acute cough in adults. Deutsches Ärzteblatt international. 2014;111:356. Irwin RS, Baumann MH, Bolser DC, et al. Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest. 2006;129:1S-23S. Kilgore D, Najm W. Common Respiratory Diseases. Prim Care Clin Office Pract. 2010; 37: 297-324. Krieger BP. When wheezing may not mean asthma: other common and uncommon causes to consider. Postgraduate medicine. 2002 Aug 1;112(2):101-11. Mannino DM, Buist AS. Global burden of COPD: risk factors, prevalence, and future trends. The Lancet. 2007 Sep 1;370(9589):765-73. Mathews KP. Respiratory Atopic Disease. JAMA. 1982 Nov; 248(20): 2587-2610. Molina JR, Yang P, Cassivi SD, Schild SE, Adjei AA. Non-small cell lung cancer: epidemiology, risk factors, treatment, and survivorship. InMayo Clinic Proceedings 2008 May 1 (Vol. 83, No. 5, pp. 584-594). Elsevier. O'Donnell AE. Bronchiectasis. Chest. 2008 Oct 1;134(4):815-23. Osann KE. Lung Cancer in Women: The Importance of Smoking, Family History of Cancer, and Medical History of Respiratory Disease. Cancer Research. 1991 Sep; 51: 4893-4897. Papiris S, Kotanidou A, Malagari K, Roussos C. Clinical review: severe asthma. Critical Care. 2001 Feb;6(1):30. Prakash UBS. Uncommon Causes of Cough. Chest. 2006;129:206S. Pratter MR. Overview of common causes of chronic cough: ACCP evidence-based clinical practice guidelines. CHEST Journal. 2006 Jan 1;129(1_suppl):59S-62S. Samama MM. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Archives of internal medicine. 2000 Dec 11;160(22):3415-20. Sethi GR, Batra V. Bronchiectasis: causes and management. The Indian Journal of Pediatrics. 2000 Feb 1;67(2):133-9. Travis, W.D., Costabel, U., Hansell, D.M., King Jr, T.E., Lynch, D.A., Nicholson, A.G., Ryerson, C.J., Ryu, J.H., Selman, M., Wells, A.U. and Behr, J., 2013. An official American Thoracic Society/European Respiratory Society statement: update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. American journal of respiratory and critical care medicine, 188(6), pp.733-748. Troy L, Corte T. Interstitial lung disease in 2015: where are we now?. Australian family physician. 2015 Aug;44(8):546. Young T, Skatrud J, Peppard PE. Risk factors for obstructive sleep apnea in adults. Jama. 2004 Apr 28;291(16):2013-6.
Feedback