1 / 27

Lung Cancer Diagnosis and Management: A Comprehensive Guide

Explore the diagnostic process and treatment options for lung cancer, including common symptoms, types, and stages of the disease. Learn about the characteristics of cancer cells and the impact on patients.

nizana
Download Presentation

Lung Cancer Diagnosis and Management: A Comprehensive Guide

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. iBSc: Question 3 By Alan McLeod Tested by Natalie Hayes

  2. Getting the best marks Read the whole question – a latter section may give you a clue about an earlier one. To see how many points you need look at the marks allocated – for example a 3 point question is generally looking for 3 salient points If giving a list answer put the best answers first – examiners will not usually mark answers too far down a list Always write something – it may get you part of a mark and is anonymised so no one will think you are stupid! If you genuinely have no clue then re-write the question to see if this sparks some ideas. If not then move on and come back at the end. And remember – always write something. Good luck!

  3. Question 4 Mr Jackson, a 62 year old retired bricklayer has been experiencing haemoptysis for three weeks. Q4.1 • List 4 differentials for haemoptysis (4)

  4. Question 4 Mr Jackson has an 80 pack year smoking history. Q4.2 • What is a ‘pack year’ (2)

  5. Question 4 Cigarette smoke is a known carcinogen. Q4.3 • List two other carcinogens (1) Q4.4 • What are the three stages of carcinogenesis (3)

  6. Question 4 You suspect lung cancer. Q4.5 • What additional symptoms might you ask about to support your hypothesis (2) Q4.6 • What cancer specific tests might you order (3)

  7. Question 4 Tests reveal a squamous cell carcinoma of the lung with liver metastases. Q4.7 • Aside from SCC, list two other common types of lung cancer (2) Q4.8 • What changes occur in a cancer cell to allow metastasis? (5)

  8. Question 4 Tests reveal a squamous cell carcinoma of the lung with liver metastases. Q4.9 • Compare the characteristics of normal and neoplastic cells (4)

  9. Question 4 When you tell him the diagnosis, Mr Jackson becomes very angry - accusing you of negligence for not spotting this earlier. Q4.10 • Aside from anger, what are the stages of grief in the model proposed by Kubler-Ross (4)

  10. Question 4 You describe to Mr Jackson the probable prognosis and progression of the disease. Q4.11 • List one local and two systemic effects that cancers in general may produce (3)

  11. The Answers View these on ‘note view’ rather than on full screen – additional notes are provided for some slides

  12. Haemoptysis? Where’s that wine…

  13. Two Useful Concepts Body Mass Index (BMI) 20-25: Ideal 26-30: Overweight 31-35: Obese Pack Years > 20 = increased chance complications

  14. Carcinogens Cigarette smoke Chemicals • PAH • Aromatic amines • Nitrosamines UV Radiation Ionising radiation • Radiotherapy • Radon gas (lung) • Industry/military

  15. Carcinogens Viruses • EBV (Epstein-Barr) • HPV (Papilloma virus) • HBV (Hepatitis B virus) Stages in carcinogenesis • Initiation • Promotion • Progression

  16. Lung cancer • Male: Female 7:1 • Decreasing • Male peak in 60s • Female peak in 70s • Rare under 25 years Presenting complaints • 90% symptomatic • 40% Haemoptysis • 75% Anorexia • 75% Dyspnoea • 75% Cough • 75% Pain • Remember Weight Loss • 10% Incidental imaging

  17. Lung Cancer - Diagnosis • Imaging • Plain film • CT • MRI • Cytology • Sputum • Bronchoscopic washings Biopsy • Peripheral lesions • Percutaneous biopsy • Proximal lesions • Bronchoscopic biopsy • Pleural Effusions • Fine needle aspiration

  18. Lung Cancer Types • Small Cell (20-30%) • Non-small Cell • Large Cell (10-15%) • Adenocarcinoma (~20%) • Commonest non-smoking • Squamous cell carcinoma (40-60%) • Commonest smoking related Treatment • Small cell • Early metastasis • Chemotherapy and radiotherapy first line • Non-small cell • Surgery first line • Lobectomy • Pneumonectomy • Radio / chemo as req

  19. Invasion and Metastasis • Invasion is the spread into adjacent tissues – may occur along natural tissue planes such as along nerves • Metastasis is the spread of cells to distant parts of the body – there are several mechanisms for this

  20. To Metastasise • Changes occur in only some cells of the tumour • By random mutation • Binds to basement membr • Becomes motile • Becomes able to attach to extracellular matrix • Becomes able to degrade extracellular matrix • Must be able to survive and grow at site of implantation

  21. Fig 1 Routes of Metastasis • Vascular • Lymphatic • Coelomic

  22. Growth Characteristics

  23. Cytoplasmic Characteristics

  24. Histological Characteristics

  25. Local and systemic effects Local • Pressure • Invasion • Ulceration • Obstruction Systemic • Weight loss (cachexia) • Loss of appetite (anorexia) • Fever • Anaemia • General Malaise • Paraneoplastic

  26. The End The slides here should allow you to mark your own work – remember 1 mark per answer* up to the maximum for the question. Multiply by 3 to get percentage points. I assume a 60% pass mark. Sorry but I am unable to give further advice on answers due to time constraints.

More Related