Overview Lung cancer is the leading cause of cancer deaths in men and women. Lung cancer can be divided into small cell and non-small cell carcinoma. Small cell lung carcinoma presents late stage and has poorer prognosis. A solitary pulmonary nodule measuring 8 mm or less can be followed radiographically. For larger lesions, a biopsy, whether bronchoscopic, percutaneous, or surgical, should be considered. Steps in management of a patient with suspected lung cancer include tissue diagnosis, staging, preoperative evaluation, and treatment with surgery, radiotherapy, or chemotherapy.
Defintion Massive haemoptysis: More than 500 mL of blood loss that is coughed up within a 24-hour period Horner Syndrome: Symptoms are ptosis, loss of pupillary dilation (miosis), and loss of sweating on the ipsilateral side (anhidrosis) caused by compression of the superior cervical ganglion and resultant loss of sympathetic innervation. Superior Vena Cava syndrome: Obstruction of venous drainage, usually by external compression of the SVC, leading to edema of the face, neck, and upper part of the torso often with formation of collateral veins on the upper chest. |
Think Most patients with hemoptysis require evaluation with bronchoscopy. Massive hemoptysis may result in death by asphyxiation. |
General
Investigations for staging
Small cell lung carcinoma (SCLC - 20%)
Non-small cell lung carcinoma ( NSCLC - 80%)
Remember Staging of SCLC is limited or extensive. NSCLC uses the TNM classification for staging |
Lung cancer characteristics | ||||
SCLC | Adenocarcinoma | Squamous cell | Large cell | |
Location | Central | Peripheral | Central | Peripheral |
Cavitation | Never | Most likely | ||
Metastases | Early | Early | Late | Late |
Neoplastic Syndrome and Extrapulmonary manifestation | ADH, ACTH | Thrombophlebitis | PTH | Superior vena cava syndromes + hoarseness |
Once a patient presents with symptoms or radiographic findings suggestive of lung cancer, the next steps are as follows:
Video: Lung Cancer Management and Staging |
Complication
NSCLC
SCLC
Prognosis
More info on Paraneoplastic Syndrome
Video: Lung Cancer Overview |