Lung Cancer
Lung cancer is a malignant tumour arising from the bronchial epithelium (bronchogenic carcinoma).
Treatment at a glance
- Early stage: surgery (lobectomy) or stereotactic radiotherapy
- EGFR-mutant non-small cell: osimertinib
- High PD-L1 and no driver mutation: pembrolizumab, with or without platinum chemotherapy
What our notes say
- Lung cancer is a malignant tumour arising from the bronchial epithelium (bronchogenic carcinoma). (Lung Cancer)
- f) Lung cancer can cause wheezing that is accompanied by a cough that may bring up bloody sputum (hemoptysis). (Examination of Respiratory system — Past Paper Questions & Answers)
- | Secondary spontaneous | Underlying lung disease: COPD (commonest), TB, PCP (HIV), cystic fibrosis, asthma, lung cancer, ILD, Marfan syndrome, catamenial (menstrual) | (Pneumothorax)
- Chest X-ray: hyperinflation, flattened diaphragms, bullae, enlarged hila; excludes lung cancer, pneumothorax, heart failure. (Chronic Obstructive Pulmonary Disease (COPD))
- Respiratory failure (type 2), cor pulmonale, polycythaemia, pneumothorax (bullae), recurrent infections, lung cancer, osteoporosis, depression, malnutrition and cachexia. (Chronic Obstructive Pulmonary Disease (COPD))
- Respiratory failure, pulmonary hypertension and cor pulmonale, acute exacerbation, lung cancer (IPF raises the risk), pneumothorax, infection (PCP on immunosuppression), weight loss. (Interstitial Lung Diseases)
Study material on Lung Cancer
- Lung Cancer
- Respiratory System Pathology 1A
- Examination of Respiratory system
- Endocrine & Renal Pathology — Must Know Notes
- Internal Medicine (MBIM 4100) main exam, Paper One: 3 July 2019
- Genetic Disorders Pathology Crash Course: Exam Revision Notes
- Occupational Lung Disease
- Respiratory system pathology mcqs
- Molecular Basis of Cancer: Cell Cycle, Apoptosis & Angiogenesis
- Epidemiology And Biostatistics
- Respiratory System Pathology 1A — Practice Questions
- Respiratory System Pathology 1A — Practice Questions
- Respiratory System Pathology 1A — Practice Questions
- MCQ: Respiratory System Pathology
- Respiratory System Pathology 1A — Practice Questions
- Respiratory System Pathology 1A — Practice Questions
Practice questions on Lung Cancer
Which of the following is the MOST likely cause of hypercalcemia in a patient with known advanced lung cancer?
- Overproduction of PTH by a parathyroid adenoma
- Overproduction of PTHrP by the tumor
- Direct bone lysis by metastatic disease
- Production of calcitriol by the tumor
Answer: B. Humoral hypercalcemia of malignancy, typically caused by PTHrP secretion, is the most common mechanism for hypercalcemia in cancer patients, particularly those with squamous cell carcinoma of the lung. PTH levels would be suppressed in this scenario. ---
The overall 5-year survival for all stages of lung cancer combined is approximately
- 5%
- 15-20%
- 50%
- 80%
Answer: B. Despite advances, the 5-year survival rate for lung cancer remains poor, averaging around 15-20%. ---
At the time of lung cancer diagnosis, what proportion already have distant metastases?
- 10%
- 25%
- Over 50%
- 90%
Answer: C. Because lung cancer is often asymptomatic until late, more than 50% of patients have distant metastases (Stage IV) at the time of presentation. ---
One of the following lung cancers has the best prognosis;
- Small cell carcinoma
- Adenocarcinoma
- Bronchioloalveolar carcinoma
- Squamous cell carcinoma
- Large cell carcinoma
Answer: C. Bronchioloalveolar carcinoma (now often classified as adenocarcinoma in situ or minimally invasive adenocarcinoma) generally has a better prognosis than other types, especially if localized.
Which lung cancer subtype is almost always metastatic at presentation and should NOT be treated surgically?
- Squamous cell carcinoma
- Large cell carcinoma
- Adenocarcinoma
- Small cell carcinoma
Answer: D. SCLC is almost always metastatic at presentation. It is treated with chemotherapy, not surgery. Despite initial sensitivity to chemotherapy, it invariably recurs with a median survival of 1 year. ---
A patient with small cell lung cancer develops hyponatremia with concentrated urine. The ectopic hormone responsible is
- PTHrP
- GnRH
- ADH
- ACTH
Answer: C. ADH secreted ectopically causes water retention and dilutional hyponatremia with inappropriately concentrated urine (SIADH). ---