Lung Cancer for Finals
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India skulptuur India skulptuuri iseloomustaavad dünaamilisus, mänglevus ning liigutuste ja žestide äärmine mitmekesisus; kehad on nii painduvad, nagu puuduks neil luud. Maistest vahekordadest ja proportsioonidest ei peeta kinni (need pole jumalate kujutamisel vajalikud). Niisamuti mitte anatoomiast, sest esinevad mitme pea ja paljude jäsemetaga inimesed. Samuti on liidetud inimesi ja loomi eriskummalisteks olenditeks. Teoste materjaliks on põhiliselt kivi, kuid kasutatakse ka vaske ja pronksi.
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Lung Cancer for Finals. Simple Success. Tim Robbins Academic FY1 UHCW. Ron Ailman : Symptoms. Cough Haempotysis Dyspnoea Chest Pain Recurrent pneumonia Anorexia/weight loss Hoarseness of voice. Patient photo/data from: http://www.macmillan.org.uk. Risk Factors. Cigarette Smoking - PowerPoint PPT Presentation
Transcript of Lung Cancer for Finals
Lung Cancer for Finals
Syp RF Signs Comp Inx Histology Rx Surg
Simple Success
Tim RobbinsAcademic FY1
UHCW
Syp RF Signs Comp Inx Histology Rx Surg
Ron Ailman: Symptoms
Patient photo/data from: http://www.macmillan.org.uk
• Cough• Haempotysis• Dyspnoea• Chest Pain• Recurrent pneumonia• Anorexia/weight loss• Hoarseness of voice
Risk Factors
• Cigarette Smoking• Industrial contaminants:
Asbestos/arsenic• Radon gas
• Genetic pre-disposition
Syp RF Signs Comp Inx Histology Rx Surg
Signs
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Pleural Effusion: Atelectasis:
Consolidation:
Chest Signs
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-Decreased chest wall movement-Stony dullness-Decreased breath sounds-Decreased vocal fremitus-Pleural Rub (above)-Mediastinal shift away
-Decreased chest wall movement- Dullness to percussion- Decreased breath sounds- Decreased vocal resonance- Mediastinal shift towards
- Crackles - Decreased chest wall movement- Dullness to percussion- Bronchial breathing / increased breath sounds- Increased vocal resonance
Com
plic
ation
s• Recurrent Laryngeal nerve palsy• Horner's Syndrome (Pancoast’s tumour)• Rib erosion
Local
• Brain, bone, liver, adrenalsMetastases
• SIADH• Excess ACTH secretion• Addisons Syndrome• Gynaecomastia
Endocrine
• Lambert Eaton Syndrome• Proximal MyopathyNeurological
• Pericarditis• SVC obstruction• Venous Thomboembolism
Cardiovascular
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Investigations
Diagnosis Stage Grade
Chest X-ray
CT
Radio-nucleotide uptake scan
SputumPleural fluid
LN aspirationBronchoscopy
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HistologySmall CellNon-Small Cell
AdenocarcinomaSquamous cell
Large-cell
50% 2 year survival if caught before
spread
Neurosecretory cells
3 month median survival if untreated
1/1.5 yrs with Rx
Staging: TNM
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TreatmentSmall CellNon-Small Cell
•Excision if no metastatic spread
•Curative radiotherapy if respiratory reserve poor
•Chemotherapy +/- radiotherapy in advanced disease (likely palliative)
•Almost inevitably disseminated
•Chemotherapy, but relapse
•Radiotherapy for symptomatic relief:
Bronchial ObstructionSVC obstruction
Haemoptysis
•SVC stenting / endobronchial therapy
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Surgery – the curve ball OSCELobectomy / pneumonectomy with LN excision
The similarities:Both have thoracotomy scars.Both have reduced chest expansion and reduced AE.
The differences:1. The signs of lobectomy are confined to lobe which is removed.
2. The signs of pneumonectomy are extensive i.e. involve the whole lung. The side involved would be flatten. It is similar to whole lung collapse.
3. Normally, the tracheal is central in lobectomy (except for upper lobe). The tracheal is almost always shifted in pneumonectomy.
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