Pathology: Neoplasticgrowth in the respiratory tract
Bronchialcarcinoma accounts for 95% of all primary cancers of the lung, with alveolar cellcarcinoma accounting for 2%.
Histologycan be split into non-small cell and small cell
Aetiology: Smokingis the largest causative factor. Other factors include occupational exposuresto substances such as asbestos
Symptoms: Cough,haemoptysis, chest pain, lethargy, weight loss, dyspnoea, hoarse voice (due toinvolvement of the recurrent laryngeal nerve)
Signs: Mayhave no signs, supraclavicular lymphadenopathy, unilateral pleural effusion
Investigations: Chest X-Ray: Lesion/mass, pleuraleffusion and/or signs of lobar collapse
CT Chest: Tumour, Node, Metastasis (TNM) Staging
Biopsy: Bronchoscopy if endobronchial lesion. CTguided biopsy.
Treatment: Limited, curable disease: surgicalresection, radical radiotherapy or combination
Non-curable disease (most common): systemic treatment withchemotherapy, localised treatment with radiotherapy for local diseasecontrol/symptomatic relief, palliative care input for symptom control andsupport
Complications: Invasion of local structures: e.g.nerves, bones, blood vessels, occlusion of bronchus
Metastatic spread: can metastasize to any site
Prognosis: Dependent of typeand stage of lung cancer but overall prognosis is poor
