CPD: Lung Cancer
If you die 5 years and 1 day after a cancer diagnosis, what are you?
Answer: a cancer survivor.
What two medical conditions require immediate intervention on the part of the general practitioner?
meningitis and pneumonia
"Cancer is a process, not a tumor". --Dr Thom
Overall cancer odds: 1/3 of US women and 1/2 of US men will have cancer, odds are increasing, in 75 years everybody will have cancer.
Why do people smoke?
to palliate a mental/emotional issue
What kind of cancer needs immediate treatment because of the very poor prognosis?
pancreatic
What other cancers have very low survival rates?
Ovarian and colon
How long do average breast cancer survivors live?
about 10-12 years after the diagnosis, die of cancer
How does one get the cancer miasm?
by being born to a mother who has cancer while she is pregnant with you
What increases in the first two years after quitting smoking?
the risk of lung cancer--specifically for those who do not quit because they want to
What are the three simultaneous components of cancer process?
--depressed immune system
--depression of at least one of the four emunctories, esp the liver, also lung, kidneys, skin
--emotional component including strong denial
When a person has an obvious mental-emotional problem, what does Dr Thom recommend?
a chest xray
What makes dying easier?
have a purpose for being
If you see a solid lesion on an xray, what % of the time is it cancer?
15-50% is CA esp if pt is over 50
10% benign
10% TB granuloma
10% histoplasmosis
5% coccidiomycosis
5% cysts
in pt under 30 has 1% chance of being cancer
Where are metastasies often found?
breast, stomach, pancreas, colon, thyroid, prostate, kidney, thyroid, cervix, rectum, testis, bone
Adenocarcinoma = 35-40% of all lung cancers, bronchoalveolar is a subtype (solitary peripheral nodule, mutlfocal dz, rapidly progressing pneumonic form), usu peripheral, clubbing, hypertrophic pulmonary osteoarthorpathy, Trousseau syndrome of hypercoagulability, weigh loss when advanced, cough & dyspnea, also pleural effusoin and severe pain dt infiltration of pleura and chest wall
Squamous cell carcinoma = 25-30%, usu central, cough, dyspnea, atelectasis, post-obstructive pneumo, wheezing, hemotpysis, HYPERCALCEMIA dt parathyroid-like hormone production
Large cell carcinoma = 10-15%, usu peripheral, cough & dyspnea, also pleural effusoin and severe pain dt infiltration of pleura and chest wall
How do lung cancer pts usually present?
with a swollen lymph node (early)
with a cough/hemoptysis (late)
How is cancer often found?
accidentally on an xray
superior sulcus tumors = can compress brachial plexus
PE findings: wheeze over tumor, enlargement of axillary and surpaclaviular nodes, enlarged liver, dullness to percussion with large tumor, change in breath sounds.
DX: xray shows opaque mass, CT, TNAB (transthoracic needle aspiration biopsy of lung nodule), cytology of sputum for toxi cells, high serum calcium (w/ metastasis esp), bronchoscopy and biopsy
Course: less than 10% survive 5 yeasr, if untreated survive 9 months
Answer: a cancer survivor.
What two medical conditions require immediate intervention on the part of the general practitioner?
meningitis and pneumonia
"Cancer is a process, not a tumor". --Dr Thom
Overall cancer odds: 1/3 of US women and 1/2 of US men will have cancer, odds are increasing, in 75 years everybody will have cancer.
Why do people smoke?
to palliate a mental/emotional issue
What kind of cancer needs immediate treatment because of the very poor prognosis?
pancreatic
What other cancers have very low survival rates?
Ovarian and colon
How long do average breast cancer survivors live?
about 10-12 years after the diagnosis, die of cancer
How does one get the cancer miasm?
by being born to a mother who has cancer while she is pregnant with you
What increases in the first two years after quitting smoking?
the risk of lung cancer--specifically for those who do not quit because they want to
What are the three simultaneous components of cancer process?
--depressed immune system
--depression of at least one of the four emunctories, esp the liver, also lung, kidneys, skin
--emotional component including strong denial
When a person has an obvious mental-emotional problem, what does Dr Thom recommend?
a chest xray
What makes dying easier?
have a purpose for being
If you see a solid lesion on an xray, what % of the time is it cancer?
15-50% is CA esp if pt is over 50
10% benign
10% TB granuloma
10% histoplasmosis
5% coccidiomycosis
5% cysts
in pt under 30 has 1% chance of being cancer
Where are metastasies often found?
breast, stomach, pancreas, colon, thyroid, prostate, kidney, thyroid, cervix, rectum, testis, bone
Adenocarcinoma = 35-40% of all lung cancers, bronchoalveolar is a subtype (solitary peripheral nodule, mutlfocal dz, rapidly progressing pneumonic form), usu peripheral, clubbing, hypertrophic pulmonary osteoarthorpathy, Trousseau syndrome of hypercoagulability, weigh loss when advanced, cough & dyspnea, also pleural effusoin and severe pain dt infiltration of pleura and chest wall
Squamous cell carcinoma = 25-30%, usu central, cough, dyspnea, atelectasis, post-obstructive pneumo, wheezing, hemotpysis, HYPERCALCEMIA dt parathyroid-like hormone production
Large cell carcinoma = 10-15%, usu peripheral, cough & dyspnea, also pleural effusoin and severe pain dt infiltration of pleura and chest wall
How do lung cancer pts usually present?
with a swollen lymph node (early)
with a cough/hemoptysis (late)
How is cancer often found?
accidentally on an xray
superior sulcus tumors = can compress brachial plexus
PE findings: wheeze over tumor, enlargement of axillary and surpaclaviular nodes, enlarged liver, dullness to percussion with large tumor, change in breath sounds.
DX: xray shows opaque mass, CT, TNAB (transthoracic needle aspiration biopsy of lung nodule), cytology of sputum for toxi cells, high serum calcium (w/ metastasis esp), bronchoscopy and biopsy
Course: less than 10% survive 5 yeasr, if untreated survive 9 months