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Lung Cancer

Dr Swapnil Pawar June 28, 2021 23


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    Lung Cancer
    Dr Swapnil Pawar

Lung Cancer Show Notes 

Shownotes – Dr Hyerim Suh

Differentials for a solitary pulmonary nodule on CXR

Common causes 

  • Lung cancer 
    • Consider CT chest, PET scan for staging and bronchoscopy or CT guided transthoracic biopsy  
  • Metastatic cancer 
    • Consider CT chest, PET scan for staging and bronchoscopy or CT guided transthoracic biopsy 
  • Hamartoma 
    • Consider CT chest 
  • Infectious 
    • Consider CT chest, fungal serologies and PPD 
  • Uncommon causes 
    • Carcinoid tumour, lymphoma, sarcoidosis, AV malformation, intrapulmonary nodule 

Treatment algorithm for small cell lung cancer 

  • Limited disease 
    • Chemotherapy 
    • Radiotherapy 
    • Prophylactic cranial irradiation 
    • Surgery for those with a NFR status 
  • Extensive disease 
    • Chemotherapy 
    • Prophylactic cranial irradiation 
    • Radiotherapy if they have had a good response to chemotherapy 

Treatment algorithm for non-small cell lung cancer 

  • Stage I & II 
    • If suitable, then for surgery and then adjuvant chemotherapy and radiotherapy 
    • If not suitable, then for radiotherapy and adjuvant chemotherapy 
  • Stage IIIA 
    • If suitable, then for neoadjuvant chemoradiotherapy then surgery and adjuvant chemoradiotherapy 
    • If not suitable for surgery, then chemoradiotherapy and monoclonal therapy 
  • Stage IIIB and IIIC 
    • If resectable, then neoadjuvant chemotherapy then surgery then adjuvant chemotherapy 
    • If not suitable for surgery, then chemoradiotherapy and monoclonal therapy 
  • Stage III or IV (extensive disease) 
    • Palliative treatment 

References: Non-small cell lung cancer, small cell lung cancer, BMJ 2021 

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