Bronchogenic Carcinoma (Lung Cancer)

 

a) Key differentiation is between small and non-small cell carcinoma, as this has ramificaitons for treatment and prognosis

 

b) Small cell carcinoma:

      - Exclusively in smokers

      - Staged as limited or extensive, and is often extensive at presentation

      - As a result, surgery typically not an option

      - Exquisitely chemo- and radiosensitive, but resistance typically develops

      - Given frequency of brain metastases, prophylactic cranial irradiation (PCI) improves survival

      - Associated with paraneoplastic syndroms (e.g. Lambert-Eaton, SIADH)

 

c) Non-small cell carcinoma

      - Adenocarcinoma

         - Most common histoligic type in women and non-smokers

         - Tend to occur in peripheral lung fields

      - Squamous cell

         - May necrose, resulting in cavitation

         - Risk of hemorrhage with bevacizumab (Avastin)

         - May produce PTHrP

      - Large cell

         - Poorly differentiated

         - Diagnosis of exclusion

 

 

(Christopher Woo MD, 8/27/10)