Histology Small Cell Non-Small Cell Adenocarcinoma Squamous 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 SypRFSignsCompInxHistologyRxSurg
Treatment Small Cell Non-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 Obstruction SVC obstruction Haemoptysis SVC stenting / endobronchial therapy SypRFSignsCompInxHistologyRxSurg
Surgery – the curve ball OSCE Lobectomy / 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. SypRFSignsCompInxHistologyRxSurg
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