Lung Cancer

How do I know i have it?

100

Signs and symptoms 

SOB 

Hemopysis 

Obstruction of vital structures 

Wheezing 

Cough 

Chest pain 

200

FH

SH

Lung cancer 

Smoking / secondhand smoke, asbesto exposure, and occupations (painter and engineer) 

300

Labs 

BIOPSY 

PET/CT

Chest X-ray

400

What type are on the hisology report? 

Squamous 

Nonsqumous ( adenocarcinoma, large cell, and small cell) 

500

How bad is it? 

Stage 1, 2, 3 and 4 

What are my Options?

100

Surgery 

Stage 1 and stage 2 called a lobectomy ( piece of the lung removed 

200

Chemotherapy - and for how long 

Cisplatin based doublet for 6 cycles 

300

Cisplain doublet therapy small cell and SE

Etoposide; SE DO NOT USE IN hypertension and if they are on hypertension meds can cause hypotension

400

Cisplatin + Taxanes

Paclitaxel and Docetaxel 

SE: PN and uncontrolled DM

500

Cisplatin + ____ nonsquamous 

counseling 

Premetrexed: Nonsquamous and supplement B12 and folic acid 

TX

100

Cisplatain + ____ (last one) 

Cisplatin = Vinorelbine : N/V 

200

What can we substitute cisplatin for? and why? 

Carboplatin and poor renal function and performance status >2

300

Immunotherapy and when they are used? 

Durvalumab (stage 3)

Pembrolizumab ( you have to be PD - L1 > 1%) 

Nivolumab (failed at cisplatin doublet) 

400

Immunotherapy side effects 

Diarrhea

Rash

Hypothyroidism 

Endocrine 

Liver Toxicity 

Pituitary 

500

What are the Targets that we are targeting in lung cancer? 

EGFR, ALK, BRAF, amd ROS1

Target therapy

100

EGFR and first line along with SE? 

Afarinib 

Eriotinib 

Osimertinib ( 1st line ) SE: PLEURAL EFFUSION/ PNA, Nail Changes, and Skin toxicity 

200

When do someone get targeted therapy? 

Stage IV adenocarcinoma with mutation

300

ALK agents with SE's 

Crizotinib 

SE: vision, nail, bliumish skin 

Ceritinib (BID) 

Alectinib (FIRST LINE) 

400

BRAF

Davrafebnib 

500

ROS 1 

Criztonib

RANDOM

100

Difference between Chemo and Immunotherapy 

Chemo: 

stops DNA replication to disrupt cancer cell formation 

Immuno: 

teaches body to activate immunne systen to attack cancer cells 

200

If they dont have mutation or nonsquamous cells then what do they get first line? 

CHEMO

300

What are the goals of STAGE 1 and STAGE 2

stage 1 cure 

stage 2 pallative 

400

Explain small cell 

rare 

aggressive 

and more common in smoker 

500

How many treatments do lung cancer (name them) and then name breast cancer treatments for a BONUS

SAY OUTLOUD LOL