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Grand Rounds / Articles

Management of Lung Cancer

This was a Telehealth Presentation offered in Saskatoon on April 7, 2009 by Dr. Shahid Ahmed, MD, FACP, FRCPC, Saskatoon Cancer Centre.

PRETEST: You may want to test yourself on the following five questions before watching the videos.

  1. Standard treatment for limited stage small cell lung cancer is:

    1. Surgery followed by adjuvant chemotherapy
    2. Radiation
    3. Chemo / Radiation
    4. Chemo / Radiation followed by surgery
    5. Chemotherapy alone
  2. The case mortality rate for lung cancer is:

    1. 25%
    2. 100%
    3. 50%
    4. 85%
    5. 10%
  3. A 59-year old woman with 25-pack history of smoking presented with cough and SOB. CXR showed a RUL mass. Biopsy showed adenocarcinoma. CT chest and abdomen showed 4 cm RUL mass with meidastinal lymphadenopathy. The most appropriate initial management would be:

    1. Proceed to surgery
    2. Mediastinoscopy
    3. Radiation therapy
    4. Colonoscopy to r/o a primary colorectal cancer
    5. Chemotherapy followed by radiation
  4. A 60-year old man presented with 6 weeks h/o cough, SOB, RUQ pain and 15 lb wt loss. CSR showed a large right hilar mass. CT showed SVC with extensive liver mets. Lab revealed impaired LFT. A FNA of lung mass confirm small cell cancer. The initial management:

    1. Observation
    2. Chemotherapy
    3. Emergent RT
    4. SVC Stenting
    5. Anticoagulation
  5. Which of the following statements is not true:

    1. Adjuvant chemotherapy in resectable lung cancer prolongs survival
    2. Chemotherapy compared with best supportive care prolongs survival in patients with advanced lung cancer
    3. Chemo / RT vs RT has been associated with a superior survival in patients with limited stage SCLC
    4. PCI prolongs survival in patients with SCLC who achieved a good response to treatment
    5. Adjuvant radiation therapy in resected non-small cell lung cancer has been associated with prolong survival

Click here for answers

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