Lung Cancer
A malignant lung tumour can obstruct airways, invade local structures or spread distantly; the high-yield pathway is rapid recognition, tissue and molecular diagnosis, stage and fitness assessment, multidisciplinary treatment and early supportive care.
Definition
Lung cancer is a malignant tumour arising in the lung, broadly classified into non-small-cell and small-cell cancers. Its clinical behaviour and treatment depend on histology, stage, molecular biology, fitness and patient priorities.
First principles
Symptoms reflect the tumour's location and biology
A central tumour can obstruct a bronchus, causing persistent cough, localised wheeze, collapse or recurrent post-obstructive infection; erosion of a vessel can cause haemoptysis. Peripheral or apical disease may be silent until it invades pleura, chest wall, brachial plexus or sympathetic pathways. Weight loss and fatigue can occur from systemic tumour effects, while endocrine or neurological paraneoplastic syndromes may precede obvious metastatic disease.
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