Chapter 90. Lung Cancer
All of the following scenarios are consistent with a recommendation to be screened with a low-dose CT scan for lung cancer (according to the recent guidelines)?
A. A 45-year-old man who has smoked a pack a day since the age of 13 years
B. A 65-year-old woman with a 40 pack–year smoking history, who quit smoking 10 years ago
C. A 50-year-old coal miner whose father and brother died of lung cancer in their 60s
D. All of the above fit the screening criteria
Option A: Incorrect. This patient is too young to meet the screening criteria.
Option B: Correct. This patient meets the inclusion criteria for the lung cancer screening trial and the subsequent recommendations.
Option C: Incorrect. This person does not meet the smoking risk requirements for the screening criteria.
Option D: Incorrect. Since answer options A and C are wrong, this option is incorrect.
Treatment options for a patient with stage IV adenocarcinoma and an ECOG PS score of 3 may include all of the following EXCEPT:
A. Palliative radiotherapy
B. Surgical resection of a distant metastasis causing symptoms
C. Platinum-containing doublet chemotherapy
D. Single agent targeted agent
E. Treatment of comorbidities to improve performance
Option A: Incorrect. Palliative radiation to help with symptoms like pain is appropriate.
Option B: Incorrect. Surgery to relieve symptoms due to a metastatic lesion is appropriate.
Option C: Correct. A platinum doublet should not be given to a lung cancer patient with an ECOG performance status of 3 due to little/no benefit, but almost certain toxicity.
Option D: Incorrect. A targeted agent with a high response rate and less toxicity than cytotoxic therapy could appropriately be used.
A newly diagnosed well-performing stage IV adenocarcinoma NSCLC patient with a mutation in exon 19 of the EGFR gene should be treated with:
Option A: Incorrect. Cetuximab is not used to treat ...