Lung cancer

1. Big picture

Lung cancer is the most lethal thoracic malignancy and is strongly linked to smoking. In the exam, recognize the pattern:

Older smoker/ex-smoker + persistent cough or change in chronic cough + hemoptysis + weight loss + recurrent pneumonia or nonresolving infiltrate → think lung cancer until proven otherwise.

The clinical workflow is:

Suspicion
↓
Chest X-ray, but normal X-ray does NOT exclude cancer
↓
Contrast chest CT
↓
Obtain tissue diagnosis
↓
Stage with CT/PET-CT ± brain MRI
↓
Classify: NSCLC vs SCLC
↓
Treat according to stage, histology, molecular profile, and performance status

Modern lung cancer management depends not only on histology, but also on molecular biomarkers and PD-L1 expression, especially in advanced non-small cell lung cancer, NSCLC. ([PubMed][1])

---