Pulmonary Medicine

Lung Cancer Control and Epidemiology

Classical Epidemiology
  1. World wide distribution of lung cancer
  2. Carcinogens most associated with lung cancer
  3. Information regarding cancer in non smokers should be present but non- mechanistic
Tobacco Control and Primary Prevention
  1. Magnitude of the tobacco epidemic world wide
  2. Global efforts to curb use of tobacco products
  3. Possible impact of these efforts on mortality from lung cancer
Tobacco Cessation
  1. Overview about how lung cancer specialists should help their patients stop tobacco use
  2. Describe mechanisms about how persistent tobacco use affects cancer treatment
  3. Provide information about how to help patients stop tobacco use
Non-Smoking Related Lung Cancer
  1. Postulated mechanisms for non-smoking related lung cancer
  2. Magnitude of the problem world wide
  3. Variance with ethnicity and geography
Early Detection and Radiologic Screening
  1. Data with regard to modern radiologic techniques in screening for lung cancer
  2. Controversy surrounding those studies
  3. Risks and benefits of screening for lung cancer.
  4. Review of radiographic differential diagnosis of pulmonary nodules
Early Detection and Developing Preclinical Biomarkers
  1. Discuss the non radiographic technologies being studied for lung cancer diagnosis and potentially early detection
  2. Results of discovery and validation of these technologies
Chemoprevention of Lung Cancer: Present and Developing Technologies
  1. Studies and agents tested for the chemoprevention of lung cancer
  2. Results of these studies.
  3. New agents and their possible mechanisms for chemoprevention

 

Clinical and Radiologic Presentation of Lung Cancer

Clinical Presentation
  1. Symptoms and signs of non-small cell lung cancer
  2. Symptoms and signs of small cell lung cancer
  3. Describe paraneoplastic and other syndromes associated with NSCLC
  4. Clinical and molecular methods for the prognostication of lung cancer
Conventional Imaging Lung Cancer

LIBERAL USE OF FIGURES AND PHOTOS

  1. Utility of chest x-ray and computerized tomography in the diagnosis of lung cancer
  2. When to use specialized studies such as MRI
PET Imaging of Lung Cancer
  1. Role of FDG in diagnostic algorithm
  2. FDG pet in the prognostication of lung cancer
  3. FDG pet in the determination of response to therapy
  4. Novel tracers: FAZA, FLT

Diagnosis and Staging of Lung Cancer

Diagnostic Work-Up of Suspected Lung Cancer
  1. Outline of the diagnostic work-up of the patient with suspected lung cancer presenting with disease confined to the chest
  2. Role of endoscopic techniques in the diagnosis and staging of lung cancer including broncoscopy, EUS, EBUS, Superdimensions and data on accuracy of staging with these singly or in combination
  3. Role and accuracy of FNA and CORE biopsy in lung cancer
Surgical Staging of the Mediastinum including Mediastinoscopy and Thoracoscopy, Preoperative and Intraoperative
  1. Review the anatomy in the context of the new lymph node map
  2. Discuss the techniques for the invasive staging of the mediastinum
  3. Discuss the prognostic implications of lymph node dissection or sampling
IASLC Staging System
  1. Discuss the present staging system for NSCLC, SCLC carcinoid
  2. Discuss future plans for the staging system

 

Surgical Management of Lung Cancer

Preoperative Functional Evaluation of the Surgical Candidate
  1. Definition of the marginally resectable patient
  2. Evaluation of preoperative morbidity and mortality of resection
  3. Testing to answer #1 and #2
  4. Comment on preoperative measures to curtail morbidity and mortality including tobacco cessation, pulmonary rehab, etc
Results of Video Assisted Techniques for Resection of Lung Cancer
  1. Definitions of VATS surgery for lung cancer, specifically pulmonary resections and different varieties of VATS
  2. How does it compare to standard resection both acute and late
  3. What are the benefits and the limitations?
  4. Evidence-based/meta/summary analyses of VATS vs Non-VATS
Results of Robotic Techniques for Resection of Lung Cancer
  1. Definition and description of components of robotic surgery in lung cancer
  2. Contrast robotic lobectomy to other techniques of resection including lymph node resection
  3. Preliminary results to date

 

Radiotherapeutic Management of Lung Cancer

Technical Requirements for Lung Cancer Radiotherapy
  1. Treatment planning, treatment delivery
  2. Talk about stage I patients who are not candidates for SBRT
Patient Selection for Radiotherapy
  1. Patient-related factors (e.g. performance status, pulmonary function) and tumor-related factors (e.g. stage, tumor volume, SUV, molecular biomarkers
Radiotherapy for Locally Advanced Non-Small Cell Lung Cancer, including Combined Modality
  1. Radiotherapy dose fractionation and time for locally advanced disease
  2. Role type and timing of chemotherapy
  3. Combination with targeted agents.
  4. Role of surgery (pros and cons)
  5. Prophylactic cranial irradiation
  6. Outcomes
Palliative Radiotherapy for Lung Cancer: Locoregional and Metastatic
  1. Indications for palliative radiotherapy (thorax, brain, bone, other).
  2. Dose, fractionation. Role in combination with other treatments (surgery, chemotherapy).
  3. Outcomes - symptom control, quality of life
Acute and Late Toxicities of Thoracic Radiotherapy: Pulmonary, Esophagus, Heart
  1. Pulmonary and heart    
  2. Esophagus
  3. Quality of life

 

Chemotherapy and Targeted Agents for Lung Cancer

Front-Line Systemic Options in Non-Small Cell Lung Cancer
  1. Historical role of systemic therapy, evolution of systemic chemotherapy in NSCLC
  2. Oncogene addicted, therapeutic choices in lung adenocarcinoma
  3. Non-oncogene addicted, current therapeutic choices based on histology

 

Other Thoracic Malignancies

Mediastinal Tumors
  1. Tumors other than thymoma
  2. Surgical radiotherapy and chemotherapy management
Neuroendocrine Tumors of the Lung Other than SCLC
  1. Diagnosis
  2. Surgical management
  3. Chemotherapy and targeted agents
Thymic Cancer/Thymoma
  1. Treatment options according to the stage of the disease
  2. Role of systemic therapy and radiotherapy

 

Symptom Management and Complications

Lung Cancer Emergencies
  1. Massive pleural effusion
  2. Treatment of thoracic pain
  3. Other lung cancer-related emergencies
Role of Palliative Care in Lung Cancer
  1. Describe when palliative care should be used
  2. Describe studies documenting the benefits of palliative care
  3. Discuss the individual components of palliative care
  4. Discuss end of life issue

 

Clinical Trials

 Methodology of Clinical Trials in Lung Cancer
  1. Statistical measures for diagnostic accuracy measurement
  2. Endpoints and design considerations for chemoprevention trials
  3. Endpoints and design considerations for early stage, and advanced stage disease
How to Promote and Organize Clinical Research in Lung Cancer
  1. Provide future prospective about how to organize clinical trials
  2. Describe how to promote clinical research in lung cancer