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 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

More than 60% of all patients with cancer are currently older than 65 years. Correspondingly, the peak of lung cancer incidence is reached in the age group between 75 and 80 years. As a consequence to this ageing patient population, three factors become of major importance for the chemotherapeutic management of lung cancer, namely functional status, age-specific phenomenon and the presence of comorbidities. While the functional status is dependent on physiological changes in organ function, ageing-specific phenomena include depression, alterations of mental status, reduced nutritional status and missing social support. Comorbidities frequently have a risk profile comparable to that of lung cancer. Clinical studies with a special focus on elderly patients are still rare. In small-cell lung cancer retrospective analyses have demonstrated that age alone is not a major prognostic factor compared to performance status, tumor stage or gender. Nevertheless elderly patients with lung cancer are still frequently excluded from clinical trials, and receive less optimal or even no chemotherapeutic treatment at all. Studies evaluating less aggressive treatment figured out that single agent therapy with etoposide is inferior compared to combination chemotherapy in patients with small cell lung cancer (SCLC). In elderly patients with non-small cell lung cancer (NSCLC), single agent treatment with vinorelbine plus 'Best Supportive Care' was significantly superior to 'Best Supportive Care (BSC)' alone; with respect to survival and symptom palliation.
Lung Cancer 2001 Sep
PMID:Influence of age and comorbidities on the chemotherapeutic management of lung cancer. 1157 16

There are more women than men at any elderly age group. Depression and osteoporosis are the commonest problems in elderly subjects. Some problems specific to males are hypogonadism, erectile dysfunction and enlargement of prostrate and to females are post-menopausal disturbances, urinary incontinence and breast and lung cancer. However, problems of special concern in both male and female elderly are malnutrition, falls and cognitive dysfunction. Men and women in general suffer from the same sorts of health problems but the frequency of these problems as well as the speed of the onset of death distinguishes them. Infact cultural and social forces act to separate the sexes in their personal health ethos and their sick propensity. The impact of old age on women is different from that of men because of differences in their status and role in society. This is specially so because proportion of widows in 60+ age group is considerably higher than that of widowers. Sexuality is often overlooked as a health status particularly in elderly women. Clinicians should recognise the importance of sexual functions to the overall health of older persons particularly women. Religious participation and involvement are associated with positive mental and physical health. Family life is the key to the health of elders specially older men. Lack of social support increases the risk of mortality and supportive relationships are associated with lower illness rates, faster recovery rates and higher levels of health care behavior.
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PMID:Gender, aging, health and society. 1184 8

This study aimed to investigate factors correlated with dyspnea in cancer patients among a broad range of medico-psycho-social factors. A total of 171 consecutive outpatients with advanced lung cancer were recruited. Dyspnea was evaluated by using the Cancer Dyspnea Scale, a valid, reliable 12-item self-rating scale developed to assess the multidimensional nature of dyspnea in cancer patients. Possible correlates, including 1) medical (clinical stage, Performance Status, SpO(2), organic causes of dyspnea, other symptoms, such as cough and pain, etc.), 2) psychological (anxiety and depression), and 3) social (education, marital status, existence of confidants, etc.), factors were collected from medical charts, interviews, and self-rating questionnaires. Multiple regression analysis revealed that psychological distress, presence of organic causes, cough, and pain were significantly correlated with dyspnea (P < 0.05, multiple R(2) = 0.303). The present study confirms that dyspnea is multifactorial and that a beneficial therapeutic strategy might include intervention for psychological distress and pain.
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PMID:Factors correlated with dyspnea in advanced lung cancer patients: organic causes and what else? 1206 73

The purposes of this study were 2-fold: to evaluate the impact of the schedule dependency of etoposide (3-day IV short course vs. a 21-day oral prolonged course) with cisplatin on the quality of life of small-cell lung cancer (SCLC) patients; and to examine the effect of baseline quality of life variables on long-term survival, after adjustment for known demographic and clinical prognostic factors. Participants were 70 patients enrolled in the cancer and leukemia group B (CALGB) protocol 9033. Quality of life was assessed at baseline, 6 and 12 weeks by: the EORTC QLQ-30, the Centers for epidemiology studies--Depression short form, the medical outcomes study (MOS) social support questionnaire, and a scale of sleep quality. Contrary to expectations, study results suggested no significant differences in the patients' life quality and treatment response based on whether they received etoposide in a 3-day IV vs. a 21-day oral regimen. The use of the baseline variables in predicting overall survival indicated that patients who were non-white and with liver involvement had decreased survival. Brain involvement, being male, and higher depressive symptoms were also found to be borderline significant in predicting decreased survival in this patient population.
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PMID:The health-related quality of life and survival of small-cell lung cancer patients: results of a companion study to CALGB 9033. 1207 61

Elevated magnetic field exposures are associated with increased childhood leukaemia risk. A link with breast and other cancers has been postulated via modified melatonin activity. Other illnesses have been linked to electricity distribution, by association or mechanistic considerations. For selected illnesses, this paper estimates the annual number of excess cases that might occur near high-voltage powerlines in the UK. Within 150m of powerlines, magnetic field exposures above 0.1 microT are postulated to result in 9000 excess cases of depression in adults and 60 cases of suicide. Electric field effects can mediate increased exposure to air pollution. Within 400m of powerlines, this may result annually in 200-400 excess cases of lung cancer, 2000-3000 cases of other illnesses associated with air population and 2-6 cases of childhood leukaemia. Seventeen cases of non-melanoma skin cancer might occur by exposure directly under powerlines.
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PMID:Does our electricity distribution system pose a serious risk to public health? 1216 Jun 79

A cancer diagnosis frequently activates a range of coping responses in patients and their spouses and may affect their emotional well-being. The authors hypothesized a curvilinear relationship between religious coping and depression in 156 spouses of lung cancer patients. Hierarchical regression analyses were conducted with blocks of variables entered as follows: demographic characteristics; cancer stage; perceived control, self-efficacy, and social support; religious coping (linear); and religious coping squared (quadratic). There was a significant association between religious coping squared and depression. Spouses who used moderate levels of religious coping were rated as less depressed than those who used lower or higher levels.
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PMID:Religious coping and depression among spouses of people with lung cancer. 1244 28

This paper reviews methods for assessing familial aggregation of disease based on simple logistic regression models. Studies are based on a case-control sampling design, where the disease status of the first degree relatives of both cases and controls are obtained. Both 'proband predictive' and 'family predictive' models are discussed, and an example is given using a case-control sample from a lung cancer study in non-smokers. The methods are extended to characterize co-aggregation of two disorders, that is, presence of one disorder in the proband increases the risk of a second disorder in the relative. An example involving eating disorders and depression is given.
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PMID:Regression methods for assessing familial aggregation of disease. 1270 8

Little is known about the experience of surviving lung cancer because of its low survival rate. However, 14% of the people with a diagnosis of lung cancer become long-term survivors. This study describes the experience of surviving lung cancer as told by a subsample of survivors from a larger quantitative investigation of the quality of life among long-term survivors of lung cancer. The Center for Epidemiologic Survey Depression (CES-D) scale was used to evaluate distressed mood. The Short-Form 36 was used to evaluate quality of life. Handheld spirometry was used to evaluate pulmonary function abnormalities. Interviews were conducted with 29 participants. Qualitative analysis showed that survivors express positive and negative aspects differentially when divided into those with distressed mood (CES-D > or = 16; n = 9) and those not distressed (CES-D < 16; n = 20). Those in the not distressed group talked of their experience in more positive terms around the five central themes than those in the distressed mood group. The central themes that emerged were existential issues, health and self-care, physical ability, adjustment, and support. Subscale scores from the SF-36 were used to enhance the experience description. The results of this study highlight the importance of attending to both the physical and emotional needs of lung cancer survivors.
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PMID:The aftermath of lung cancer: balancing the good and bad. 1283 57

Using a stress process model, risk factors (caregiving stressors, caregiver health, and negative social interactions) and protective factors (caregiving appraisals and social resources) were examined as predictors of family caregiver well-being (depression and life satisfaction). Eighty spousal caregivers of hospice patients with dementia or lung cancer completed structured interviews and self-report measures assessing components of the stress process model. Results suggest that objective measures of patient impairment or amount of care provided are not strong predictors of caregiver depression or life satisfaction. Female gender, caregiver health problems, and negative social interactions were risk factors for poorer caregiver well-being. Caregivers who subjectively appraised caregiving tasks as less stressful, who found meaning and subjective benefits from caregiving, and with more social resources had lower depression and higher life satisfaction, even after controlling for patient impairment and caregiver appraisal variables. Regression models accounted for 42% of variance in caregiver depression and 52% of variance in caregiver life satisfaction. Counseling for hospice family caregivers could utilize the stress process framework, and pay particular attention to finding meaning or subjective benefits from caregiving, and remaining active in social roles. Further research providing evidence on caregiver risk and protective factors could improve the conceptual and empirical basis for psychosocial interventions for hospice family caregivers.
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PMID:Predictors of depression and life satisfaction among spousal caregivers in hospice: application of a stress process model. 1285 38

Epidemiological research has consistently shown that physical activity decreases the risk of coronary heart disease, hypertension and stroke. The finding that a low level of physical activity is a major determinant of the growing epidemics of obesity is also firm and consistent. The direct association existing between a sedentary lifestyle and the incidence of diabetes mellitus is solid and of great importance for public health. Additional benefits from a a physically active lifestyle are a reduction in the incidence and prevalence of osteoporosis, lower risk of falls and fractures in the elderly, and a lower risk of anxiety and depression. Although evidence is less consistent, low levels of physical activity have been related to a higher risk of colon, breast and lung cancer. Some preliminary evidence relates physical activity with a lower risk of dementia. During the last three decades a huge amount of epidemiological research has led to uniform conclusions about the benefits of a physically active lifestyle. In spite of this fact, the prevalence of sedentary lifestyles is rising. Therefore, health promotion interventions are urgently needed to reach the objective of engaging in regular and moderate physical activity for at least 30 minutes per day in most, preferably all, days of the week.
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PMID:[Benefits of physical activity and harms of inactivity]. 1464 30


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