Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0178874 (tumor progression)
 40,807 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The lack of control of physical suffering among cancer patients in the last days or hours of life is a common medical problem but it is rarely discussed in an open fashion. We carried out a prospective study of the dying of 120 terminal cancer patients assisted by a home care team. We documented how long it was before death that physical symptoms, unendurable to the patient and controlled only by sedation-inducing sleep, appeared. In 63 patients (52.5%), unendurable symptoms due to tumor progression or irreversible acute organic phenomena appeared, on average two days before death. Of the 63 patients, 47 had only one uncontrollable symptom, 15 had two symptoms and one patient had three symptoms. The most common symptoms included dyspnea (33 patients), pain (31), delirium (11), and vomiting (5). The most frequent symptoms were dyspnea in lung and head and neck disease; pain in breast, gastrointestinal tract, colon-rectum, and male genitourinary tract cancer; and vomiting in female genitourinary tract malignancies. Data reported emphasize the clinical relevance of physical symptoms in the last days of life in terminal cancer patients and how these serve to indicate imminent death. More than 50% of these patients die with physical suffering that is controllable only by means of sedation.
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PMID:Symptom prevalence and control during cancer patients' last days of life. 171

Fifteen patients with Stage IIIB or IV non-small cell lung cancer gave informed consent to receive three or more 96-hour infusions of ATP at a dose of 50 mcg/kg/min or higher to determine whether ATP has antineoplastic activity against this tumor type and to better define the spectrum of toxicity for ATP given as a single agent. There were no objective complete or partial responses observed. The median survival of the overall group was 187 days and the median time to tumor progression was 113 days. The major toxic side effects were chest pain and dyspnea, leading to the cessation of treatment in 5 patients. We conclude that ATP at this dose and schedule of administration is an inactive agent in patients with advanced non-small cell lung cancer.
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PMID:Phase II study of intravenous adenosine 5'-triphosphate in patients with previously untreated stage IIIB and stage IV non-small cell lung cancer. 974 May 48

A 48-year-old man presented with dyspnea. He was diagnosed as having advanced lung adenocarcinoma of stage IV (T4N2M1). After 3 courses of paclitaxel therapy every 3 weeks intravenously, subjective symptoms, arterial blood gas and radiographical findings improved very much. In the process of the tumor reduction, chest CT showed unique radiographical findings of so-called lung fibrosis over the entire lung and reduction of lung volume. An additional 3 courses of weekly paclitaxel therapy have been given on an outpatient basis. After the change of therapy, the reduction in the tumor has continued and the tumor progression is under control without a decline in the patient's QOL from the start of the chemotherapy over 6 months to the present.
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PMID:[A case of stage IV advanced lung adenocarcinoma treated effectively using paclitaxel with the fibrosing radiographically on the chest CT]. 1147 49

Thirty-nine patients with advanced non-small cell lung cancer, refractory or resistant to platinum or taxanes derivatives were treated on an out-patient basis with vinorelbine 25 mg/m2 intravenous (I.V.) on days 1 and 8 followed by gemcitabine 800 mg/m2 l.V. on days 1 and 8. Chemotherapy was repeated every 3 weeks. The patients were evaluated for response every two cycles of treatment. All 39 patients were assessable for toxicity and 35 were assessable for response. On an intent to treat analysis, only 1 (2.6%) patient achieved a partial response (PR) (95% CI 0.09% to 17.6%); fourteen patients (35.9%, 95% CI 29.45% to 67.4%) had stable disease (SD) and 24 (61.5%) had progressive disease (PD). The median time to tumor progression (TTP) was 4.7 months (range 0.13 to 18.9 months), the median survival time was 7.3 months (range 0.6 to 18.9 months) and the 1-year survival rate was 35%. Clinical benefit response including improvement of PS, dyspnea and anorexia, pain and cough reduction and cessation of hemoptysis and fever was observed in 10% to 50% of patients. Grade 3/4 neutropenia occurred only in 2 (5.2%) patients. Five patients experienced febrile neutropenia, which was successfully treated with G-CSF and broad-spectrum antibiotics. No patient experienced grade 3/4 anaemia or thrombocytopenia. One patient experienced grade 4 fatigue and stopped the treatment. Nausea / vomiting, fatigue, neurotoxicity, diarrhea and fever were mild in the majority of patients and did not result in any clinically significant problem. There were no treatment-related deaths. In conclusion, the combination of gemcitabine and vinorelbine showed low objective response rate in patients previously treated with CDDP/taxanes-containing regimens. This regimen was relatively well-tolerated and was associated with prolonged 1-year survival and improvement in cancer related symptoms. To validate these findings a randomized trial of gemcitabine and vinorelbine versus taxotere or best supportive care is required.
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PMID:An out-patient second-line chemotherapy with gemcitabine and vinorelbine in patients with non-small cell lung cancer previously treated with cisplatin-based chemotherapy. A phase II study of the Hellenic co-operative Oncology Group. 1171 2

Dyspnea is a very common symptom in cancer patients. It is an important symptom because it interferes with patient's quality of life and because its treatment is often difficult. Dyspnea may be defined as an uncomfortable awareness of breathing. Diagnosis relies on physical examination, which intends also to assess severity of dyspnea and etiology. In cancer patients many mechanisms may be involved: tumor progression, side effects of treatments, associated disease especially from cardiac or infectious origin. A specific treatment (whenever it is possible) is associated with symptomatic measures. Oxygen therapy is often used. Morphine can decrease the sensation of dyspnea by its central effects and is useful especially in palliative setting. Benzodiazepines reduce anxiety induced by dyspnea. Physiotherapy, support of patient and family must not be neglected.
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PMID:[Management of dyspnea in the cancer patient]. 1280 23

A 72-year-old man was admitted to our hospital because of progressive dyspnea due to pulmonary emphysema. Chest CT revealed a nodular lesion in the right S6 and swollen right hilar lymph nodes. The diagnosis was not confirmed bronchoscopically. A subsequent biopsy of a subcutaneous mass in the left lateral pectoral region demonstrated metastatic cancer. Laboratory data on admission showed marked elevation of amylase activity in both serum and urine. Amylase isozyme patterns identified the salivary types. The pancreas and salivary glands were unlikely to have any clinical involvement in the hyperamylasemia, but lung cancer with subcutaneous metastasis was strongly suspected clinically as the source. Chemotherapy failed to prevent tumor progression and the patient eventually died of respiratory failure. Immunohistological examination of the subcutaneous lesion showed positive staining for salivary-type amylase, whereas that of the lung primary lesion disclosed small cell carcinoma and negative staining for amylase. In most cases, amylase-producing lung cancers have been diagnosed as adenocarcinoma. Amylase-producing small cell carcinoma is very rare.
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PMID:[A case of amylase-producing lung cancer]. 1458 92

A 71-year-old man complained of dyspnea and general fatigue. His blood tests showed severe renal dysfunction. Computed tomographic scan, bone scintigram, and cystoscopy revealed primary signet ring cell carcinoma of the urinary bladder with multiple bone metastases (cT2N0M1). As the general condition of the patient was poor, nephrostomy was performed. He died one month after the diagnosis due to cancer progression. The prognosis of signet ring cell carcinoma of the bladder is poor because many cases presented at an advanced stage. Fifty cases of signet ring cell carcinoma in the urinary bladder reported in Japan are reviewed.
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PMID:[Primary signet ring cell carcinoma of the bladder: a case report]. 1577 66

Imatinib targets KIT and platelet-derived growth factor receptors (PDGFR) and is highly effective in the treatment of CML and GIST patients. Pancreatic cancers express KIT and PDGFRs. Therefore, 26 patients with unresectable pancreatic cancer were randomized to either gemcitabine (1000 mg/m2 weekly) or imatinib (2x400 mg po) treatment daily. Pancreatic adenocarcinoma was confirmed histologically and expression of KIT and PDGFRbeta was determined immunohistochemically in the biopsy specimens. Quality of life was assessed with two standard questionnaires. No objective responses were seen in either group. Median time to progression was 77 and 29 days (P=0.411) and median survival time was 140 and 60 days (P=0.517) for gemcitabine and imatinib, respectively. Survival and treatment responses were independent of KIT and PDGFRbeta expression in patients treated with imatinib. Grade 3/4 toxicities of imatinib treatment were anemia, elevated liver enzymes, vomiting, and dyspnea. Patients treated with imatinib reported diarrhoea and/or altered bowel function more frequently, which were treatable symptomatically. Quality of life was similar in both groups. In this small series of pancreatic cancer patients, treatment with imatinib was not associated with a significant control of cancer progression.
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PMID:The tyrosine kinase inhibitor imatinib fails to inhibit pancreatic cancer progression. 1589 16

We describe a case series of 35 patients with either benign (14) or malignant (21) tracheal stenosis who were treated using a novel silicone stent, the HCPA-1, designed to prevent migration. Between March 2001 and September 2008, 13 women and 22 men received 41 HCPA-1 stents. The median duration of stenting in benign cases was 457 days (range, 4-2,961 days). Successful stent removal with curative results was accomplished in 2 patients with tracheomalacia and 1 with post-intubation stenosis. In malignant cases, the median duration of stenting was 162 days (range, 1-1,279 days). Five patients had tumor progression with obstruction requiring repeated laser resection, dilatation, or additional stents. Two patients died due to airway obstruction despite bronchoscopic intervention. Twelve patients with malignant lesions died with the stent in place. At the end of the study, 3 patients with malignant disease remained alive; 2 were lost to follow-up. The HCPA-1 stent proved to be safe, with no severe complications during the study period, and effective in improving quality of life with relief of dyspnea.
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PMID:Novel silicone stent to treat tracheobronchial lesions: results of 35 patients. 2114 99

Disseminated microvascular pulmonary tumor embolism (DMPTE) is extremely rare and invariably fatal. Typical symptoms and signs of DMPTE include shortness of breath and inadequate oxygenation. Here we demonstrate a patient with unexplained progressive pulmonary hypertension followed by sudden cardiac arrest, who finally diagnosed of DMPTE pathologically under veno-arterial extracorporeal membrane oxygenation (VA-ECMO) system support. A 59-year-old gentleman was diagnosed of advanced non-small cell lung cancer with clinical stage of T3N2M1 in February 2008. His disease had been controlled well for two years under first-line clinical trial and salvage pemetrexed treatment. In early January 2010, he suffered from dyspnea on exertion gradually, although cancer progression was not proven by computed tomography (CT) scan. Transthoracic echocardiography also revealed normal heart size and function. However, he was sent to emergency room (ER) one month later due to dyspnea where pulmonary hypertension was discovered by repeated echocardiography. Follow-up CT scan was shown neither evidences of tumor progression nor pulmonary thromboembolic event in all major pulmonary vessels. Unfortunately, he was found to be unconscious suddenly at ER during urination and diagnosed as pulse-less electrical activity. Cardiopulmonary resuscitation (CPR) was initiated immediately and he was sent to intensive care unit with VA-ECMO system under the impression of cardiovascular system dysfunction. He passed away 10 days after intensive treatment. A necropsy was performed after we received the inform consent from his family. DMPTE was confirmed by pathologists. Currently, diagnosis of DMPTE is challenging and treatment is limited although advances of modern medicine. DMPTE should be kept in mind if cancer patients have dyspnea, inadequate oxygen saturation and unexplained pulmonary hypertension during their disease courses that unexpected serious consequences, like sudden cardiac arrest, may happen.
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PMID:Disseminated microvascular pulmonary tumor embolism from non-small cell lung cancer leading to pulmonary hypertension followed by sudden cardiac arrest. 2133 71


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