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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In order to assist in the definition of the natural history of lung cancer in the elderly population, a number of biological characteristics were studied, retrospectively, by comparing previously abstracted data from a cancer registry for three cohorts of patients: young (ages 40 to 50, n = 364), middle-aged (ages 51 to 69, n = 822), and elderly (ages 70 and above, n = 209). Compared to the younger cohort, the elderly cohort demonstrated more presenting symptoms of dyspnea, fewer symptoms of chest pain but a similar frequency of weight loss as a presenting sign. The elderly cohort contained more chronic, comorbid diseases but demonstrated more localized cancer and less metastatic disease compared to the younger cohorts. More than 80% of both groups did not undergo surgical resection. We conclude that elderly patients may be a relevant subgroup of lung cancer patients who must be included in studies of new strategies for disease detection, treatment, and management, and the identification of biological characteristics that could further define this high-risk subset of cancer patients.
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PMID:Characteristics of lung cancer in elderly patients. 362 14

Respiratory infections of 19 subjects of advanced age and/or with underlying respiratory disease were treated with cefoperazone (CPZ) and its clinical effects were studied. Sixteen subjects suffered from respiratory tract infection and 3 subjects had pneumonia. The age of the subjects ranged from 39 to 77 years with the mean of 63.8, 7 of them being more than 70 years of age. The underlying respiratory diseases included chronic pulmonary emphysema in 6 subjects, diffuse panbronchiolitis in 3, bronchiectasis in 3, silicosis in 2 and one each of chronic bronchitis, pulmonary fibrosis, lung cancer and old pulmonary tuberculosis. One case, 75 years of age, had renal insufficiency. The daily dose of CPZ was 4 grams in 18 of the 19 subjects and the duration of administration ranged 5 to 22 days. The remaining 1 subject received 2 g of CPZ daily for 6 days. Clinical effects were judged from the changes in fever, cough, amount of sputum, dyspnea, rales, cyanosis, chest X-ray, white blood cell counts, CRP, erythrocyte sedimentation rates and results of sputum culture. Clinical effects were good in 16 subjects, fair in 1, and poor in 2. Bacteriological follow-up was carried out in 13 subjects. Infecting bacteria were eliminated from 5 subjects, reduced in 2 and, in 4 subjects, they were replaced by other bacteria. In 1 subject, P. aeruginosa was isolated from sputum even after the treatment with CPZ, and in another subject H. influenzae relapsed immediately after the cessation of the CPZ treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Effects of cefoperazone on respiratory infections of patients of advanced age and/or with underlying respiratory diseases]. 373 62

One hundred and fifty-nine patients with symptoms of superior vena caval obstruction who presented to two major hospitals over a 10-year period, from 1970 to 1979, were reviewed. Lung cancer was the most common histological diagnosis. The most common symptoms were dyspnoea and a feeling of fullness in the head. The most common physical findings were dilatation of the neck or chest wall veins, or oedema of the face and arms. Superior mediastinal widening was the most common radiological abnormality. No significant morbidity was associated with any diagnostic procedure. Only patients with lymphoma had a significantly longer survival period, both from the diagnosis of the disease, and from the onset of the symptoms of superior vena caval obstruction. There is no evidence that superior vena caval obstruction is an absolute medical emergency. Appropriate diagnostic steps should be undertaken to establish the histological diagnosis. The prognosis for some tumour types may be improved by combined modality therapy (chemotherapy plus radiotherapy).
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PMID:Superior vena caval obstruction: a 10-year experience. 379 66

Twenty-eight therapeutic bronchoscopic procedures with laser were carried out on 20 patients with primary lung cancer. Indications for laser bronchoscopic study were nonresectable, endoscopically visible tumor in patients who had any of the following complications after chemotherapy and/or radiation therapy: increasing dyspnea, postobstructive pneumonia, atelectasis, or hemoptysis from an endoscopically visible site. Symptomatic benefit was noted by 15 of 20 patients after laser therapy. There were two procedure-related deaths. Our conclusions regarding selection of patients for laser therapy of endotracheal and endobronchial lesions are given.
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PMID:Laser therapy in patients with primary lung cancer. 620 86

From 1963-1974, 141 patients with lung cancer were treated with curative intent in the A. Maxwell Evans Clinic in Vancouver. The clinical presentation, age and sex distribution, histology, and reasons for surgery not being carried out are examined. The results of this treatment are presented. An attempt has been made to isolate a group of patients who have a better prognosis so that treatment selection can be improved. Hemoptysis, cough, dyspnea, and incidental finding on routine chest x-ray were the most common manner of presentation. Thirty-four percent of the patients were over 70 years of age and 13% were women. The crude overall three- and five-year survival rates were 18 and 10% (19 and 9% in the men, 17 and 14% in the women). Patients presenting with dyspnea had a better survival than those presenting with cough and hemoptysis. Patients with lesions less than 3 cm in diameter had a 28% three-year survival, compared with 14% for lesions greater than 5 cm in diameter. The three- and five-year survival rates in patients over 70 years of age were 23 and 17% respectively. The response to treatment and the survival was better in the patients with squamous cell carcinoma. Twenty-two percent were alive at three years and 12% at five years as compared with 9 and 5% for other histologies. Fifty-four percent of the 35 patients with a complete response and with squamous cell carcinoma were alive at three years, compared with only 8% of the 12 patients with other histologies who showed a complete response.
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PMID:The role of curative radiotherapy in the treatment of lung cancer. 624 73

Study on the mode of presentation among 3815 lung cancer patients showed that 3608 (75%) presented with respiratory symptoms and 953 (25%) with extrapulmonary symptoms. Of the respiratory symptoms, cough was the complaint in 1940 (51%), features of superior vena cava obstruction (SVO) in 451 (12%), hemoptysis in 332 (9%), and dyspnea in 139 (4%). Analysis of extrapulmonary symptoms showed 348 (9%) patients appeared with complaints of bone pain, 273 (7%) with pyrexia of unknown origin (PUO). 235 (6%) with enlarged cervical glands, 39 (1%) with hoarseness, 29 (0.76%) with arm pain, 14 (0.36%) with jaundice, and the remaining 15 (0.39%) patients, categorized as miscellaneous group, presented with heterogeneous symptoms. In our study, cough, SVO, hemoptysis, dyspnea, bone pain, enlarged cervical glands, and PUO were the commonest mode of presentation and significantly higher than earlier reports (P less than 0.001). Our results may be explained by patient and/or physician delay due poor awareness of high-risk symptoms of lung cancer.
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PMID:Pulmonary and extrapulmonary manifestations in delayed diagnosis of lung cancer in Bangladesh. 670 2

Twelve cases of interstitial pneumonitis were seen in 50 patients (24%) treated with cyclophosphamide, methotrexate, and etoposide (VP-16-213) for small cell anaplastic lung cancer. The clinical course and pathologic characteristics were consistent with drug-induced pneumonitis in all 12 cases. One additional patient had concurrent histologic evidence of interstitial pneumonitis, pneumocystis infection, and perivascular metastases. Patients presented with severe dyspnea, hypoxemia, cough, fever, and bilateral interstitial infiltrates on chest films. The onset was rapid and unpredictable, following as little as one month or as much as five months of therapy. Nine patients recovered but there were three deaths in the acute period directly attributable to the drug-induced pneumonitis. Although the use of twice weekly oral methotrexate may have been a causative factor, a previously unsuspected drug interaction with etoposide may be the etiologic factor resulting in this unusually high incidence of pulmonary toxicity. The difficulty in establishing a diagnosis of interstitial pneumonitis in this group of patients with chronic lung disease and lung cancer is well known. The extent of morbidity and mortality seen in this study and the commercial availability of etoposide make earlier clinical recognition of this complication imperative.
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PMID:Chemotherapy-induced interstitial pneumonitis during treatment of small cell anaplastic lung cancer. 672 94

Ten-year results are reported from a randomised controlled trial of anti-smoking advice in 1445 male smokers, aged 40-59, at high risk of cardiorespiratory disease. After one year reported cigarette consumption in the intervention group (714 men) was one-quarter that of the "normal care" group (731 men); over 10 years the net reported reduction averaged 53%. The intervention group experienced less nasal obstruction, cough, dyspnoea, and loss of ventilatory function. Over 10 years their mortality from coronary heart disease was 18% lower than controls (49 and 62 deaths), and that for lung cancer was 23% lower (18 and 24 deaths). Deaths from non-lung cancers were higher in the intervention group (28 v 12 deaths). This unexpected difference was due about equally to an excess in intervention and a deficiency in normal care men, it showed no site specificity, and it was unrelated to change in smoking habit. These findings suggest that it is more likely to have been due to change than to intervention. The total number of deaths were 123 in the intervention group and 128 in normal care (95% confidence limits of difference -22% to +23%). The policy of encouraging smokers to give up the habit should not be changed.
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PMID:A randomised controlled trial of anti-smoking advice: 10-year results. 711 52

The use of pleuroscopy in patients with bronchogenic carcinoma has not been reported previously. We performed this procedure in 45 lung cancer patients in whom pleural involvement was suspected. Pleural fluid or mestastases were found in 37 patients, 5 of whom had also major atelectasis due to bronchial obstruction by tumor. Neoplasm penetrating vital structures (aorta, brachial plexus) was found in 3 patients, tumor confining to resectable structures in 3; no pleural abnormalities were disclosed in 2. Based on these findings, 43 tumors were assigned stage III. Only on two occasions pleuroscopy did not aid staging. In 20 patients with massive pleural effusion causing dyspnea we insufflated talc in order to produce pleurodesis. This was fully successful in 16 patients, while in 2 the pleural cavity became only partially obliterated, with symptomatic relief. In 2 patients pleurodesis could not be evaluated because of early death caused by progression of cancer. Pleuroscopy is a highly informative procedure, applicable when involvement of pleura by lung cancer is suspected. It is helpful in clinical staging of the tumor and in assessment of its resectability, particularly in elderly, poor-risk patients. It provides the best way for talc insufflation when pleurodesis is indicated. Pleuroscopy should have an established place in the clinical evaluation and staging of lung cancer.
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PMID:Pleuroscopy in clinical evaluation and staging of lung cancer. 731 52

The contributions of several recent reports to the definition of pulmonary effects of PVC dust inhalation are reviewed. Granulomatous reaction, with inclusion of PVC particles in macrophages and histocytes, and associated interstitial pulmonary fibrosis have been found to lead to exertional dyspnoea, diffuse micronodular chest radiographic opacities and restrictive pulmonary dysfunction. The effects of vinyl chloride (VC) monomer (gas) on proteins and the immunologic mechanisms triggered by the altered protein are possible mechanisms for the development in some cases of interstitial pulmonary fibrosis secondary to VC exposure. Vinyl chloride, a confirmed carcinogen, has been associated with, among other malignant tumors, a significant increase in the incidence of lung cancer. The magnitude of this effect has not yet been completely evaluated.
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PMID:Review of pulmonary effects of poly(vinyl chloride) and vinyl chloride exposure. 733 34


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