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

We report a case of drug induced pneumonitis caused by oral etoposide. A 63-year-old man was admitted to our hospital in August 1991 because of low grade fever and dyspnea. He underwent right upper lobectomy on Nov. 27th, 1990 for lung cancer (squamous cell carcinoma), and courses of adjuvant chemotherapy (CBDCA, IFX, etoposide) during the following admission period. He was discharged on Feb. 14th, 1991, and as an outpatient, oral etoposide (25 mg/day) was administered for about 7 months (6,125 mg in total). Chest X-ray film on admission showed reticulonodular shadows in bilateral lung fields, and computed tomography showed diffuse interstitial shadows. Blood gas analysis showed marked hypoxemia (PaO2 breathing room air was 48.4 Torr). Transbronchial lung biopsy revealed edema of the alveolar walls and marked proliferation of type II alveolar epithelial cells, suggesting cytotoxic reaction. After termination of etoposide administration and following steroid pulse therapy, both clinical symptoms and hypoxemia were ameliorated. To our knowledge, this is the first report of etoposide-induced pneumonitis.
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PMID:[A case of drug induced pneumonitis caused by oral etoposide]. 836 32

We used Expandable Metallic Stent (EMS) to bilateral bronchial stenosis due to invasion of lung cancer. A 75-year-old man was admitted to our hospital because of dyspnea and a fainting fit on October 19, 1991. He had been suffered from squamous cell carcinoma of right lung with bilateral bronchial invasion (T4N2M0), which has no indication for surgery. As the stenosis of bilateral main bronchus and the respiratory distress progressed, we applied EMS to the patient and inserted it into the left main bronchus on December 19, 1991. The procedure promptly relieved the respiratory distress and improved his quality of life. Bronchial endoscopy, performed on the 20th postoperative day, revealed the left bronchus patency. Thus, EMS applied to the bronchial stenosis caused by advanced lung cancer may be a choice of palliative therapy and can improve the quality of patient's life.
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PMID:[Usefulness of expandable metallic stent to bronchial stenosis caused by an advanced lung cancer--a case report]. 851 75

Breathlessness has been described as an unpleasant sensation, but if it encompasses suffering, as some argue, it is much more than this. Breathlessness is also a major issue for people with cancer. Much of the effort to manage breathlessness has thus far focused on the treatment of underlying causes or on pharmacological strategies. In this paper, broader rehabilitative goals of care and treatment for breathlessness in lung cancer are addressed. Breathing control techniques have been developed to help patients with non-malignant disease to avoid breathlessness at rest or on exertion. A study is described (Corner et al., 1995) which evaluated the effectiveness of breathing retraining and psychosocial support for breathlessness in lung cancer. Breathlessness can be a frightening and powerful experience. It can symbolize a threat to life itself. In these circumstances, the goal of therapy is to alleviate loss of function and to ease the psychological burden that so restricts the individual. An 'integrative' model of breathlessness is discussed, in which the emotional experience of breathlessness is considered inseparable from the sensory experience and the biological mechanisms. Evidence is presented from a small study of the experiences of nurses working in the experimental clinic for breathlessness which suggests that the emotional consequences of breathlessness have a profound influence on how it is managed in practice. Finally, it is argued that symptoms are sometimes generalized too much. Experience is particular, not universal, and an open, accepting and therapeutic approach to managing illness has to be involved with messy and sometimes frightening emotions.
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PMID:Nursing as therapy in the management of breathlessness in lung cancer. 854 41

A 42-year-old man with one year history of cough and chest pain due to right upper lung cancer was scheduled for radical surgery. An echocardiogram and a lung scan showed a tumor mass in the left atrium, which was originating from carcinoma of the right upper lobe. Right pneumonectomy and atrial tumor extirpation were done successfully under the state of cardiac arrest using extracorporeal circulation with topical cooling by crushed ice in order not to spread the tumor cells into systemic circulation. He was extubated on the 1st postoperative day. But, thereafter he developed moderate dyspnea. On 7, 10 and 13th postoperative days he fell into the state of CO2 narcosis. Decreased capacity of the lung after the pneumonectomy and left phrenic nerve injury during the operation were considered factors causing the respiratory insufficiency. Patient was discharged 6 weeks later and continued to have consultations at the outpatient clinic.
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PMID:[Extracorporeal circulation for removal of carcinoma of the lung invading the left atrium]. 858 64

Patients with unilateral vocal cord paralysis from intrathoracic malignancies may have significant dysfunctions of speech, swallowing, ventilation, and effective coughing as a result of inadequate compensation of the nonparalyzed cord. In patients with already compromised pulmonary function, aspiration can be a life-threatening event. Sixty-three patients with intrathoracic malignancies required surgical correction of vocal cord paralysis. Primary pathology included lung cancer (49), esophageal cancer (nine), and miscellaneous tumors (five). Symptoms included hoarseness (62), dyspnea (21), aspiration (26), weight loss (19), dysphagia (14), and pneumonia (14). The surgical procedures included medial displacement of the vocal cord with silicone elastomer (48), temporary Gelfoam injection (seven), and Teflon (polytetrafluoroethylene) injection (eight) to move the affected cord to a medial position. In 11 patients, the operation was performed in the acute postoperative setting to improve pulmonary toilet. Symptomatic improvement was noted in the following proportions of affected patients: hoarseness, 92%; dyspnea, 90%; dysphagia, 93%; aspiration, 92%; pneumonia, 93%; and weight loss, 47%. Overall success rate of the intervention was 57 of 63 patients (90%). All 11 patients treated in the acute setting had immediate improvement. A variety of complications occurred in 17% of patients. Surgical management of vocal cord paralysis in patients with intrathoracic malignancies prevents life-threatening pulmonary complications in the acute postoperative setting. In chronic situations, it provides patients with improved speech, swallowing, and pulmonary function, resulting in improved quality of life, even for patients not cured of their disease.
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PMID:Vocal cord medialization for unilateral paralysis associated with intrathoracic malignancies. 858 6

We report a case of primary lung cancer in a 16-year-old boy. A histologic diagnosis of squamous cell carcinoma was made by bronchoscopic biopsy before surgery. The serum alphafetoprotein (AFP) level was markedly elevated at 193 ng/dl. Preoperative and postoperative evaluation revealed no evidence of scrotal mass. We performed right pneumonectomy with combined resection of the invaded portion of the left atrium under extracorporeal circulation. Despite the rapid improvement in the patient's general condition after surgery, the AFP level continued to increase without a transient decrease and reached 3160 ng/ml on the 23rd postoperative day. When the patient was readmitted because of dyspnea and headache on the 36th postoperative day, hypercalcemia of 13.9 mg/dl was noted, and this was resistant to subsequent treatment. The patient died on the 46th postoperative day.
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PMID:AFP-producing squamous cell carcinoma of the lung in an adolescent. 860 92

The aims of this study were (a) to estimate the prevalence of pain and eight other common symptoms in a large population of patients with advanced cancer from different palliative care centers, and (b) to assess the differences in prevalence of the symptoms by primary site. In 1990-1991, the prevalence of eight major symptoms and performance status were assessed prospectively among 1840 cancer patients in seven hospices in Europe, the United States, and Australia. The data were collected at each institution using structured data collection sheets from the World Health Organization's (WHO) Cancer and Palliative Care Unit. The prevalence of moderate to severe pain was 51%, ranging from 43% in stomach cancer to 80% in gynecological cancers. Nausea was most prevalent in gynecological (42%) and stomach (36%) cancers, and dyspnea (46%) in lung cancer. There were statistically significant differences in the prevalence of most symptoms depending on the primary site of cancer and the hospice. Population-based follow-up studies are needed to document the incidence and prevalence of symptoms throughout the course of the disease.
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PMID:Prevalence of symptoms among patients with advanced cancer: an international collaborative study. Symptom Prevalence Group. 871 10

To clarify clinical significance of symptoms presented at the beginning of treatment, we analyzed the symptoms in 240 patients with non-small cell lung cancer treated with definitive radiation therapy. Symptoms were classified into four groups: no symptom (Grade 0), cough, sputum/hemosputum and fever up (Grade 1), chest pain and breathlessness (Grade 2), appetite loss, body weight loss, SVC syndrome, hoarseness, and pain in the upper limb/shoulder (superior sulcus tumor) (Grade 3), and their therapeutic outcomes were examined. The 2- and 5-year overall actuarial survival rates for patients with squamous cell carcinoma were 38.5% and 15.4% for Grade 0, 40.5% and 20.1% for Grade 1, 17.9% and 2.6% for Grade 2, and 15.8% and 5.3% for Grade 3. A statistical difference was noted in survival between Grades 0-1 and Grades 2-3 (P < 0.01), but was not seen between Grades 0 and 1, or between Grades 2 and 3. As for patients with stage III disease alone, the difference in survival was still significant between Grades 0-1 and 2-3 (P < 0.05). In patients with adenocarcinoma/large cell carcinoma, however, no obvious relationship was found between symptoms and prognosis, except for body weight/appetite loss. In conclusion, though the symptoms closely related to clinical stage and performance status and not an independent prognostic factor, chest pain and breathlessness correlated with poor therapeutic outcome as well as body weight loss and T3-4 related symptoms, while cough, sputum (hemosputum), and fever were favorable symptoms in patients with squamous cell carcinoma who received definitive radiation therapy.
Lung Cancer 1995 Dec
PMID:Clinical implication of symptoms in patients with non-small cell lung cancer treated with definitive radiation therapy. 871 67

The role of post-operative radiotherapy for patients with non-small-cell lung cancer (NSCLC) is unclear despite five previous randomised trials. One deficiency with these trials was that they did not include adequate TNM staging, and so the present randomised trial was designed to compare surgery alone (S) with surgery plus post-operative radiotherapy (SR) in patients with pathologically staged T1-2, N1-2. M0 NSCLC. Between July 1986 and October 1993, 308 patients (154 S, 154 SR) were entered from 16 centres in the UK. The median age of the patients was 62 years, 74% were male, > 85% had normal or near normal levels of general condition, activity and breathlessness, 68% had squamous carcinoma, 52% had had a pneumonectomy, 63% had N1 disease and 37% N2 disease. SR patients received 40 Gy in 15 fractions starting 4-6 weeks post-operatively. Overall there was no advantage to either group in terms of survival, although definite local recurrence and bony metastases appeared less frequently and later in the SR group. In a subgroup analysis, in the N1 group no differences between the treatment groups were seen, but in the N2 group SR patients appeared to gain a one month survival advantage, delayed time to local recurrence and time to appearance of the bone metastases. There is, therefore, no clear indication for post-operative radiotherapy in N1 disease, but the question remains unresolved in N2 disease.
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PMID:The role of post-operative radiotherapy in non-small-cell lung cancer: a multicentre randomised trial in patients with pathologically staged T1-2, N1-2, M0 disease. Medical Research Council Lung Cancer Working Party. 876 82

A retrospective study was performed in patients diagnosed with primary lung cancer, and admitted to the Instituto Nacional de Enfermedades Respiratorias between 1984 to 1992. One thousand and nineteen patients were studied, 636 males and 383 females. We found a higher incidence in the group among 61-70 years of age in both sexes. The highest percentage of tumors were from the adenocarcinoma variety, followed by the epidermoid carcinoma, while the small-cell carcinoma presented a lower incidence. Smoking has been associated with the development of lung cancer. Many of our patients were smokers. The highest frequency was in smokers with a smoking habit of more than 30 years and a rate of more than 10 cigarettes per day. However, an important part of the patients with cancer did not have a smoking habit, which led us to believe that there are other etiological possibility factors (genetic or environmental) that could be involved. Most of the cases of cancer were staged as stage IIIb and stage IV and the patients had an ECOG of 1-2. The main symptoms were coughing, sputum, dyspnea and thoracic pain. This data shows an increasing frequency of lung cancer in Mexico city as well as other countries, it also shows that it is going to be a serious health problem in the future. We consider that in order to improve the prognosis, it is necessary to increase the educational and orientation campaigns among the adult population with or without a smoking history.
Lung Cancer 1996 Jun
PMID:Primary lung cancer in Mexico city: a report of 1019 cases. 879 2


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