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

An antero-lateral cordotomy was performed on a 62-year-old man who had been suffering from intractable right chest pain caused by lung cancer. Six hours after the cordotomy a new pain occurred in an analogous part of the body on the opposite side; the intensity increased gradually and it became as severe as the original within 1 week. Reference of sensation from analgesic area of cordotomy to the opposite side of the body was induced by noxious stimuli. Intrathecal phenol block to the nerves conveying the cancer pain abolished the new pain and the reference of sensation from this blocked area, though it remained unchanged in other analgesic areas of cordotomy. This substantiates that the new pain was a reference of the original cancer pain.
Pain 1987 Jul
PMID:A mechanism of new pain following cordotomy; reference of sensation. 361 82

From 1956 to 1985, autopsy was done on 17 lung cancer patients in our hospital. There were two patients with focal metastasis as the presenting symptom without any primary cancer manifestations. One patient was admitted for severe right epigastric pain followed by severe pain in the left epigastrium. The chest film revealed nothing except some indefinite inflammatory lesions in the left upper lung. The patient died of uremia in 6 months. A primary carcinoma of 2 cm in diameter in the left lower lung was found on autopsy, which widely spread to the right lung, ovaries, upper segment of the left ureter, peribronchial and periaortic lymph nodes. Histological diagnosis was poorly differentiated adenocarcinoma. The other patient had destruction of the sphenoid bone with cranial nerve paralysis and hypothalamic syndrome at first. The primary cancer, a poorly differentiated adenocarcinoma of 2 X 3 X 1.5 cm in size, was found in the right upper lung on autopsy. Focal metastatic symptom as the initial presentation of lung cancer is rare. These tumors, as small lesions, frequently occur in the peripheral part of the lung. However, the site in which the presenting symptom develops may not necessarily be the place prone to metastasis. The presenting symptom, in turn, would depend upon the tendency of causing symptoms in the involved site. The author suggests that careful searching and identifying of the pulmonary lesion be routinely done for patients with metastatic carcinomatous symptoms only.
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PMID:[Focal metastatic symptom as the initial presentation of lung cancer--report of two autopsied cases]. 365 19

The prognostic significance of bone scintigraphy was investigated by following 587 consecutive patients with lung cancer, in whom this investigation had been performed, for up to 9 years, or until death. Survival was unrelated to age, sex or cell type. However, pain and abnormal bone scintigraphy were both independently associated with a significantly reduced survival compared with those who were free of pain or who had normal bone scintigraphy. These factors were cumulative. The association remained equally valid for all cell types. Claims that a single metastasis is not prognostically significant are unfounded. It is suggested that the results of some chemotherapy trials must be reconsidered in the light of present findings, because of the lack of adequate control groups; the results could be construed to show a beneficial effect only in patients with bone metastases and a poor prognosis, but little or no effect in patients with normal bone scintigraphy. As judged by clinical and radiological follow-up and post-mortem examination, skeletal scintigraphy in patients with lung cancer had a sensitivity of 0.89, a non-specificity (false positives/true negatives) of 0.00 and an accuracy of 0.78. With existing radiopharmaceuticals there is an irreducible residue of false negatives due to deposits which provoke little or no osteoblastic response. Bone scintigraphy is, thus, indicated in any patient with lung cancer with unexplained symptoms and whenever staging is required, because of the prognostic implications. It should precede other staging investigations because the high detection rate may render other tests unnecessary.
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PMID:Bone scintigraphy in lung cancer: a reappraisal. 380 98

The incidence of the Pancoast syndrome ranges from 2 to 5% of patients with lung cancer. We treated 20 cases between 1979 and 1984 with 29 procedures including percutaneous cordotomy, selective posterior radiculotomy, decompressive laminectomy, central administration of opiates, and TENS. Selective posterior radiculotomy gave the best pain relief.
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PMID:Therapeutic approach to the Pancoast pain syndrome. 384

The authors analyse the results up to death in 103 followed-up patients undergoing unilateral percutaneous cervical cordotomy for persistent cervico-thoracic malignant pain (45 cases of Pancoast syndrome and 58 cases of thoracic pain associated with lung cancer or metastases). On the basis of epidemiological data, relationships emerge between onset of pain, stage of cancer, patient survival and lasting efficacy of pain relief. Twenty (44%) of 45 patients with Pancoast syndrome were pain-free up to death as a result of cordotomy alone, while only 13/58 patients (22%) with thoracic pain were pain-free as a result of cordotomy alone owing to the very high incidence of mirror pain in this group of patients (42/58 patients, 72%) compared to those with Pancoast syndrome (14/45 patients, 31%). The type and intensity of mirror pain, however, were of such a nature in both groups as to be amenable to control with analgesic drugs. In both groups of patients, there was a low incidence of the causes of post-cordotomy pain recurrence contralateral to the lesion, i.e., deafferentation pain, fading of analgesia, and pain above the levels up to which deep pin-prick analgesia had been obtained. Cordotomy alone or, as necessary, in conjunction with analgesic drugs afforded complete pain control in 34/45 patients (75%) with Pancoast syndrome and in 50/58 patients (86%) with thoracic pain. These data provide evidence of the unique usefulness of the procedure in controlling otherwise intractable persistent cervicothoracic malignant pain, when the technique is correctly performed.
Pain 1985 Apr
PMID:Results up to death in the treatment of persistent cervico-thoracic (Pancoast) and thoracic malignant pain by unilateral percutaneous cervical cordotomy. 385 85

Hypertrophic pulmonary osteoarthropathy (HPO) is a disabling complication of lung cancer often requiring thoracotomy with vagotomy for control of pain. This condition was confirmed by scintigraphy in six consecutive patients with biopsy-proved lung cancer. All had characteristic bone and joint pain unresponsive to a variety of analgesics. Treatment with indomethacin gave dramatic relief of pain within 72 hours in all six. Consideration should be given to instituting a controlled trial to establish the efficacy of indomethacin for the treatment of HPO.
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PMID:Indomethacin therapy for hypertrophic pulmonary osteoarthropathy in patients with bronchogenic carcinoma. 399 10

Five cases of intramedullary spinal cord metastasis are presented and an additional 50 cases from the English language literature since 1960 are reviewed. Lung cancer and breast cancer were the most frequently occurring primary neoplasms, but a wide variety of solid tumors may cause intramedullary spinal cord metastasis. The presenting symptoms were pain and/or weakness. The neurologic status deteriorated rapidly in the majority of patients in a period to days to weeks. Progression to a cord hemisection syndrome or cord transection occurred in approximately half of the patients. The characteristic myelographic appearance of fusiform swelling of the cord was seen in one third of the patients, but the myelogram was normal in 42%. Plain radiographs of the spine showed no evidence of metastatic disease in three fourths of cases. The cerebrospinal fluid protein level was frequently elevated, but results of cytologic studies were usually negative. High-resolution computer-assisted tomographic scanning may show intramedullary metastases. Radiation therapy combined with corticosteroid administration offers the only effective palliation. The recognition of intramedullary spinal cord metastasis is an ominous finding. Intramedullary spinal cord metastasis generally occurred in the setting of widespread systemic and intracranial disease, but occasionally was the only site of relapse. More than 80% of patients died within 3 months. Heightened awareness of this entity may lead to early diagnosis at a stage when neurologic deficits are reversible and, it is hoped, more effective palliation can be achieved.
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PMID:Clinical features and natural history of intramedullary spinal cord metastasis. 405 74

Thirty-one patients with metastatic brain tumors (MBT) from lung cancer and ten patients with MBT from melanoma received BCNU, 100 mg/m2, every four weeks by intracarotid and/or vertebral artery infusion into each involved site. Twenty-five patients with lung cancer and all melanoma patients are currently evaluable. Twelve patients with lung cancer had complete and partial responses lasting from 1 to 14 months. Four of them with the histologic diagnosis of small cell carcinoma, one with large cell carcinoma and one with squamous cell carcinoma showed complete response. None of the patients with melanoma MBT experienced any response. All of the patients had periorbital erythralgia and/or occipital pain during the infusion. Four patients manifested mild focal seizures during the infusion or 6 to 24 hours after the treatment. Transient confusion with disorientation was observed in two patients 4 and 24 hours, respectively, after a BCNU infusion. Two patients developed reversible thrombocytopenia after the fifth course of the IA chemotherapy. Median survival of patients with MBT from lung carcinoma was 4 months, with two of them still alive at 10 and 14 months, respectively. Only one patients of the 25 with lung carcinoma died from MBT. Failure to control the primary disease resulted in the deaths of a vast majority of the patients.
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PMID:Phase II study--intra-arterial BCNU therapy for metastatic brain tumors. 626 14

Of 230 bronchial carcinoma patients, 30 underwent resection and 13 (5.6%) survived 5 years. Some of the domestic implications of the diagnosis were sought through study of the 200 non-surgically treated patients and by interviews with 191 of their relatives. Seventy-eight per cent of the relatives said that the illness had not been as bad as they had anticipated. Fifty-five per cent of patients died within 4 months of their first examination and 28.5% of relatives were unprepared for the suddenness of the death. Five per cent of patients died of a massive haemoptysis. For two-thirds of a subgroup of 56 patients, inability to get to the lavatory with help from one person, was a herald of death within 10 days. Some findings offered comfort for relatives living with a lung cancer patient: 41% of patients had no pain at all, 23.5% needed no treatment and 9.5% weakened and died very peacefully.
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PMID:Answering the relatives of lung cancer patients. 648 29

The neodymium-yttrium aluminum garnet (Nd-YAG) laser has demonstrated its effectiveness in treatment of a number of benign and malignant tracheobronchial disorders. This laser has many advantages over past methods of endobronchial therapy, such as cryosurgery and electrocautery. It is a precise, no-touch method that produces little pain during therapy and little or no edema or infection afterward. Since the laser is a form of nonionizing radiation, therapy may be repeated as often as needed. Unlike the carbon dioxide laser, the Nd-YAG laser may be used with standard flexible endoscopes. Currently, the commonest indication for Nd-YAG laser therapy is obstruction of a large airway by an inoperable neoplasm. Whether this technique can be applied more widely in management of early lung cancer, possibly in combination with radiotherapy, chemotherapy, or surgery, will be determined by further study.
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PMID:Nd-YAG laser therapy for tracheobronchial disorders. 654 19


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