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

One hundred and thirty-one patients presenting to a general hospital with neurological symptoms deriving from spinal metastases were reviewed. The primary site of tumour was the lung in 33 per cent, breast in 28 per cent, other sites in 25 per cent and unknown in 14 per cent. Haematological malignancies were excluded. In 47 per cent of cases the spinal metastasis produced the first evidence of malignant disease. Spinal or radicular pain was the initial complaint in 69 per cent of cases, followed by the appearance of neurological symptoms. Leg weakness usually preceded sphincter disturbance, and was the commonest reason for referral. Spinal cord compression occurred in 106 patients, 10 had compression of conus medullaris or cauda equina and 15 had evidence of radicular compression only. Plain x-rays of the spine were abnormal in 84 per cent of patients, and in 94 per cent of those with carcinoma of the breast. The results of treatment by radiotherapy alone were retrospectively compared with those of surgical decompression (with or without radiotherapy). There was no significant difference between these results for immediate response to treatment or for long-term outcome. The best predictor of outcome was the site of primary tumour. Only 17 per cent of patients with lung cancer responded well to treatment and only 2 per cent were alive one year after treatment; 51 per cent of patients with breast cancer responded well and 36 per cent were alive at one year. Surgical treatment is considered preferable in cases in which the diagnosis of cancer is not proven, when there is a possibility of neural compression by diseased bone rather than soft tumour tissue and when the area has previously been irradiated. These groups accounted for about 60 per cent of our patients. Radiotherapy alone may be preferred if multiple lesions are demonstrated. In other cases a therapeutic decision is required. The availability of neurosurgical and radiotherapeutic facilities will be a factor. There is no clear evidence from our figures or from the literature of a difference between results obtained by radiotherapy alone and those with surgical decompression followed by irradiation. The choice of treatment will depend upon the particular requirements of each individual parent.
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PMID:Spinal metastases. A retrospective survey from a general hospital. 706 72

This study was the first to compare patient and family member perceptions of sensory pain and to describe the relationships between these perceptions and psychological factors in patients with lung cancer and pain. Our findings indicate that family members understand the patient's pain location about 75% of the time; however, family members rarely understand the patient's pain intensity, pain quality, or pain pattern. Our findings also indicate that family members tend to overestimate strategies used by patients to cope with pain, especially in patients with low levels of anxiety and in patients with an internal locus of control. Although findings from this study differ from some previous studies, our study provides additional data to suggest that discrepancies may exist between family member and patient perceptions of the cancer pain experience. Nurses need to be aware of potential discrepancies and to combine assessment information from both patients and family members when developing pain management interventions.
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PMID:Family members' perceptions of cancer pain. Comparisons with patient sensory report and by patient psychologic status. 750 32

Prediction of survival can be relevant in palliative care in those units with selective admission policies and limited resources, for planning patient management and in discharge planning for those patients expected to go home. In this study, factors most predictive of prognosis were identified. Those factors shown to have no effect on survival included the performance of investigations or procedures, anti-cancer therapy, morphine dose on admission and original admitting ward. Patients admitted primarily for pain control had a significant survival advantage over those patients admitted for palliation of some other symptom. Actual survival correlated well with predicted outcome. Factors most predictive of relative risk of death in a multivariate analysis were dyspnoea, decubitus ulcers, predicted outcome, interventions and a diagnosis of lung cancer. When symptoms alone were analysed, dyspnoea and immobility carried the highest relative risk of death.
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PMID:Prediction of survival in a hospital-based continuing care unit. 751 31

In the period from 1983-1991 133 patients (102 men, 31 women) with lung cancer were treated in our pain clinic for 8083 days. Pain was associated with tumour infiltration in 86% of patients and related to therapy in 15%. Even in 6 of 8 patients who were admitted with a diagnosis of "postthoracotomy syndrome" and in all 4 patients with "postradiation syndrome" local recurrence was diagnosed during follow-up. All 17 cases of brachial plexus lesions were caused by local tumour spread. Symptomatic treatment according to WHO guidelines resulted in good pain relief in 92% of patients and on 82% of days. The incidence of dyspnea decreased from 51% of the patients to 16%. Strong opioids were used on 56% of treatment days. Parenteral or spinal administration of opioids was necessary on 3% of days only.
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PMID:[Pain assessment and therapy in bronchial carcinoma]. 752 65

We present a case study of 34 years old female patient who had intractable pain in terminal stage of lung cancer. She complained severe persistent shooting pain in left lateral pectoral region, where was a wound of thoracotomy. She was given several analgesics orally in order of their efficacy, but could not get sufficient pain relief. From the nature of the pain that she had, neurological findings, and the result of thermography examination, we decided that the pain was associated with the failure of sympathetic nervous system. Then, she was admitted to our hospital and received the thoracic epidural block after epidural catheterization. But she could not get continuous pain relief. For the purpose of her return to the home therapy, we tried to administer MS Contin to her. Subsequently, she took a turn for the worse and died due to respiratory dysfunction in our hospital in the middle of her pain treatment.
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PMID:[Home therapy approach in cancer patients--pain control (case 3-1)]. 752 93

The present experimental study shows that anticancer agents may accumulate around electrodes placed in saline and in lung when the electrodes are charged with direct electric current. We also observed that electrochemical therapy (ECT) in combination with chemotherapy was more effective for treatment of localized tumours (human lung cancer PC-13 transplated to nude mice) than was ECT or systemic chemotherapy alone. In a clinical study, 26 patients (27 lesions) received ECT with or without systemic chemotherapy. We observed a decrease in tumour size in more than 70% of the cases, and in two cases the use of ECT alone resulted in complete regression of the tumour. In one case there was an increase in tumour size. The main side-effects observed during treatment of lung cancer was pain during treatment, fever after treatment, and pneumothorax. We conclude that ECT may be effective in controlling localised tumours. The clinical use of ECT is, however, associated with several problems and the mechanism of this treatment has not yet been completely established.
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PMID:Clinical and experimental studies of anti-tumoural effects of electrochemical therapy (ECT) alone or in combination with chemotherapy. 753 Oct 23

Sixty consecutive lung cancer patients referred to a palliative care service were followed until death to obtain specific information about the prevalence, characteristics and localization of pain. To determine the course of treatment, an Opioid Escalation Index and Effective Analgesic Score were calculated. The prevalence of pain was almost 90%. Chest and lumbar pain were the most common sites with a clear correlation between site and metastases for the chest. Somatic incident pain did not achieve good pain relief while patients with neuropathic pain did not show any particular disadvantage compared to those exhibiting somatic or visceral pain. Mean Opioid Escalation Index and percentage of pain control observed in lung cancer patients were similar to those recorded in the general cancer population.
Pain 1994 Oct
PMID:Pain characteristics of advanced lung cancer patients referred to a palliative care service. 753 37

In April 1988 the Christie Hospital started using the microSelectron-HDR machine to deliver intraluminal radiotherapy (ILT) to inoperable bronchial carcinomas causing symptoms due to endobronchial disease. Results of treatment in the first 406 patients with primary non-small-cell carcinoma are presented. Three main categories of patient were defined. Category 1 consisted of 324 patients (79.8%) who were previously unirradiated and received a single fraction of ILT as their primary treatment, mostly to a dose of 1500 cGy (76%) or 2000 cGy (23%) at 1 cm from the centre of the iridium-192 treatment source. The percentage of these patients whose symptoms or signs were improved at 6 weeks following ILT were as follows: stridor 92%, haemoptysis 88%, cough 62%, dyspnoea, 60%, pain, 50% and pulmonary collapse, 46%. Approximately two-thirds of these patients (67.3%) derived long lasting palliation and required no further treatment during their lifetime. The other third of patients needed subsequent treatment at some stage because of recurrence of their symptoms and in this situation external beam radiotherapy (EB) or a repeat ILT treatment was effectively utilised. Category 2 consisted of 65 patients (16%) who had previously received EB but required ILT when their tumour recurred. At 6 weeks post-ILT levels of symptom palliation were broadly similar to those obtained if ILT was used in previously unirradiated individuals, although the improvement was not so well sustained with time and only 7% showed improvement in pulmonary collapse at 6 weeks. Category 3 consisted of 17 patients (4.2%) in whom ILT was used concurrently with EB as a combined initial treatment. Similar levels of palliation were seen when compared with patients who received a single ILT treatment only. Overall, ILT was well tolerated in terms of early and late morbidity. In conclusion, the efficiency of a single ILT treatment in palliating symptoms due to endobronchial tumour in previously unirradiated individuals is comparable with that reported in series where treatment for advanced lung cancer combines a prolonged course of EB concurrently with several ILT treatments.
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PMID:High dose rate intraluminal radiotherapy for carcinoma of the bronchus: outcome of treatment of 406 patients. 753 4

We investigated the validity and reliability of QOL questionnaire for lung cancer patients in palliative therapy. The questionnaire covered twelve items: appetite, feelings, sleep, mental and physical fatigue, pain, anxiety, daily activity, abdominal and respiratory conditions, linear and face scales. The data were collected from 65 patients and analyzed with principal component analysis and correlation analysis. 1) The percentage of complete answers was 81.5%. 2) Appetite, feelings, sleep, mental fatigue, anxiety and mental scale, pain, respiratory condition, abdominal condition, physical fatigue and physical scale, and satisfied internal consistency. 3) The test-retest reliability was satisfied 4) The inquiry items were grouped into physical, mental and activity scales, and these scales belonged to different dimension. 5) There were correlations between a linear scale, face scale, total score and items. 6) In concurrent validity, there were correlations between performance status and the activity scale, SDS, STAI and the mental scale. 7) In sensitivity, the total score and face score were worst within one week after chemotherapy, and then recovered. This questionnaire was indeed valid and reliable for use as a QOL questionnaire for lung cancer patients in palliative therapy.
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PMID:[Development of quality of life (QOL) questionnaire for use of lung cancer patients in palliative therapy--study of validity and reliability. No.1]. 754 Aug 25

The effects of cisplatin and carboplatin in QOL were studied using a QOL questionnaire seeking to conform their validity and reliability in lung cancer patients. The questionnaire was composed of eleven items; appetite, feeling, sleep, mental fatigue, pain, anxiety, daily activity, abdominal and respiratory conditions, linear analog and face scale as global scale. The data were collected from 21 patients treated with cisplatin (Cis group) and 9 patients administered carboplatin (Carbo group). Chronological changes of QOL were measured by AUC (area under the curve) method. 1) The total score of 9 items, linear analog and face scales rose immediately to the highest levels (worse) after treatment and maintained this level for 1 week in the Cis group. The Carbo group levels rose from 3 days and returned to the control level at 9 days after treatment. 2) AUC of the total score, linear analog and face scales in the Cis group increased significantly when compared with those of the Carbo group. 3) When compared with the Cis and Carbo groups the physiological and active scales were not different, but the psychological scale showed a significant difference between the two groups. 4) The total score of the psychological scale correlated the abdominal score in the Cis group, but not in the Carbo group. 5) Sleep and mental fatigue were related to the aggravation of QOL at 5-6 days after Carboplatin treatment. These results suggested that this QOL questionnaire had sufficient sensitivity to reflect any chemotherapeutic side-effects. 6) AUC is useful method in chronological evaluation of QOL.
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PMID:[Development of quality of life (QOL) questionnaire for use of lung cancer patients in palliative therapy--study of validity and reliability no. 2, the effects of chemotherapeutics in QOL]. 754 77


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