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

Levels of symptom distress are most often measured in a clinical trial context rather than in general ambulatory populations. The purpose of this paper is to report levels of symptom distress in such a population, and to describe the factors associated with this distress. Over a 6-month period, a consecutive sample of 434 newly diagnosed patients, including 82 patients with lung cancer, were tested with the symptom distress scale at two tertiary oncology clinics serving the population of one Canadian prairie province. While levels of symptom distress in this population were generally low, the most problematic symptoms for patients were fatigue and insomnia, with 40% and 30% having moderate or high scores on these symptoms, respectively. Patients with advanced disease reported more distress than those with early stage disease; women reported more distress than men; older patients had less distress than younger patients; distress was highest in lung cancer patients and lowest in men with genitourinary cancers. Consistent with the findings of four previous studies, the single measure of symptom distress was a significant predictor of survival in lung cancer patients, with the exception of three patients who had substantial post-thoracotomy symptoms.
J Pain Symptom Manage 1995 Aug
PMID:Symptom distress in newly diagnosed ambulatory cancer patients and as a predictor of survival in lung cancer. 756 Dec 24

This article reports the author's experience with the surgical treatment of metastatic lung cancer to the thoracic spine. A 65-year-old woman (case 1) had undergone a right upper lobectomy with a diagnosis of adenocarcinoma. Three years later, she complained of severe back pain, and visited our hospital. CT scan showed a metastatic spine disease (Th6 and 7) which caused the back pain. A 59-year-old woman (case 27 was admitted to our hospital complaining of an abrupt onset of paraplegia. Two years ago, she underwent left upper lobectomy with a diagnosis of adenocarcinoma. Urgent examination revealed a large metastatic lesion on Th5 and 6 which compressed the spinal cord. After excision of the tumor as extensively as possible, the both patients underwent surgical decompression of the spinal cord, bone grafting and posterior reconstruction of the spine with a metallic instrumentation. Severe back pain was relieved postoperatively. Improvement of neurological deficit was dramatic in case 2. The goal of surgical treatment of metastatic thoracic spine disease is to improve the quality of the remaining life, by relief of pain and preservation or restoration of neurologic function. The dismal consequences of prolonged bed rest, paraplegia, and a painful premature death can be avoided with thoughtful and timely surgical treatment.
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PMID:[Surgical treatment of metastatic lung cancer to thoracic supine]. 760 2

We established a thoracotomy method in which visual observation and a thoracoscope are used in combination. This method requires only small dermal incision--a three-cm-long posterior and two-cm-long anterior incision--in the fourth intercostal space around the angulus inferior scapulae. Using this method, we performed lobectomy and mediastinal lymph node dissection on 20 lung cancer cases (preoperatively diagnosed as stage I, T1N0M0 cases). Because the conventional thoracoscopic surgery relies strictly on two-dimensional images obtained from a thoracoscope, stereoscopic information on the location of the operation could not be obtained. Our new method, however, in corporates both a direct view obtained from two small incisions and a view on a video monitor, so the surgeon has constant access to a stereoscopic information on the location of the operation. We found that this thoracotomy using a thoracoscope was not only very useful in terms of respiratory function, the alleviation of pain, and aesthetic appearance, but that it also reduced hemorrhaging during surgery, decreased the length of time required for the thoracotomy and suturing, and enabled mediastinal dissection equal to that of standard thoracotomy.
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PMID:[Video assisted lung resection and mediastinal lymph nodes dissection for lung cancer: small incisions for 4th intercostal space]. 763 18

Central to risk assessment for lung resection is the fact that surgery offers the only chance of long-term survival and cure in non-small carcinoma of the lung. The challenge is, therefore, to offer surgery to as many patients as possible, whilst avoiding the risk of death from postoperative respiratory failure. Risk assessment is based on careful evaluation of the patient's existing cardiac and respiratory disease. The use of a cardiac risk index, such as that described by Detsky, will ensure that cardiac risk factors are recognised and, where possible, ameliorated prior to surgery. Pre-existing respiratory disease may be assessed by arterial blood gas analysis, exercise testing, whole and regional lung function tests. Criteria based on these tests have been proposed to aid patient selection prior to lung resection. However, these criteria take no account of the beneficial influence on outcome of modern anaesthesia and postoperative care. The elimination of postoperative pain, along with techniques such as minitracheostomy and incentive spirometry have allowed surgery to be offered to many patients who would have been deemed unsuitable by standard criteria. Patients with potentially resectable lung cancer must never be arbitrarily excluded from surgery on the basis of any single criteria or test. Referral for assessment by an experienced team consisting of a thoracic physician, surgeon and anaesthetist will maximise the number of patients offered surgery for this otherwise incurable disease.
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PMID:Is this patient fit for thoracotomy and resection of lung tissue? 764 93

We report a 74-year-old man with a lung cancer, who developed right leg weakness, neurogenic bladder, and multiple cranial nerve palsies. The patient was well until December of 1992, when he was 74-year-old, when he noted transient double vision; in February of 1993, he noted numb sensation and weakness in his right leg. Later in the same month, he developed overflow incontinence of urine and weakness in his right face. He also noted deafness in his left ear (he had a marked loss of hearing in his right ear since childhood because of otitis media). His weakness in his right leg had progressed, and he was admitted to our service on March 19, 1993. On admission, he was afebrile and BP was 130/50 mmHg. General physical examination was unremarkable. On neurologic examination, he was alert and oriented to all spheres; no dementia was noted nor were detected aphasia, apraxia, and agnosia. His optic fundi were unremarkable; ocular movement appeared normal, however, he complained of diplopia in far vision. Sensation of the face was intact. He had right facial palsy of peripheral type; he was unable to close his right eye, and Bell's phenomenon was observed on attempted eye closure. On the left side, he had facial spasm. He had marked bilateral deafness. He had no dysarthria or dysphagia. The remaining of the cranial nerves were intact. Motor wise, he was unable to stand or walk alone; weakness did not appear to account for his difficulty in gait; manual muscle testing revealed 4/5 weakness in his tibialis anterior muscle, 1/5 in the peroneus longus, 0/5 in his extensor hallucis longus and extensor digitorum longus, all on the right side. Brachioradial and quadriceps femoris reflexes were increased to 3/4; plantar response was equivocal on the right side, and flexor on the left. Sensory examination revealed loss of touch and pain sensation in the L5 and S1 distributions in his right leg: vibration and position sensations were also diminished in his right foot. He had overflow urinary incontinence with loss of bladder sensation. Marked nuchal stiffness was noted, however, no Kernig's sign or eye ball tenderness was present. Pertinent laboratory findings were as allows; WBC 8,100/microliters, Ht 42.5%, platelet 326,000/microliters, TP 6.8 g/dl, BUN 16 mg/dl, creatinine 0.54 mg/dl, glucose 95 mg/dl, Na 136 mEq/l, K 4.4 mEq/l, Cl 100 mEq/l; liver profile was normal; CEA 436.6 ng/ml, CA19-93 U/ml; urinalysis was normal.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[A 74-year-old man with urinary incontinence, right leg weakness and multiple cranial nerve palsies]. 766 22

The role of palliative irradiation was analysed in 55 patients with liver metastases from colorectal (n = 35), breast (n = 10) and lung cancer (n = 10), treated between January 1982 and June 1992 with irradiation doses more than 10 Gy. In 47 patients irradiation alone was done. The great majority of patients were treated because of pain (n = 21) or cholestasis (n = 22). In 29 patients the disease involved not only the liver, but was disseminated. A mean dose of 23.8 Gy was delivered, with daily fractions of 1.5 (n = 30), 1.8 (n = 1) or 2 Gy (n = 16). Complete and near complete pain relief was obtained in six (28.6%) and nine (42.9%) patients. Normalized and near normalized values of bilirubin serum levels were obtained in five (22.7%) and seven (31.9%) patients. As well relief of pain as normalisation of cholestasis were significantly correlated with the irradiation doses applied. Median survival was 36.5 days for patients with lung cancer, 70.5 and 73 days for patients with breast and colorectal cancer. Irradiation doses given (10 to 18 Gy vs. 19 to 28 Gy vs. 29 to 48 Gy) and the status of disease (liver only vs. disseminated) were significantly correlated to prognosis (p = 0.00001, p = 0.0007). Patients of the high-dose group or patients with liver metastases alone revealed a median survival of 174 or 175 days. Since May 1991 simultaneous radio-chemotherapy, with the systemic application of leukovorine and 5-FU, was performed in eight patients with colorectal cancer. After performing a three-dimensional radiotherapy planning, which enclosed the whole liver inside the target volume, a mean dose of 29.4 Gy, with daily single fractions of 1.5 Gy was delivered. The follow-up, done with CT or NMR revealed in seven patients a progression free interval of three to 8.5 (5.5) months. After a median follow-up of 221 days the median survival was 333 days. In the treatment of patients with liver metastases a clear therapeutic selection has to be done according to valid prognostic criteria. In the majority of our patients with clinical symptoms, i.e. pain or cholestasis, irradiation alone was sufficient for palliation of these symptoms. Prognosis is limited because of the disseminated state of disease in 62% of the patients. In a group of patients, suffering from colorectal cancer with good prognostic criteria, the simultaneous application of radiotherapy and systemic chemotherapy was able to increase significantly the survival with minor toxicity.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[The value of radiotherapy for liver metastases]. 768 54

Among 808 surgically resected lung cancer cases at Shanghai Chest Hospital during the period of January 1991 to December 1992, 140 of them (17.3%) underwent pneumonectomy (47 right, 93 left). In the 140 cases: 124 male, 16 female; aged 27-74 yrs, pre-operative abnormal EKG was found in 38 cases. Postoperatively, arrhythmia occurred in 76 cases, with an incidence of 54.3%. Of the 76 arrhythmias, atrial fibrillation was seen in 7 patients, atrial premature beats in 2, supraventricular tachycardia in 1 and sinus tachycardia in 66. The results indicate that cardiac arrhythmia is a common complication after pneumonectomy for lung cancer surgery. The major causes of arrhythmia were incisional pain, hypovolemia due to blood loss and respiratory insufficiency due to anoxia. The perioperative measures to prevent arrhythmia were discussed.
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PMID:[Cardiac arrhythmia after lung cancer surgery--an analysis of 140 pneumonectomy cases]. 772 Apr 99

We report two cases of a pain syndrome caused by large adrenal metastases in patients with lung cancer. A review of the literature identified 23 previously reported patients with primary lung cancers who appear to have had a similar syndrome, although in none of these cases were other likely causes of the pain syndrome carefully excluded. The syndrome characteristically includes unilateral flank pain but may have abdominal components as well, and has only been reported in patients with large metastases (> or = 5 cm in largest diameter). Although the mechanism by which large adrenal metastases cause the pain syndrome is not clear, we suggest that treatment that includes local anesthetic agents or steroids may be effective. The pain syndrome caused by large adrenal metastases is not included in reviews of cancer pain syndromes but needs to be considered in the differential diagnosis of patients with lung cancer and flank or abdominal pain.
J Pain Symptom Manage 1995 Feb
PMID:A pain syndrome associated with large adrenal metastases in patients with lung cancer. 773 Jun 88

We report a case of T1N0M0 lung cancer in which we successfully performed video-assisted right lower lobectomy and mediastinal lymph node dissection. The lobectomy was done on a 64-year-old woman who had a 2-cm adenocarcinoma in the right lower lobe. The procedure could be done safely and adequately using three trocars and a 5-cm mini-thoracotomy. The patient had an uncomplicated postoperative course and was satisfied with minimal postoperative pain, quick recovery, and minute skin scars. Video-assisted lobectomy may be a reasonable approach in selected patients of primary lung carcinoma.
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PMID:Video-assisted right lower lobectomy for a lung cancer with mini-thoracotomy. 773 42

Video-assisted thoracic surgery has been adopted by some thoracic surgeons as the preferred approach over thoracotomy for many benign and malignant diseases of the chest. However, little concrete evidence exists to support this technique as the superior approach. This randomized study was carried out to define the advantages of video-assisted lobectomy over muscle-sparing thoracotomy and lobectomy. Sixty-one patients with presumed clinical stage I non-small-cell lung cancer were entered into the study. Each patient was randomized to muscle-sparing thoracotomy and lobectomy or video-assisted lobectomy. Six patients were excluded from the study either because final pathologic results revealed nonmalignant disease (3 patients) or because an attempted video-assisted lobectomy was converted to a thoracotomy. This left 30 patients in the thoracotomy group and 25 patients in the video-assisted group. No significant differences existed between the two groups in operating time, intraoperative blood loss, duration of chest tube drainage, or length of hospital stay. Significantly more postoperative complications occurred in the thoracotomy group (p < 0.5), the majority of which were prolonged air leaks. Return to work time was not an issue because the majority of the patients were either retired or not working at the time of the operation. Only three patients had persistent postthoracotomy pain (thoracotomy, n = 2; video-assisted lobectomy, n = 1). We conclude that video-assisted lobectomy was not associated with a significant decrease in duration of chest tube drainage, length of hospital stay, postthoracotomy pain, or, in this group of patients, a faster recovery time and return to work. Video-assisted lobectomy continues to expose the patient to the risk of a major pulmonary resection being done in an essentially closed chest. These results illustrate the need for critical evaluation of video-assisted thoracic surgery before the procedure is accepted as a superior approach based on presumed and thus far unproved advantages.
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PMID:Lobectomy--video-assisted thoracic surgery versus muscle-sparing thoracotomy. A randomized trial. 773 62


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