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

Sixty patients suspected of having lung cancer were evaluated for bone metastasis by means of technetium 99m stannous-polyphosphate bone scanning and correlative radiographic bone survey. Diagnosis of lung cancer was histologically proved in all patients. Scans demonstrated evidence of bone metastasis in 20 patients (33.4%) and radiographs, in 10 patients (16.6%). Twenty-four patients had repeat skeletal evaluation at one to eleven months after the first study. Of these patients, 7 initially demonstrating both negative scans and radiographs showed abnormal scans within five months. Bone scans correlated with radiographs in 53.3% and with accompanying bone pain in 33.3% of patients. False negative and false equivocal results were noted in 4 patients. This study suggests that bone scanning with 99mTc stannous-polyphosphate detected early bone metastasis in patients with lung cancer before these lesions became evident clinically or radiographically. Bone scanning is of value during the initial evaluation to determine operability in patients with lung cancer.
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PMID:Bone scanning in the evaluation of patients with lung cancer. 45 97

From May 1986 until July 1987, oral morphine hydrochloride in water solution was used in terminal patients, under a strict protocol of administration, and complying with the basic principles of Palliative Care. A retrospective study was carried out on the 40 patients who had received the drug for more than three consecutive days. As shown in Table 1, the average age of the treated patients was 70 years. The ambulatory patients represented 27.5% of the sample. The average initial dose was 60 mg, and the average maintenance dose was 120 mg. The median treatment time was 45 days. "Good" results were achieved in 85% of the patients, and "fairly good" in the remainder ("good" results were defined as "satisfactory symptom control, good life quality"--in this group there were some patients who obtained total suppression of the symptoms and optimal life-quality, i.e. "excellent" results; "bad" results were defined as "total absence of therapeutic effect"; and "fairly good" results, the intermediate cases). The more frequently treated symptoms were: 67.5%, pain due to tumor mass; and 20%, pain due to nerve compression-invasion, bone pain, and dyspnoea due to pulmonary metastases or primary lung cancer: total symptoms was more than a hundred per cent, because a number of patients had more than one symptom. Whenever necessary, adjuvant drugs were employed. Side effects were seen in 37% of the patients (specially nausea, vomiting, constipation, and somnolence for more than four days).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Oral morphine in the treatment of patients with terminal disease]. 213 Feb 44

In summary, carcinoma is the most frequent cancer that metastasizes to the skin; lung cancer in men and breast cancer in women. Clinically distinctive patterns of cutaneous metastasis of epithelial origin include alopecia neoplastica, pulsatile nodules, Sister Mary Joseph's nodules, morpheaform, and cellulitis-like lesions. Biopsying these lesions reveals adenocarcinoma, squamous cell carcinoma, or anaplastic carcinoma. The type of histologic pattern seen can be a clue to the organ of origin giving rise to the cutaneous metastasis. Skin that is damaged allows for circulating malignant cells, often of epithelial or leukemic origin, to lodge and proliferate locally (inflammatory oncotaxis). The commonest form of leukemia to affect the skin of elderly males is chronic lymphocytic leukemia. However, when leukemia involves the mucous membranes, acute myeloid leukemia (acute monocytic and acute myelomonocytic leukemia) is the most likely diagnosis. When papules, nodules, or plaques develop on the head, neck, or torso in a middle-aged male accompanied by lymphadenopathy, there must be a high index of suspicion that these lesions are metastatic lymphomatous deposits. Definitive histologic diagnosis on a skin biopsy specimen is difficult. In this situation, it is best to rely on histologic patterns seen in lymphoid tissue along with cellular marker studies. An elderly patient having bone pain, anemia, elevated blood calcium level, and renal failure along with purplish or skin-colored nodules and plaques on the trunk has a good chance of having multiple myeloma. Biopsying these lesions is most certain to reveal atypical plasma cells, and blood immunoelectrophoresis will demonstrate characteristic monoclonal gammopathy. There are two malignancies seen in children under 3 years of age that often times affect the skin in a characteristic fashion. Letterer-Siwe disease, which is distinguished from other histocytic disorders by its cell of origin, the Langerhans cell, clinically shows maculopapular and erosive lesions distributed in a seborrheic pattern. Neuroblastoma derived from cells of the neural crest demonstrates clinically widespread bluish papulonodules. Kaposi's sarcoma, a multifocal vascular malignancy, has a wide spectrum of clinical expression. Those patients who are immunocompromised secondary to concomitant disease or immunosuppressive therapy are more susceptible to a disseminated fulminant course accompanied by opportunistic infection. In conclusion, although specific signs of internal malignancy are less common than nonspecific ones, they are just as important; if the clinician managing the cancer patient is familiar with these clues to internal disease, proper patient management will ensue.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Specific cutaneous manifestations of internal malignancy. 307 47

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

Filgrastim, a recombinant human granulocyte colony-stimulating factor (G-CSF), has identical biological activity to that of endogenous human G-CSF, but differs in that it contains an N-terminal methionine residue and is not glycosylated. It principally stimulates activation, proliferation and differentiation of neutrophil progenitor cells and has been evaluated in the treatment of patients with various neutropenic conditions, both iatrogenic and disease-related. Two comparative studies have demonstrated that prophylactic administration of filgrastim 230 micrograms/m2/day significantly reduces the incidence, duration and severity of neutropenia in patients with previously untreated small-cell lung cancer receiving standard-dose chemotherapy with CDE (cyclophosphamide, doxorubicin plus etoposide). Concomitant with the amelioration of neutropenia, the incidence of febrile neutropenia was significantly reduced by 50% and there were 35 and 50% decreases in hospitalisation rates and intravenous antibiotic requirements. Since not all patients receiving standard-dose chemotherapy are at risk of infectious complications, prophylactic filgrastim use may be reserved for those patients who have developed febrile neutropenia during a previous cycle of the same regimen. This strategy may prove less costly, although potential savings must be weighed against a greater risk of patient morbidity and reduced quality of life. When combined with standard intravenous antibiotic therapy, filgrastim further decreases morbidity in patients with established febrile neutropenia and may have a positive impact on overall treatment costs by shortening the length of hospitalisation. Attention is focused on the use of haematopoietic growth factors to support dose-intensification of chemotherapy with a view to improving treatment outcomes in patients with chemo-responsive tumours. Filgrastim, used alone, permits modest increases in dose-intensity and/or dose-escalation of some standard-dose chemotherapy regimens. Moreover, the drug has proven useful as an adjunct to myeloablative chemotherapy followed by stem cell rescue with autologous bone marrow transplantation and/or peripheral blood progenitor cells. However, the impact of these dose-intensification approaches on survival remains to be determined in well-controlled clinical studies. Filgrastim is effective in increasing the neutrophil count and decreasing morbidity in patients with severe chronic neutropenia, including Kostmann's syndrome, and in idiopathic and cyclic neutropenia. In addition, filgrastim has accelerated neutrophil recovery in patients with idiosyncratic drug-induced agranulocytosis. Available data indicate that filgrastim is generally well tolerated. The most frequent adverse reaction is mild to moderate medullary bone pain, reported by approximately 20% of patients, although this can generally be controlled using simple analgesics without the need to discontinue treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Filgrastim. A review of its pharmacological properties and therapeutic efficacy in neutropenia. 753 Jun 30

CDDP and 5-FU are time dependent drugs and their increasing effect is expected because of the dual chemical modulation. The low dose continuous infusion of CDDP and 5-FU was applied to the terminal adenocarcinoma patients with the metastatic lesions. One patient was 42 years old lung cancer patient with the metastatic lesions in the liver, the bone, the pericardial space, the underskin, the muscles and the lymph nodes (stage IV). The another patient was 61 years old rectum cancer patient with lung and hepatic metastasis (stage V). Both patients were directly informed of the true name of the disease and the poor curability from the physician in charge. The physician promised them to take the home therapy as much as possible in order to pursuit their own life value at home. The lung cancer patient got the radiotherapy first to remove the bone pain and the rectum cancer patient was operated to make the stoma to avoid the obstructive ileus beforehand. After the therapy, two patients took the low dose continuous infusion of CDDP and 5-FU. In both cases, the abdominal symptoms such as nausea and vomiting due to the therapy were not recognized and the hematopoietic disorders and the renal failure were slight, so they could get the therapy continuously for very long. The lung cancer patient lived 9 months after the diagnosis and the low dose infusion chemotherapy has continued for 7 months, the home stay for 4 months. The rectum cancer patient lived 13 months and the same chemotherapy has continued for 12.5 months, the home stay for 7.5 months. The low dose continuous infusion therapy of CDDP and 5-FU is an effective treatment for terminal cancer patients as one of the home therapies from the point of the QOL (quality of life).
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PMID:[Low-dose continuous infusion therapy 5-FU and CDDP enabled terminal patients with lung and rectal cancer to remain at home]. 780 48

The most commonly used radionuclides for cancer patients in Japan have been still 67Ga and 201T1 chloride. In addition to the diagnosis of lung cancer and thyroid tumor, 201T1 is recently applied to patients with brain tumor, bone and soft tissue tumor and parathynoid adenoma. Comparing to Nuclear Cardiology and Brain Nuclear Medicine, where many new radiopharmaceuticals have been developed, there are few new drugs in Nuclear Oncology. In other words, new radiopharmaceuticals are expected to be developed for the diagnosis and/or therapy of cancer. In addition to 131I for thyroid cancer, new radiopharmaceuticals such as 111In-octreotide and 99mTc(V)-DMSA have been clinically employed. In spite of strong expectation, radiolabeled monoclonal antibodies have not been clinically used in Japan. However, the technique of humanized antibodies has been established and in U.S.A., 131I-labeled antibodies are reported to be effective for the treatment of malignant lymphoma. 89Sr is useful for the relief of bone pain caused by the bone metastasis. New findings that SPECT of 18F-FDG, a positron emitter, has been revealed to have a great potential in the management of cancer patients, will give a great impact on Nuclear Oncology.
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PMID:[Current status of nuclear oncology in Japan]. 852 36

Approximately one half of prescribed radiotherapy is given for palliation of symptoms due to incurable cancer. Distressing symptoms including pain, bleeding, and obstruction can often be relieved with minimal toxic effects. Painful osseous metastasis is common in oncologic practice. Ninety percent of patients with symptomatic bone metastases obtain some pain relief with a lowdose, brief course of palliative radiotherapy. One half of the responding patients may experience complete pain relief. A single dose of 800 cGy in the setting of painful bone metastasis may provide pain control comparable to more protracted treatment at a higher dose of radiation. Patients with lytic disease in weight-bearing bones, particularly in the presence of cortical destruction, should be considered for prophylactic surgical stabilization of their condition. Routinely a brief, fractionated course of radiotherapy is given postoperatively. Pain due to multiple bone metastases uncontrolled by analgesics can be managed with single doses of halfbody irradiation. Doses of 600 cGy delivered to the upper half-body (above the umbilicus) and 800 cGy to the lower half-body (from the umbilicus to the middle of the femur) will provide some pain relief in 73% of patients. Half-body techniques have been investigated as prophylactic treatment, as a complement to local-field irradiation, and as fractionated rather than singledose therapy. Although intravenous administration of strontium 89 has been associated with myelosuppression, this treatment has been shown (a) to relieve pain due to bone metastasis and (b) to delay development of new painful sites. Recent data from phase III trials demonstrated that bisphosphonates have a role in reducing skeletal morbidity due to bone metastasis. Bone pain was reduced, and the incidence of pathologic fracture and the need for future radiotherapy was decreased. Radiotherapy relieves clinical symptoms in 70% to 90% of patients with brain metastases. Brief treatment schedules (e.g., 2000 cGy in five fractions over 1 week) are as effective as more prolonged therapy. Patients with solitary brain metastasis and no extracranial disease or controlled extracranial disease should be considered for surgical resection, because phase III data indicate enhanced survival with such an approach. Whole-brain radiotherapy is routinely administered postoperatively. A phase III study is examining the impact of accelerated fractionated doses of radiotherapy (two treatments per day) on survival of patients with brain metastases. Stereotaxic radiosurgical treatment is becoming increasingly available and permits delivery of radiation to metastatic intracranial tumor with minimal exposure of normal surrounding brain This treatment is most commonly used at the time of a solitary recurrence of disease in patients who previously received whole-brain radiotherapy. A role for this modality in newly diagnosed brain metastases remains to be defined. Chest symptoms are common in patients with locally advanced lung cancer and are effectively palliated with one 1000 cGy or two 850 cGy one fraction doses of radiation to the thoracic inlet and mediastinum. Chest pain and hemoptysis are more effectively palliated than cough and dyspnea. In patients with stage III cancer there is no compelling evidence that radiotherapy confers a survival advantage, and it may be reasonable to administer thoracic radiotherapy only when the patient has significant symptoms and the goal is to achieve control of these symptoms. Approximately 75% of the cases of superior vena cava syndrome are due to lung cancer, and small-cell lung cancer is the most common histologic type. A histologic diagnosis should be obtained before treatment is started, because detection of lymphoma or small-cell carcinoma would necessitate systemic therapy. Eighty percent of the patients with vena cava syndrome due to malignant disease achieve symptom relief with a brief, fractionated, palliative course of rad
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PMID:Radiotherapy for palliation of symptoms in incurable cancer. 920 88

The bone-seeking radiopharmaceutical Sr-89 has been used as a palliative treatment for patients with bone pain caused by bone metastases. The authors report the results of nine patients (three with prostate cancer, four with breast cancer, one with thyroid cancer, and one with lung cancer) who underwent therapy with Sr-89 chloride for painful bone metastases, and evaluate Sr-89 imaging with bremsstrahlung. Two levels of dosage (1.5 and 2.2 MBq/kg) were used. Sr-89 imaging was performed in seven patients 1 week after injection. Abnormal uptake was seen in all and was consistent with the results of Tc-99m HMDP imaging. Six patients were assessed at 3 months and three patients toward the time they were terminal; 78% (seven of nine) derived some benefit. Two patients had a favorable clinical response and showed improvement on Tc-99m HMDP imaging.
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PMID:Strontium-89 therapy and imaging with bremsstrahlung in bone metastases. 929 93

Cancer commonly metastasizes to bone and up to 80% of breast, prostate, and lung cancer patients will have bone metastases. The site and distribution of bone metastases, and the presence of skeletal complications such as pathologic fracture and spinal cord compression affect the patient's prognosis. In many cases, bone metastases are too advanced to be eliminated through chemotherapy or radiotherapy; in these cases, treatment is given to relieve or prevent further symptoms. Several treatments are used in palliative care, including radiation therapy, systemic radiopharmaceuticals, chemotherapy, hormone therapy, and bisphosphonates. Radiotherapy remains the treatment of choice, and radiation treatment given in a single fraction has proven to be an efficient and cost-effective alternative to traditional multifraction radiotherapy courses. Analgesics are important in palliative therapy because they relieve pain while administering and awaiting the relief of pain from treatment. Furthermore, analgesics will relieve persistent levels of pain if complete pain relief is not achieved with therapy. Currently, bone pain is not adequately treated by many physicians and up to 79% of patients experience severe pain in the period before palliative therapy.
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PMID:Bone metastases: approaches to management. 1154 73


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