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

The best treatment for inoperable "non small cell" lung cancer remains unknown. While metastatic patients are usually treated palliatively, the therapeutic course for locally advanced disease is less clear cut and more controversial. The common habit was been to treat these patients only when disturbing symptoms are present. But this is now changing, because defined radiotherapy techniques and combinations with chemotherapy and/or radiosensitizers produce better results. Also, in palliative treatments new dose-fractionalised schemes are being sought, with the aim of less discomfort and better efficacy. Two clinical trials are presented. The first is a palliative, 10 Gy single-dose treatment of 17 patients with chest symptoms. Results have been encouraging: 67% symptoms palliated at 1 month from treatment. Palliation was however short: 42% at 2 months, 32% at 3 months. The low incidence and mildness of acute complications in this small number of patients permit us to conclude that the treatment is feasible and tolerable; short-lived palliation could be used in patients with a short life expectancy. In the second study, was a multimodality treatment-polychemotherapy (Cisplatin 100 mg/mq days 1, 22 and Vinblastine 5 mg/mq days 1, 8, 15, 22) followed by radiotherapy (60 Gy/30 fractions/42 days) with Cisplatin (5 mg/mq/d) as a radiosensitizer. 15 patients have been recruited, but only 7 could be evaluated. 5/7 objective responses were observed (3 complete). Whole acute toxicity is acceptable. The lack of data concerning late toxicity does not allow conclusions about the feasibility of this therapeutic.
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PMID:[Locally advanced non-small cell lung tumors: curative or palliative radiotherapy]. 896 97

Lesbians may engage in behavior that places their health at risk and may delay health care and screening more than do their heterosexual counterparts. This article examines influences on lesbians' health risk factors and health-seeking behaviors. A statewide, self-administered survey of members of a lesbian community organization was performed. Univariate and bivariate analyses were calculated, and linear regression was used to examine models of health risks and health-seeking behavior. Of 324 respondents, 90% had disclosed sexual orientation to at least one provider, 22% reported seeking care without symptoms (preventive care), and 23% reported waiting until symptoms are at their worst or never seeking care. Young age, belief in the importance of lung cancer, difficulty of getting health care when needed, reliance on the partner for health support, and fewer male partners were all associated with greater health risk for lesbians. Difficulty obtaining health care, difficulty communicating with the primary care provider, discomfort in discussing depression, and degree of comfort in discussing menopause were all associated with a delay in seeking health care. Sensitive communication with lesbians and further identification of lesbians' specific barriers to care may improve health-seeking behavior and provide more opportunities for screening and risk factor counseling in this population.
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PMID:Health risk factors and health-seeking behavior in lesbians. 906 79

Part I of this two-part paper employs a comparative design to compare primary family caregivers' assessments of lung cancer patients' symptom distress with patients' own perceptions of symptom distress in the home setting. Part II describes the results of the qualitative component of this research. A convenience sample of 37 patient-family caregiver dyads completed the McCorkle and Young Symptom Distress Scale (SDS). Family caregivers' global scores were moderately correlated with patients' global scores (r = 0.71; P < 0.001). No significant differences in ratings were found for ten of the 13 symptoms assessed. Therefore, when the patient is unable to provide a self-report of symptom distress, health-care professionals may seriously consider family caregivers' assessments of patients' symptom distress to be reasonable estimates for at least ten of the 13 symptoms on the SDS.
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PMID:Perceptions of symptom distress in lung cancer patients: I. Congruence between patients and primary family caregivers. 929

To determine the diagnostic efficacy of thoracoscopic fine-needle aspiration (FNA) of solitary pulmonary nodules suspicious for lung cancer, we performed intraoperative thoracoscopic FNA for diagnostic purposes in 8 consecutive patients with peripheral solitary pulmonary nodules suspicious for lung cancer. Thoracoscopic FNA yielded an accurate diagnosis in all cases. There were 5 cases of non-small cell lung carcinoma, 1 small cell lung carcinoma, 1 renal carcinoma metastasis, and 1 inflammatory nodule. Results of FNA were obtained in less than 10 minutes in 6 cases. Maximum time to diagnosis was 20 minutes. The surgical procedure was expedited in the 6 cases of lung cancer because lobectomy followed FNA rather than the performance of a diagnostic wedge resection. A minor hematoma after FNA was the single complication. Thoracoscopic FNA yielded a prompt and accurate diagnosis of peripheral solitary pulmonary nodules. Thoracoscopic FNA should be considered as an alternative to preoperative percutaneous FNA, which risks pneumothorax and patient discomfort. In cases of lung cancer, thoracoscopic FNA allows the surgeon to bypass a diagnostic wedge resection and to proceed with definitive lobectomy.
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PMID:Thoracoscopic fine-needle aspiration of solitary pulmonary nodules. 935 61

Colorectal cancer is the third most common non-skin malignancy in women, after breast and lung cancer. Although approximately 40% of the 65,000 women diagnosed each year eventually die of the disease, colon cancer is highly curable when diagnosed at an early stage. Moreover, because the majority of colon cancers arise in previously benign colonic polyps, there is a substantial period, up to several years, in which removal of polyps can reduce the risk of colon cancer. Recently, the United States Preventive Task Force recommended universal screening for colon cancer after age 50. Strong evidence from randomized controlled trials and case-control studies supports use of annual testing for occult blood in stool and flexible sigmoidoscopy every 5-7 years. Although the risk of colon cancer is similar in men and women, women frequently have the perception that colorectal cancer is a man's disease. Partially in consequence, women are less likely than men to undergo screening sigmoidoscopy. Further barriers include primary care providers' lack of awareness of updated guidelines and patients' lack of compliance with multiple screening tests and their fear of discomfort. Because the risk of colorectal cancer can be reduced by up to 75% in those who undergo screening and subsequent surveillance to remove further polyps, it is crucial that women be targeted to undergo screening tests for colorectal cancer.
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PMID:Colorectal cancer in women: an underappreciated but preventable risk. 951 Nov 31

Myocardial involvement by malignant neoplasm is rare and often not clinically manifested. The diagnosis is usually made only at autopsy. A 71-year-old man with squamous cell lung cancer presented with chest discomfort. His electrocardiogram was diagnostic of acute myocardial infarction. However, because of the lack of classic symptoms and signs of acute myocardial infarction and normal serum levels of cardiac enzymes, an echocardiography was performed before initiation of thrombolytic therapy. The echocardiography showed a huge hyperechoic mass located in the posterolateral aspect of the left ventricle with myocardium invasion. Thrombolytic therapy was withheld. In patients with lung cancer, an electrocardiogram representative of acute myocardial infarction can rarely be induced by myocardial involvement with lung cancer.
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PMID:Lung cancer mimicking acute myocardial infarction on electrocardiogram. 992 10

Morbidity, mortality and discomfort related to gastrectomy has led some investigators to treat patients with stage I-II primary gastric high-grade lymphoma (PGL) with a conservative strategy. Here we report a retrospective series of 21 patients with PGL treated with primary chemotherapy alone or followed by radiation therapy and analyze previously reported series, focusing on therapeutic results, treatment-related morbidity and stomach preservation rate. All 21 patients with stage I-II PGL received an initial anthracycline-containing chemotherapy, which was followed by involved field-radiation therapy in 8 cases. Data regarding toxicity, response and relapse rates and survival of this patient group and 14 previously published series, involving 316 patients treated with conservative modality, were also analyzed. In the present series two patients did not complete the planned treatment, while the remaining 19 achieved a complete remission (response rate: 90%). Three patients relapsed, all of whom had been treated with chemotherapy alone. Two patients died of lymphoma, one of sepsis and the other of lung cancer while still relapse-free. The survival rate at 50 months is 81%, and the 5-year actuarial cause-specific survival is 82%. The stomach preservation rate is 100%. Previously reported series showed a response rate ranged between 76% and 100%. Gastrointestinal bleeding was observed in only 3% of cases, while no cases of gastric perforation were reported. Treatment mortality rate was 2.5%. 5-year actuarial survival ranged between 73% and 90% and stomach preservation rate was 97%. Short-term chemotherapy obtained similar results to more prolonged treatment. In conclusion, conservative treatment with primary chemotherapy followed by involved field-radiation therapy should be used for the first-line treatment of patients with stage I/II PGL considering that it is associated with a high response and survival rates, and with an insignificant risk of bleeding or perforation, high stomach preservation rate and good quality of life.
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PMID:Non-surgical treatment with primary chemotherapy, with or without radiation therapy, of stage I-II high-grade gastric lymphoma. 1034 80

High dose rate brachytherapy for lung and esophageal cancer is performed by placing a high activity Iridium 192 source into the lumen of the airway of esophagus. Because of the high activity of the source it remains in place for only a matter of minutes, and fractionated treatments are feasible. Before this development, conventional dose rate brachytherapy required hospitalization with attendant patient discomfort, expense, and complicated radiation safety requirements. The development of high activity remote afterloading machines has removed these practical disadvantages and has led to a great interest in the use of this technology for radical treatment and palliation of obstructing malignancies. There are several unresolved issues concerning this modality for both lung and esophageal cancer. For both diseases, optimal dose and fractionation schemes are not well defined but the palliative benefits for recurrent lung cancer have been clearly shown. The use of a brachytherapy boost following radical external beam radiation therapy of lung cancer is not proven to be advantageous. For esophageal cancer, the value of brachytherapy for palliation is not established. However, there are preliminary data to suggest that it can improve outcome when used routinely after radical treatment with external beam radiation therapy.
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PMID:High Dose Rate Remote Afterloading Brachytherapy for Lung and Esophageal Cancer. 1071 79

Dyspnoea is one of the most frequent and refractory symptoms in cancer patients. Lack of an appropriate assessment tool for dyspnoea seems to disturb establishment of management strategy. The purpose of this study was to develop and validate a brief self-rating scale to assess the multidimensional nature of dyspnoea in cancer patients. We developed a 12-item scale, the Cancer Dyspnoea Scale (CDS), composed of three factors (sense of effort/sense of anxiety/sense of discomfort), by using factor analysis. One hundred and sixty-six patients with advanced or recurrent lung cancer participated in the validation phase. The CDS showed good feasibility (average time required to complete it was 140 s). Construct validity, confirmed by repeating factor analysis, was good. Convergent validity, confirmed by a relation to Visual Analogue Scale of dyspnoea and modified Borg's scale, was also good (average: r= 0.57 and 0.52, respectively, and both P < 0.001). The CDS had good internal consistency (average Cronbach's alpha = 0.86) and stability (average test-retest reliability r = 0.66, P < 0.005). The present study demonstrated that the CDS is a brief, valid and feasible scale for assessing the multidimensional nature of dyspnoea in cancer patients.
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PMID:Development and validation of the Cancer Dyspnoea Scale: a multidimensional, brief, self-rating scale. 1073 49

Patients with cancer experience high levels of symptom distress. Current measures of symptoms generally weight the importance of each symptom equally, and do not generally address the relative importance of different symptoms to patients. The purpose of this pilot study was to explore whether the assumption of equal weighting is warranted in measurements of symptom distress. Consecutive patients presenting with primary lung cancer at the Lung Medicine Unit of one Swedish hospital completed the Symptom Distress Scale and a Thurstone scale eliciting patients' weightings of the symptoms' relative importance three times: after first contact with the unit, then 1 and 2 months later. The results show that subjects weighted some symptoms as significantly more important than others, and the ordering of symptoms was found to differ by intensity and perceived importance in this group. Outlook was the symptom rated most important at T1. Fatigue received the highest intensity score, but ranked second lowest in importance. Kendall's coefficient showed minimal agreement among these patients as to the specific order for the weighting of the importance of symptoms. In addition to theoretical relevance, this issue is clinically relevant in selecting symptoms that should be the focus of intervention and in determining how the success of interventions should be judged.
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PMID:Measuring symptom distress in patients with lung cancer. A pilot study of experienced intensity and importance of symptoms. 1076 78


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