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

Screening for distress in cancer patients is recommended by the National Comprehensive Cancer Network, and a Distress Thermometer has previously been developed and empirically validated for this purpose. The present study sought to determine the rates and predictors of distress in a sample of patients being seen in a multidisciplinary lung cancer clinic. Consecutive patients (N=333) were recruited from an outpatient multidisciplinary lung cancer clinic to complete the Distress Thermometer, an associated Problem Symptom List, and two questions about interest in receiving help for symptoms. Over half (61.6%) of patients reported distress at a clinically significant level, and 22.5% of patients indicated interest in receiving help with their distress and/or symptoms. Problems in the areas of family relationships, emotional functioning, lack of information about diagnosis/treatment, physical functioning, and cognitive functioning were associated with higher reports of distress. Specific symptoms of depression, anxiety, pain and fatigue were most predictive of distress. Younger age was also associated with higher levels of distress. Distress was not associated with other clinical variables, including stage of illness or medical treatment approach. Similar results were obtained when individuals who had not yet received a definitive diagnosis of lung cancer (n=134) were excluded from analyses; however, family problems and anxiety were no longer predictive of distress. Screening for distress in a multidisciplinary lung cancer clinic is feasible and a significant number of patients can be expected to meet clinical criteria for distress. Results also highlight younger age and specific physical and psychosocial symptoms as predictive of clinically significant distress. Identification of the presence and predictors of distress are the first steps toward appropriate referral and treatment of symptoms and problems that contribute to cancer patients' distress.
Lung Cancer 2007 Feb
PMID:Distress screening in a multidisciplinary lung cancer clinic: prevalence and predictors of clinically significant distress. 1708 83

We reported 2 cases of acute pulmonary embolism after resection for lung cancer. A 47-year-old male was admitted to our hospital with ground-glass opacity (GGO) on a chest computed tomography (CT). We performed a right upper lobectomy and node dissection (ND) 2a dissection. Two days after the operation, he developed hypotension and hypoxemia. He was diagnosed as acute pulmonary embolism by chest CT and lung scintigram. A 68-year-old women was performed right S6 segmentectomy for lung cancer. The next day, she complained of sudden chest discomfort and dyspnea. She was diagnosed as acute pulmonary embolism by chest CT. Immediately, we started anticoagration therapy with heparin and their condition were improved. It was very important to early diagnose and start anticoagration therapy immediately for acute pulumonary embolism.
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PMID:[Acute pulmonary embolism following lung resection: report of two cases]. 1787 19

As a method of chest drainage, we analyzed the extended utility of silastic flexible drains (Blake drains, Ethicon, Inc., Somerville, NJ) for general thoracic surgery. In 420 cases of general thoracic surgery, Blake drains were used. To examine the utility of Blake drains, we investigated the diseases for which they were used, their effectiveness in addressing postoperative complications. The treated diseases for which Blake drains were used comprised 181 cases of primary lung cancer, 44 cases of metastatic lung tumor, 57 cases of benign lung disease, 32 cases of mediastinal tumor, 6 cases of myasthenia gravis, 76 cases of spontaneous pneumothorax, 14 cases of chest wall and/or pleural tumor, 6 cases of empyema, and 4 cases of diaphragmatic disease. Blake drains functioned efficiently in 3 cases of re-operation for postoperative bleeding, 2 cases of adhesion therapy with drugs for persistent air leaks, and 1 case of re-operation for chylothorax. There were no cases of either complications or patient complaints of discomfort resulting from drain placement. The use of Blake drains for general thoracic surgery is considered to be an acceptable option, and it is necessary to proceed with further investigations of larger numbers of cases.
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PMID:The use of Blake drains following general thoracic surgery: is it an acceptable option? 1883 56

Bisphosphonate osteonecrosis (BON) is a relatively recent adverse drug event that affects the oral cavity almost exclusively. It has been reported in individuals with metastatic breast, prostate, and lung cancer as well as in multiple myeloma. It has also been reported in a small subset of individuals who have been treated with bisphosphonate therapy for osteoporosis and Paget's disease of bone. Published studies to date have been characterized by relatively small sample sizes. Based on these studies, incidence appears to range between 0.1% and 11% depending on the population being studied and a number of other co-factors that have not been completely understood. The pathobiology of BON has not been fully elucidated and risk factors involved in the process need confirmation. Patients with this complication have altered quality of life and can suffer from discomfort and pain. Management is difficult and, while many treatment protocols have been proposed, at best they have only had partial success. This review of literature discusses a number of issues involving BON, with focus on the definition, possible association of BON and bisphosphonate therapy, pathobiology of BON and several additional research questions that need further investigation.
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PMID:Bisphosphonate osteonecrosis (BON): unanswered questions and research possibilities. 1946 6

PURPOSE Standardized questionnaires for patient-reported outcomes are generally composed of specified predetermined items, although other areas may also cause patients distress. We therefore studied reports of what was most distressing for 343 patients with inoperable lung cancer (LC) at six time points during the first year postdiagnosis and how these concerns were assessed by three quality-of-life and symptom questionnaires. PATIENTS AND METHODS Qualitative analysis of patients' responses to the question "What do you find most distressing at present?" generated 20 categories, with 17 under the dimensions of "bodily distress," "life situation with LC," and "iatrogenic distress." Descriptive and inferential statistical analyses were conducted. RESULTS The majority of statements reported as most distressing related to somatic and psychosocial problems, with 26% of patients reporting an overarching form of distress instead of specific problems at some time point. Twenty-seven percent reported some facet of their contact with the health care system as causing them most distress. While 55% to 59% of concerns reported as most distressing were clearly assessed by the European Organisation for Research and Treatment for Cancer Quality of Life Questionnaire Core-30 and Lung Cancer Module instruments, the Memorial Symptom Assessment Scale, and the modified Distress Screening Tool, iatrogenic distress is not specifically targeted by any of the three instruments examined. CONCLUSION Using this approach, several distressing issues were found to be commonly reported by this patient group but were not assessed by standardized questionnaires. This highlights the need to carefully consider choice of instrument in relation to study objectives and characteristics of the sample investigated and to consider complementary means of assessment in clinical practice.
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PMID:Are the most distressing concerns of patients with inoperable lung cancer adequately assessed? A mixed-methods analysis. 2021 57

Currently, megavoltage CT studies in most centres with tomotherapy units are performed prior to every treatment for patient set-up verification and position correction. However, daily imaging adds to the total treatment time, which may cause patient discomfort as well as results in increased imaging dose. In this study, four alternative megavoltage CT imaging protocols (images obtained: during the first five fractions, once per week, alternating fractions and daily on alternative weeks) were evaluated retrospectively using the daily position correction data for 42 patients with lung cancer. The additional uncertainty introduced by using a specific protocol with respect to the daily imaging, or residual uncertainty, was analysed on a patient and population bases. The impact of less frequent imaging schedules on treatment margin calculation was also analysed. Systematic deviations were reduced with increased imaging frequency, while random deviations were largely unaffected. Mean population systematic errors were small for all protocols evaluated. In the protocol showing the greatest error, the treatment margins necessary to accommodate residual errors were 1.2, 1.3 and 1.7 mm larger in the left-right, superior-inferior and anterior-posterior directions, respectively, compared with the margins calculated using the daily imaging data. The increased uncertainty because of the use of less frequent imaging protocols may be acceptable when compared with other sources of uncertainty in lung cancer cases, such as target volume delineation and motion because of respiration. Further work needs to be carried out to establish the impact of increased residual errors on dose distribution.
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PMID:Evaluation of megavoltage CT imaging protocols in patients with lung cancer. 2037 7

The patient was a 75-year-old female with a history of no smoking. Under a diagnosis of lung cancer, she underwent a right lower lobectomy in March 2008. She was started on oral Uracil-Tegafur (UFT) (400 mg/day) from April and in May developed fatigue, respiratory discomfort, and tachycardiac atrial fibrillation. Chest X-ray film showed an increase in right pleural effusion. Thoracentesis revealed a yellowish, serous exudate containing predominantly lymphocytes, with no evidence of malignancy. Despite continued diuretic administration for 5 months from July, it was difficult to control the pleural effusion, and her activities of daily living remained low. In December of the same year, the oral administration of UFT was terminated, which 2 weeks later resulted in a marked decrease in pleural effusion on chest X-ray film. Respiratory discomfort and fatigue also subsided, and her general condition improved markedly. Herein we report a case of oral UFT-induced pleural effusion following lung cancer surgery.
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PMID:Uracil-Tegafur-induced pleural effusion following lung cancer surgery. 2105 48

Identifying and understanding causes of disease is arguably the central aim of the discipline of epidemiology. However, while the discipline has matured over the past sixty years, developing a battery of quantitative tools and methods for data analysis, the discipline of epidemiology lacks an explicit, shared theoretical account of causation. Moreover, some epidemiologists exhibit discomfort with the concept of causation itself, concerned that it creates more confusion than clarity. This paper describes how, during the post-war period, epidemiologists began to think about causation in new ways as they encountered novel challenges in studying chronic diseases. The epidemiologic evidence linking cigarette smoking and lung cancer in the 1950s provided a focus for debates over causation. While some epidemiologists embraced probabilistic concepts of cause and effect, others maintained that causal mechanisms must ultimately be deterministic. The tension between probabilistic risk factors and deterministic causal mechanisms continues to haunt epidemiology today.
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PMID:Causes, risks, and probabilities: probabilistic concepts of causation in chronic disease epidemiology. 2198 3

Respiratory gating and tumor tracking are two promising motion-adaptive lung cancer treatments, minimizing incidence and severity of normal tissues and precisely delivering radiation dose to the tumor. Accurate respiration measurement is important in respiratory-gated radiotherapy. Conventional gating techniques are either invasive to the body or bring insufficient accuracy and discomfort to the patients. In this paper, we present an accurate noncontact means of measuring respiration for the use in gated lung cancer radiotherapy. We also present an accurate tumor tracking technique for dynamical beam tracking radiotherapy. Two 2.4 GHz miniature radars were used to monitor the chest wall and abdominal movements simultaneously to get high resolution and enhanced parameter identification. Ray tracing technique was used to investigate the impact of antenna size in clinical practice. It is shown that our multiple radar system can reliably measure respiration signals for respiratory gating and accurate tumor tracking in motion-adaptive lung cancer radiotherapy.
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PMID:A multi-radar wireless system for respiratory gating and accurate tumor tracking in lung cancer radiotherapy. 2225 37

Victims exposed to sulfur mustard (HD) in World War I and Iran-Iraq war, and those suffered occupational or accidental exposure have endured discomfort in the respiratory system at early stages after exposure, and marked general physical deterioration at late stages due to pulmonary fibrosis, bronchiolitis obliterans or lung cancer. At molecule levels, significant changes of cytokines and chemokines in bronchoalveolar lavage and serum, and of selectins (in particular sE-selectin) and soluble Fas ligand in the serum have been reported in recent studies of patients exposed to HD in Iran-Iraq war, suggesting that these molecules may be associated with the pathophysiological development of pulmonary diseases. Experimental studies in rodents have revealed that reactive oxygen and nitrogen species, their product peroxynitrite (ONOO(-)), nitric oxide synthase, glutathione, poly (adenosine diphosphate-ribose) polymerase, activating protein-1 signaling pathway are promising drug targets for preventing HD-induced toxicity, whereas N-acetyl cysteine, tocopherols, melatonin, aprotinin and many other molecules have been proved to be effective in prevention of HD-induced damage to the respiratory system in different animal models. In this paper, we will systemically review clinical and pathophysiological changes of respiratory system in victims exposed to HD in the last century, update clinicians and researchers on the mechanism of HD-induced acute and chronic lung damages, and on the relevant drug targets for future development of antidotes for HD. Further research directions will also be proposed.
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PMID:Sulfur mustard and respiratory diseases. 2338 76


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