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

The majority of patients with non-small cell lung cancer (NSCLC) present with advanced disease, which is associated with a poor prognosis and symptoms such as pain, coughing, and shortness of breath. In patients who present at an earlier stage, the progressive nature of NSCLC and its resistance to treatment often result in recurrence, with the associated symptoms of advanced disease. These symptoms negatively affect patient quality of life and performance status rating, both of which are predictive of treatment response and survival. There is increasing interest in using assessments of improvements in symptoms and quality of life as outcomes in clinical trials for patients with advanced NSCLC. Patients with NSCLC have limited therapeutic options. Even those patients who are able to tolerate chemotherapy can expect median survival increases of only 2 to 4 months. The new targeted therapies for lung cancer, in contrast, are relatively nontoxic and may provide benefits for symptoms and quality of life in addition to tumor responses. The Functional Assessment of Cancer Therapy-Lung (FACT-L) scale is a validated, sensitive, and reliable patient questionnaire that evaluates and quantifies quality of life across several dimensions, including lung cancer-related symptoms (Lung Cancer Subscale). The Lung Cancer Subscale ranges from 0 (severe debilitation) to 28 (asymptomatic). A change of two points reflects a clinically significant change in NSCLC-related symptoms and quality of life. In phase I studies and also in the Iressa Dose Evaluation in Advanced Lung Cancer (IDEAL)-1 and IDEAL-2 phase II monotherapy trials, treatment of patients with advanced NSCLC with the epidermal growth factor receptor-tyrosine kinase inhibitor ZD1839 (Iressa; AstraZeneca Pharmaceuticals LP, Wilmington, DE) has shown tumor responses as well as rapid improvements in NSCLC-related symptoms and quality of life. In IDEAL-1 and IDEAL-2, improvements in NSCLC-related symptoms and quality of life, as measured by FACT-L, correlated with tumor response, and improvements in symptoms also correlated with progression-free and overall survival. Although symptom response is correlated with tumor response, it is also uniquely predictive of progression-free and overall survival. The FACT-L questionnaire has also been included in phase III trials of ZD1839 treatment in combination with chemotherapy regimens.
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PMID:Impact of ZD1839 on non-small cell lung cancer-related symptoms as measured by the functional assessment of cancer therapy-lung scale. 1264 83

Patients with advanced non-small cell lung cancer (NSCLC) who fail to respond to cytotoxic chemotherapy or who cannot tolerate chemotherapy have limited treatment options. In addition, patients with advanced NSCLC often experience disease-related symptoms that impact their quality of life. Treatment goals in this setting include palliation of symptoms and improvement in quality of life, in addition to tumor response or disease stabilization and increased survival. ZD1839 (Iressa, gefitinib) is an orally active, small-molecule, epidermal growth factor receptor-tyrosine kinase inhibitor that has shown single-agent efficacy for previously treated advanced NSCLC. In phase I clinical trials, ZD1839 provided relief from symptoms often associated with lung cancer, including fatigue, shortness of breath, and chest pain. The IRESSA Dose Evaluation in Advanced Lung Cancer (IDEAL)-1 and IDEAL-2 clinical trials evaluated ZD1839 treatment at 250 mg/day and 500 mg/day in patients with advanced NSCLC for objective tumor response and safety, as well as for improvements in NSCLC-related symptoms and health-related quality of life. The majority of patients enrolled in these studies had received multiple prior treatments. Rapid, sustained symptom improvement was documented for many patients receiving ZD1839 at 250 mg/day or 500 mg/day in both IDEAL trials and was positively associated with clinical benefits, such as tumor response and increased survival.
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PMID:Effects of ZD1839 (Iressa, gefitinib) treatment on symptoms and quality of life in patients with advanced non-small cell lung cancer. 1520 79

The primary objective of these trials was to determine the 1-year survival of advanced non-small cell lung cancer (ANSCLC) patients (> or =70 years with PS 0-2 or > or =18 years with PS 2) receiving sequential paclitaxel and carboplatin (P --> C) or concurrent P + C. The secondary objectives were assessment of toxicities and quality of life. A total of 121 patients with NSCLC were treated. P--> C patients received paclitaxel (80 mg/m(2)) weekly x 3, followed by 1 week of rest; these 4-week cycles were repeated until relapse. At relapse, patients received carboplatin (AUC = 5, IV) on Day 1 of each 3-week cycle until evidence of further progression or lack of improvement. P + C patients received paclitaxel (80 mg/m(2)) and carboplatin (AUC = 2), weekly x 3, followed by 1 week of rest, until relapse. Patients in both studies were premedicated prior to paclitaxel administration. Sequential P + C resulted in a median survival of 8.2 months (range: <1-18.8) and P + C patients had a median survival of 9.2 months (range: <1-22.0). In both groups (P--> C) and P + C), the 1-year survival was 31%. For patients treated sequentially, treatment-related AEs (TRAE, > or =Grade 3) included fatigue (7%), neuropathy (5%), and leukopenia and diarrhea (3%, each). Grade 4 AEs were limited to neutropenia, febrile neutropenia, and sepsis (1 episode each). For patients receiving concurrent P + C, TRAE included neutropenia and leukopenia (15%, each) and shortness of breath and bilateral bone pain (10%, each). Leukopenia (n = 2) and neutropenia (n = 1) were the only Grade 4 events reported. The analysis of quality of life (QOL) questionnaires indicated that there were no obvious differences between treatment groups during the study. These drugs and treatment schema were well-tolerated when administered in the community setting and resulted in survival rates that were similar to what is reported in the literature with combination therapy administered to "high risk" patients. Finding the optimal chemotherapy regimen, that can be tolerated, remains a challenge in elderly patients.
Lung Cancer 2005 Jan
PMID:Sequential versus concurrent paclitaxel and carboplatin for the treatment of advanced non-small cell lung cancer in elderly patients and patients with poor performance status: results of two Phase II, multicenter trials. 1560 61

A 54-year-old woman with a history of fatigue and shortness of breath was found to have a pericardial effusion and mild mediastinal lymphadenopathy. Video-assisted pericardioscopy revealed thickened pericardium studded with multiple nodules. Histologically the tumor was diagnosed as papillary adenocarcinoma. The site of the primary tumor could not be identified. As lung cancer is one of the most frequent causes of pericardial metastases the patient was treated with cisplatin and vinblastin. Following 5 courses of chemotherapy--given over a 4 month period--the amount of pericardial effusion and pericardial thickness did not change. The material from pericardial biopsy was reexamined and positive immunostaining for calretinine was found. The final diagnosis was primary pericardial mesothelioma of epithelioid type. Palliative radiotherapy of mediastinum was planned but the patient deteriorated and died due to disease progression with venous thrombosis and superior vena cava syndrome. The case illustrates the difficulties in establishing diagnosis of primary pericardial mesothelioma which is a rare tumor with poor prognosis.
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PMID:[Diagnostic difficulties in primary mesothelioma]. 1575 64

The purposes of this study were to describe the quality of life (QOL) of terminally ill patients in a home-based hospice program and to examine the relationship between QOL data and patients' symptom distress, ability to function, interpersonal communication (support from family and friends), well-being (their affairs in order), and transcendence (religious comfort/support) as recorded in their charts. QOL was measured by the Missoula-Vitas Quality of Life Index (MVQOLI), an instrument designed specifically for use with terminally ill patients. The study was conducted over a three-year period with 129 terminally ill patients enrolled in a home-based hospice program of care. The MVQOLI was administered to patients within 20 days of their admission to hospice. A retrospective chart review was conducted to determine patients' levels of symptom distress, ability to function, social support, whether or not their affairs were in order, and religious comfort/support. The mean age of participants in this study was 67, with 54.3 percent male and 45.7 percent female. Cancer was the primary diagnosis for 92.2 percent of the sample, and 35 percent of these patients had a diagnosis of lung cancer. Of the 7.8 percent non-cancer diagnoses, five were diagnosed with AIDS, four with chronic obstructive pulmonary disease, and one with chronic heart failure. The results of this study revealed positive scores on the five dimensions of the MVQOLI QOL scale, indicating that within 20 days of admission to hospice, patients rated their QOL as good to very good. Data obtained from the chart review also indicated that patients did not experience a great deal of symptom distress (e.g., pain, nausea, shortness of breath, and restlessness). A significant correlation existed between age and QOL; number of interventions and pain levels; and marital status, well-being, interpersonal relationships, and transcendence. Shortness of breath and well-being were significantly correlated with QOL. There was no significant correlation between gender, race, or closeness to death and the five dimensions of the MVQOLI and chart review assessments.
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PMID:The quality of life of hospice patients: patient and provider perceptions. 1585 87

Docetaxel (Taxotere) is one of the most active new generation chemotherapy agents against advanced non-small cell lung cancer (NSCLC). This study aimed to determine the activity, toxicity and impact on the quality of life (QOL) in patients treated with docetaxel after failure with first-line platinum-based combination chemotherapy. Twenty-one patients with advanced NSCLC who had previously received the platinum-containing regimen were treated with docetaxel 75 mg/m2 every 3 weeks. QOL was assessed at intervals during the treatment period using the Functional Assessment of Cancer Treatment - Lung (FACT-L). Of the 21 patients enrolled, 16 were able to be evaluated for response and 20 were included in the toxicity analysis. The median age was 57 (range, 39-75 years). A median of 3 cycles was given (range, 1-9). Of the 16 evaluatable patients, there was one partial response (6.3%) and 4 with stable disease (25%). The median survival time was 8.1 months and the 1-year survival rate was 25%. Myelosuppression and peripheral neuropathy were the major toxicities. Grade 3/4 neutropenia and paresthesia occurred in 6 patients (30%) and 3 patients (15%), respectively. There was no significant improvement or deterioration in the overall FACT-L, TOI (Trial Outcome Index) and lung cancer symptom scores during the treatment. Symptom improvement was noted, in particular for shortness of breath and weight loss in the majority of patients. It is concluded that docetaxel is a well tolerated second-line treatment for recurrent NSCLC. Of particular importance was that the treatment did not negatively impact the overall quality of life, on the contrary, did palliate some of the lung cancer related dash symptoms in many patients.
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PMID:Doxetaxel in previously treated non-small cell lung cancer patients: clinical efficacy and quality of life. 1590 78

Primary exposure to asbestos in India can be encountered in the form of asbestos mining, asbestos cement industries, asbestos processing unit and during renovation and demolition of old asbestos cemented roof or other structures as well as modern electrical as well as mechanical appliances in which asbestos is still found. Ultimately construction workers, electricians, vehicle mechanics and other workers in the building trades who are exposed to asbestos inhale hundreds and thousands of amphiboles, which causes lung damage. It is being mined in India at places such as Andhra Pradesh (Pulivendla), Jharkand (Roro), Rajasthan (Ajmer, Bhilwara, Udaipur, Rajsamand) and the common problem faced by the locals are asbestosis through air and fluorosis through drinking water. The problem continues to be in India as well as other developing countries. Also, India import and re-export asbestos to other countries and workers at shipyard, transport of the hazardous material on road and roadside residents all are vulnerable to this uncommon disease. The signs and symptoms generally found with the workers are shortness of breath, persistent and productive cough due to pulmonary fibrosis can show up many years after the asbestos exposure.
Lung Cancer 2005 Jul
PMID:Asbestos problem in India. 1595 Aug 10

The authors report a 48-year-old white male with lung cancer who was admitted to their clinic with a 1-year history of cough and shortness of breath. The patient was hospitalized because of progression of his complaints over 1 month. On the 3rd day of hospitalization, he expectorated a piece of gauze. The authors performed a fiber-optic bronchoscopy and saw pieces of gauze originating from granulation tissue located in the angle of the lower trachea and left main bronchi. A detailed anamnesis revealed that a mediastinoscopy had been performed 3 years ago for lung cancer staging: the gauze had migrated from the mediastinum to the endobrochial space.
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PMID:An unusual endobronchial foreign body: a gauze that migrated from the mediastinum. 1621 Aug 96

Magnetic resonance imaging (MRI) of the lung is challenging because of substantial drawbacks. However, lung pathologies that are associated with increased attenuation values in CT enhance visualization in MRI: proton density is increased and tissue-air interfaces, resulting in susceptibility artifacts, are reduced in pneumonia, pneumonitis, edema, and carcinoma. On the other hand, many lung diseases result in shortness of breath, so that patients cannot hold their breath for long periods. Therefore, fast imaging techniques are required which should also allow for high spatial resolution so that small lesions can be detected. Calcifications and air pockets within lesions are not readily recognized with MRI. Thin section CT is standard for the diagnosis of pneumonia. With parallel imaging techniques, MRI examination of the lungs can be performed with short periods of breath holding, which allow for sub-centimeter resolution in the z-axis. Especially for follow-up examinations in immunocompromised patients and, in some instances, for the staging of malignant diseases (malignant pleural mesothelioma, lung cancer, respectively), MRI is very promising and may contribute to a decrease in the radiation exposure of the patients.
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PMID:[Magnetic resonance imaging in the evaluation of pneumonia]. 1639 4

A 79-year-old patient was admitted with fever and shortness of breath. His medical history included treatment for lung cancer 3 years previously. The patient's clinical and radiological status remained unchanged despite antibiotic treatment for pneumonia. No infectious pathogen could be identified. Treatment with systemic steroids for suspected cryptogenic organizing pneumonitis (COP) was started. Following steroid treatment the patient's shortness of breath ameliorated and C-reactive protein was normal. Three weeks after admission Mycobacterium avium complex (MAC) grew in sputa cultures and therefore a diagnosis of MAC pneumonia was made.
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PMID:[Mycobacterium avium pneumonia in an HIV negative patient]. 1739 31


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