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Prete M, Ballarin G, Porciello G, Arianna A, Luongo A, Belli V, Scalfi L, Celentano E. Bioelectrical impedance analysis-derived phase angle (PhA) in lung cancer patients: a systematic review. BMC Cancer 2024; 24:608. [PMID: 38769506 PMCID: PMC11106952 DOI: 10.1186/s12885-024-12378-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/13/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Lung cancer is the second most diagnosed cancer in the world. Up to 84% of diagnosed patients have malnutrition, which can negatively affect quality of life and survival and may worsen with neoadjuvant treatment. Bioelectrical Impedance Analysis-Derived Phase Angle (PhA) in these patients could be a valid tool to assess the nutritional status in order to improve their condition. METHODS This review provides an update on PhA assessment in lung cancer patients over the past twenty years. We searched PubMed, Embase, Scopus, Web of Science, and Cochrane, for articles regarding the PhA obtained from Bioelectrical Impedance Analysis in lung cancer patients. The authors independently performed a literature search: sample size, patient population, study type, study dates, survival and interventions were evaluated. The final review included 11 studies from different countries. RESULTS Eight studies only considered patients with lung cancer, while three studies considered patients with different kind of cancer, including lung. Correlation data between PhA and age are conflicting. In patients undergoing clinical treatment and patients undergoing surgical treatment lower PhA was observed. A lower PhA is associated with a shorter survival. In three studies emerged a relationship between Karnofski Performance Status and Handgrip Strenght with PhA. From one study, univariate logistic regression analysis showed that higher PhA values represent a protective factor for sarcopenia. CONCLUSION Our research underlined interesting, but not conclusive, results on this topic; however more researches are needed to understand the clinical meaning of PhA.
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Affiliation(s)
- Melania Prete
- Division of Radiotherapy, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Naples, 80131, Italy
| | - Giada Ballarin
- Department of Medical, Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, 80133, Italy
| | - Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80131, Italy.
| | - Aniello Arianna
- Department of Public Health, Federico II University Hospital, Via Pansini 5, Naples, 80131, Italy
| | - Assunta Luongo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80131, Italy
| | - Valentina Belli
- Scientific Direction, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80131, Italy
| | - Luca Scalfi
- Department of Public Health, Federico II University Hospital, Via Pansini 5, Naples, 80131, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Naples, 80131, Italy
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Madkhali MA, Alhazmi E, Hakami F, Darraj H, Hamdi S, Hakami KM, Gadi WH, Sharahily RM, Hufaysi AH, Alhazmi L, Oraibi O, Alqassimi S, Mohrag M, Elmakki E. A Cross-Sectional Study on the Knowledge and Awareness of Lung Cancer and Screening in Jazan Region, Saudi Arabia. J Multidiscip Healthc 2023; 16:3857-3870. [PMID: 38076592 PMCID: PMC10710187 DOI: 10.2147/jmdh.s435129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/28/2023] [Indexed: 12/30/2023] Open
Abstract
BACKGROUND Lung cancer (LC) is the most common cause of cancer-related deaths worldwide. With lung cancer often diagnosed at advanced stages, understanding the local population's awareness levels is crucial for designing effective preventive strategies. By identifying gaps in knowledge, the research aims to inform targeted health education efforts, optimize resource allocation, influence policy development, and contribute to the limited body of research on lung cancer awareness in the region, ultimately fostering improved public health outcomes. METHODS This was a cross-sectional observational study conducted in Jazan region, Saudi Arabia, from July 2022 to June 2023, 671 participants over 18 years old, encompassing both genders, were gsurveyed. Data was collected through a questionnaire covering sociodemographic characteristics and LC-related awareness. SPSS 23 was used for analysis. Factors associated with knowledge scores were explored using independent t-tests and ANOVA, with the Tukey post-hoc test identifying specific group differences. RESULTS The study included 671 participants, most participants were between 18 and 35 years (73.5%), with 38.5% males and 61.5% females. Lung cancer (LC) awareness was high (95.1%), with 4.9% reporting a family history. Knowledge assessment revealed a mean score of 14.66, with 41.6% having low, 49.5% moderate, and 8.9% high knowledge levels. Correct responses were notable for recognizing LC as a common cancer, a leading cause of death, and associating smoking and shisha with risk. Symptoms were well identified. Screening awareness was at 63.5%, with 78.8% willing to undergo tests if at risk. Age, marital status, and occupation were associated with knowledge, while factors like gender, nationality, residency, education, income, and smoking status showed no significant associations. CONCLUSION The findings indicate that there are knowledge gaps related to LC and its screening in Jazan region in Saudi Arabia. Effective awareness programs targeting specific sociodemographic groups are needed to improve the early detection and outcomes.
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Affiliation(s)
- Mohammed Ali Madkhali
- Department of Internal Medicine, Division of Hematology and Oncology, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Essam Alhazmi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Faisal Hakami
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Hussam Darraj
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Sulaiman Hamdi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | - Wala H Gadi
- Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | | | - Luai Alhazmi
- Internal Medicine Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Omar Oraibi
- Internal Medicine Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Sameer Alqassimi
- Internal Medicine Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Mostafa Mohrag
- Internal Medicine Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Erwa Elmakki
- Internal Medicine Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
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Romeo HE, Barreiro Arcos ML. Clinical relevance of stem cells in lung cancer. World J Stem Cells 2023; 15:576-588. [PMID: 37424954 PMCID: PMC10324501 DOI: 10.4252/wjsc.v15.i6.576] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/18/2023] [Accepted: 05/08/2023] [Indexed: 06/26/2023] Open
Abstract
Lung cancer is the major cause of cancer-related deaths worldwide, it has one of the lowest 5-year survival rate, mainly because it is diagnosed in the late stage of the disease. Lung cancer is classified into two groups, small cell lung cancer (SCLC) and non-SCLC (NSCLC). In turn, NSCLC is categorized into three distinct cell subtypes: Adenocarcinoma, squamous cell carcinoma, and large cell carcinoma. NSCLC is the most common lung cancer, accounting for 85% of all lung cancers. Treatment for lung cancer is linked to the cell type and stage of the disease, involving chemotherapy, radiation therapy, and surgery. Despite improvements in therapeutic treatments, lung cancer patients show high rates of recurrence, metastasis, and resistance to chemotherapy. Lung stem cells (SCs) are undifferentiated cells capable of self-renewal and proliferation, are resistant to chemotherapy and radiotherapy and, due to their properties, could be involved in the development and progression of lung cancer. The presence of SCs in the lung tissue could be the reason why lung cancer is difficult to treat. The identification of lung cancer stem cells biomarkers is of interest for precision medicine using new therapeutic agents directed against these cell populations. In this review, we present the current knowledge on lung SCs and discuss their functional role in the initiation and progression of lung cancer, as well as their role in tumor resistance to chemotherapy.
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Affiliation(s)
- Horacio Eduardo Romeo
- School of Engineering and Agrarian Sciences, Pontifical Catholic University of Argentina, Institute of Biomedical Research (BIOMED-UCA-CONICET), CABA C1107AAZ, Buenos Aires, Argentina
| | - María Laura Barreiro Arcos
- School of Engineering and Agrarian Sciences, Pontifical Catholic University of Argentina, Institute of Biomedical Research (BIOMED-UCA-CONICET), CABA C1107AAZ, Buenos Aires, Argentina
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Kokeza J, Strikic A, Ogorevc M, Kelam N, Vukoja M, Dilber I, Zekic Tomas S. The Effect of GLUT1 and HIF-1α Expressions on Glucose Uptake and Patient Survival in Non-Small-Cell Lung Carcinoma. Int J Mol Sci 2023; 24:10575. [PMID: 37445752 DOI: 10.3390/ijms241310575] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/16/2023] [Accepted: 06/21/2023] [Indexed: 07/15/2023] Open
Abstract
Lung cancer is the second-most-common cancer while being the leading cause of cancer deaths worldwide. It has been found that glucose transporter 1 (GLUT1) and hypoxia-inducible factor 1α (HIF-1α) are overexpressed in various malignancies and that they correlate with the maximum standard uptake values (SUVmax) on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG PET/CT) and poor prognosis. In this study, we aim to evaluate the relationship between the SUVmax, GLUT1, and HIF-1α expression with primary tumor size, histological type, lymph node metastases, and patient survival. Of the 48 patients with non-small-cell lung cancer, those with squamous cell carcinomas (SCCs) had significantly higher GLUT1 and HIF-1α immunohistochemical expressions in comparison to adenocarcinomas (ACs), while there was no statistically significant difference in FDG accumulation between them. No significant correlation was noted between either GLUT1 or HIF-1α protein expression and FDG uptake and overall survival. However, an analysis of tumor transcriptomics showed a significant difference in overall survival depending on mRNA expression; patients with SCC and high HIF-1α levels survived longer compared to those with low HIF-1α levels, while patients with AC and low GLUT1 levels had a higher average survival time than those with high GLUT1 levels. Further studies are needed to determine the prognostic value of the expression of these factors depending on the histologic type.
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Affiliation(s)
- Josipa Kokeza
- Department of Pulmonology, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Ante Strikic
- Department of Oncology and Radiotherapy, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
| | - Marin Ogorevc
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
| | - Nela Kelam
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
| | - Martina Vukoja
- Laboratory of Morphology, Department of Histology and Embryology, School of Medicine, University of Mostar, 88 000 Mostar, Bosnia and Herzegovina
| | - Ivo Dilber
- Department of Oncology and Nuclear Medicine, General Hospital Zadar, Ul. Bože Peričića 5, 23000 Zadar, Croatia
| | - Sandra Zekic Tomas
- Department of Pathology, Forensic Medicine and Cytology, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
- Department of Pathology, University of Split School of Medicine, Šoltanska 2, 21000 Split, Croatia
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Long H, Ji J, Chen L, Feng J, Liao J, Yang Y. EB-OCT: a potential strategy on early diagnosis and treatment for lung cancer. Front Oncol 2023; 13:1156218. [PMID: 37182131 PMCID: PMC10168178 DOI: 10.3389/fonc.2023.1156218] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/12/2023] [Indexed: 05/16/2023] Open
Abstract
Lung cancer is the leading cause of cancer-related death in China and the world, mainly attributed to delayed diagnosis, given that currently available early screening strategies exhibit limited value. Endobronchial optical coherence tomography (EB-OCT) has the characteristics of non-invasiveness, accuracy, and repeatability. Importantly, the combination of EB-OCT with existing technologies represents a potential approach for early screening and diagnosis. In this review, we introduce the structure and strengths of EB-OCT. Furthermore, we provide a comprehensive overview of the application of EB-OCT on early screening and diagnosis of lung cancer from in vivo experiments to clinical studies, including differential diagnosis of airway lesions, early screening for lung cancer, lung nodules, lymph node biopsy and localization and palliative treatment of lung cancer. Moreover, the bottlenecks and difficulties in developing and popularizing EB-OCT for diagnosis and treatment during clinical practice are analyzed. The characteristics of OCT images of normal and cancerous lung tissues were in good agreement with the results of pathology, which could be used to judge the nature of lung lesions in real time. In addition, EB-OCT can be used as an assistant to biopsy of pulmonary nodules and improve the success rate of biopsy. EB-OCT also plays an auxiliary role in the treatment of lung cancer. In conclusion, EB-OCT is non-invasive, safe and accurate in real-time. It is of great significance in the diagnosis of lung cancer and suitable for clinical application and is expected to become an important diagnostic method for lung cancer in the future.
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Affiliation(s)
- Hang Long
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jiaqi Ji
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Lijuan Chen
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jiayue Feng
- Department of Cardiology, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Jie Liao
- Department of Cardiology, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
| | - Yang Yang
- Department of Respiratory and Critical Medicine, Sichuan Provincial People’s Hospital, Sichuan Academy of Medical Sciences, Chengdu, Sichuan, China
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L'Hotta AJ, Yan Y, Davis AA, Waqar SN, Chheda MG, Tan BR, Lyons KD, Park Y, King AA. Trajectories of participation in daily life among individuals newly diagnosed with cancer: A 5-month longitudinal study. Support Care Cancer 2023; 31:213. [PMID: 36917417 PMCID: PMC10011771 DOI: 10.1007/s00520-023-07672-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 03/07/2023] [Indexed: 03/16/2023]
Abstract
PURPOSE To determine how participation in daily life is impacted during the first six months following a new cancer diagnosis and to identify risk factors for participation restrictions. Patient-reported outcomes (PROs) were used to suggest referrals to rehabilitation services. METHODS Participants (n = 123) were adults (> 18 years) with the newly diagnosed primary brain, breast, colorectal, or lung cancer. PROs were collected at baseline (within 30 days of diagnosis/treatment initiation), two and five months post baseline. Daily life participation was assessed through the community participation indicators (CPI) (score range: 0-1) and patient-reported outcome measurement information system (PROMIS) ability to participate, (score range: 20-80; mean: 50, SD: 10). PROMIS-43 profile was also completed. Linear mixed-effect models with random intercept evaluated change in participation over time. RESULTS The baseline total sample mean CPI score was 0.56; patients reported mildly impaired participation based on PROMIS scores (baseline: 46.19, 2-month follow-up: 44.81, 5 months: 44.84). However, no statistically significant changes in participation were observed over the study period. Risk factors for lower participation included receiving chemotherapy, lower physical function, higher anxiety and fatigue, and reduction in employment, p < 0.05. PROs indicated that roughly half of the participants may benefit from physical or occupational therapy or mental health support, but only 20-36% were referred by their medical team. CONCLUSION People newly diagnosed with cancer experience impaired participation, but they are infrequently referred to supportive services such as rehabilitation. The use of PROs to assess participation, physical function, and mental health can promote access to supportive care services by identifying patients who may benefit from rehabilitation beyond those identified through routine clinical care.
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Affiliation(s)
- Allison J L'Hotta
- Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA.
| | - Yan Yan
- Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA
| | - Andrew A Davis
- Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA
| | - Saiama N Waqar
- Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA
| | - Milan G Chheda
- Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA
| | - Benjamin R Tan
- Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA
| | - Kathleen D Lyons
- Massachusetts General Hospital Institute of Health Professions, Boston, MA, USA
| | - Yikyung Park
- Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8505-45-01, St. Louis, MO, 63110, USA
| | - Allison A King
- Washington University in St. Louis School of Medicine & St. Louis Children's Hospital, St. Louis, MO, USA
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Hofmann L, Heinrich M, Baurecht H, Langguth B, Kreuzer PM, Knüttel H, Leitzmann MF, Seliger C. Suicide Mortality Risk among Patients with Lung Cancer-A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4146. [PMID: 36901154 PMCID: PMC10002176 DOI: 10.3390/ijerph20054146] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/18/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
The risk for suicide in patients with cancer is higher compared to the general population. However, little is known about patients with lung cancer specifically. We therefore implemented a systematic review and random-effects meta-analysis of retrospective cohort studies on suicide in patients with lung cancer. We searched a high number of common databases up to 02/2021. For the systematic review, a total of 23 studies was included. To exclude bias due to patient sample overlap, the meta-analysis was performed on 12 studies. The pooled standardized mortality ratio (SMR) for suicide was 2.95 (95% Confidence Interval (CI) = 2.42-3.60) for patients with lung cancer as compared to the general population. Subgroups with a pronouncedly higher risk for suicide compared to the general population were found for patients living in the USA (SMR = 4.17, 95% CI = 3.88-4.48), with tumors of late stage (SMR = 4.68, 95% CI = 1.28-17.14), and within one year after diagnosis (SMR = 5.00, 95% CI = 4.11-6.08). An increased risk for suicide was found in patients with lung cancer, with subgroups at particular risk. Patients at increased risk should be monitored more closely for suicidality and should receive specialized psycho-oncological and psychiatric care. Further studies should clarify the role of smoking and depressive symptoms on suicidality among lung cancer patients.
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Affiliation(s)
- Luisa Hofmann
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilians-University, Nußbaumstraße 7, 80336 Munich, Germany
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany
| | - Michael Heinrich
- Faculty of Medicine, University of Regensburg, Universitätsstraße 31, 93053 Regensburg, Germany
| | - Hansjörg Baurecht
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany
| | - Peter M. Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany
| | - Helge Knüttel
- University Library, University of Regensburg, Universitätsstraße 31, 93053 Regensburg, Germany
| | - Michael F. Leitzmann
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - Corinna Seliger
- Department of Neurology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Yang K, Hua S, Wei W, Yang C, Zhu X, Li SC. Economic burden of advanced lung cancer patients treated by gefitinib alone and combined with chemotherapy in two regions of China. J Med Econ 2023; 26:1424-1431. [PMID: 37855437 DOI: 10.1080/13696998.2023.2272536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/16/2023] [Indexed: 10/20/2023]
Abstract
AIM To assess the economic burden of different chemotherapies for lung cancer patients and influencing factors in China. MATERIALS AND METHODS The economic burden of lung cancer, including direct, indirect and intangible costs was measured within three months after diagnosis and treatment. Direct cost included the cost of hospitalization, outpatient visits, out-of-pocket drug purchases, costs of transportation, accommodation and meal expenses while seeking treatments in hospitals. Cost information was attained from questionnaire and patients' medical record. Indirect cost was measured by the patients' and their caregivers' productive days lost due to outpatient visits and hospitalization for lung cancer treatment. Intangible cost was obtained through the willingness-to-pay method from a questionnaire completed by the patient. RESULTS Among the total cost of CNY71,401.92, direct cost, indirect cost and intangible cost constituted 89.02%, 4.29%, and 6.69% respectively. Educational level, occupation, family income, lung cancer classification, and the city of residence significantly influenced the total cost. LIMITATIONS Limitations in our study included: First, our follow-up period of three months was relatively short compared to the whole survival period of lung cancer patients. Second, the sample size of the chemotherapy combined with targeted therapy group was not large enough, and the cost data obtained would need confirmation in future studies. Third, participants came from only two localities, which may somewhat limit the representativeness of the study results for the whole of China. CONCLUSIONS The economic burden of lung cancer treatment mainly came from the cost of the drugs. Patients taking chemotherapy had significantly higher cost compared to patients using targeted therapy. The cost was generally higher for those with higher educational level, those with higher family income, and those living in an economically more developed city. Patients with NSCLC had higher cost compared to patients with SCLC.
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Affiliation(s)
- Kehong Yang
- Faculty of Pharmacy, Bengbu Medical College, Bengbu, P.R. China
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Susan Hua
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Wenting Wei
- Guangdong Cadre Health Management Center, Guangdong Provincial Geriatrics Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, P.R. China
| | - Congyan Yang
- The First Affiliated Hospital of Bengbu Medical College, Bengbu, P.R. China
| | - Xinhai Zhu
- Department of Oncology, The First Affiliated Hospital of Jinan University, Guangzhou, P.R. China
| | - Shu Chuen Li
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
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Akpoviroro O, Pramick M, Adjei A. Isolated Pancreatic Metastasis from a Lung Adenocarcinoma Primary: A Case Report and Literature Review. Case Rep Oncol 2023; 16:988-998. [PMID: 37900790 PMCID: PMC10601769 DOI: 10.1159/000531841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/20/2023] [Indexed: 10/31/2023] Open
Abstract
Isolated pancreatic metastasis is a rare occurrence and is commonly misdiagnosed as primary pancreatic malignancy. We present a case of a 65-year-old female patient with a history of stage IIIA lung adenocarcinoma, who developed significant epigastric pain 27 months after diagnosis and treatment of a primary lung adenocarcinoma. This patient was found to have a pancreatic head lesion initially suspected to be a primary pancreatic neoplasm but eventually discovered to be a metastatic lesion from the previously treated primary lung adenocarcinoma.
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Affiliation(s)
- Ogheneyoma Akpoviroro
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Geisinger Wyoming Valley Medical Center, Internal Medicine Department, Wilkes-Barre, PA, USA
| | - Michelle Pramick
- Geisinger Wyoming Valley Medical Center, Pathology and Laboratory Medicine, Wilkes-Barre, PA, USA
| | - Abdul Adjei
- Geisinger Wyoming Valley Medical Center, Hematology and Medical Oncology Department, Wilkes-Barre, PA, USA
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Disease-related compound identification based on deeping learning method. Sci Rep 2022; 12:20594. [PMID: 36446871 PMCID: PMC9708143 DOI: 10.1038/s41598-022-24385-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 11/15/2022] [Indexed: 12/02/2022] Open
Abstract
Acute lung injury (ALI) is a serious respiratory disease, which can lead to acute respiratory failure or death. It is closely related to the pathogenesis of New Coronavirus pneumonia (COVID-19). Many researches showed that traditional Chinese medicine (TCM) had a good effect on its intervention, and network pharmacology could play a very important role. In order to construct "disease-gene-target-drug" interaction network more accurately, deep learning algorithm is utilized in this paper. Two ALI-related target genes (REAL and SATA3) are considered, and the active and inactive compounds of the two corresponding target genes are collected as training data, respectively. Molecular descriptors and molecular fingerprints are utilized to characterize each compound. Forest graph embedded deep feed forward network (forgeNet) is proposed to train. The experimental results show that forgeNet performs better than support vector machines (SVM), random forest (RF), logical regression (LR), Naive Bayes (NB), XGBoost, LightGBM and gcForest. forgeNet could identify 19 compounds in Erhuang decoction (EhD) and Dexamethasone (DXMS) more accurately.
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Zhang Y, Ding Y, Liu C, Li J, Wang Q, Li Y, Hu X. Relationships Among Perceived Social Support, Family Resilience, and Caregiver Burden in Lung Cancer Families: A Mediating Model. Semin Oncol Nurs 2022:151356. [DOI: 10.1016/j.soncn.2022.151356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022]
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12
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Yoo SS, Lee SY, Choi SH. Extracorporeal membrane oxygenation for lung cancer-related life-threatening hypoxia: A case report. World J Clin Cases 2022; 10:8974-8979. [PMID: 36157640 PMCID: PMC9477050 DOI: 10.12998/wjcc.v10.i25.8974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/04/2022] [Accepted: 07/22/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Life-threatening hypoxia can occur in patients with lung cancer due to bronchial obstruction. Extracorporeal membrane oxygenation (ECMO) can be used as a bridge therapy for patients with severe hypoxia not relieved by conventional mechanical treatment. However, the usefulness of chemotherapy in patients with lung cancer receiving ECMO therapy is not well known.
CASE SUMMARY A 53-year-old man visited the emergency room with worsening dyspnea for 1 mo. A series of imaging and diagnostic tests were performed, and stage IIIB (cT4N2M0) lung cancer was eventually diagnosed. On hospital day 3, he experienced dyspnea and hypoxia that was not relieved with oxygen support via a high-flow nasal cannula. ECMO was initiated because his respiratory condition did not improve even with mechanical ventilation. The patient then underwent gemcitabine/cisplatin chemotherapy without dose reduction while on ECMO. After two cycles of chemotherapy, there was a decrease in the size of the primary tumor in the right main bronchus. After the completion of concurrent chemoradiotherapy, a computed tomography scan revealed further improvement in the right main bronchus narrowing. Eight months after a lung cancer diagnosis, the patient did well without any dyspnea.
CONCLUSION ECMO is a potential bridge therapy for respiratory failure in patients with central airway obstruction secondary to lung cancer.
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Affiliation(s)
- Seung Soo Yoo
- Department of Internal Medicine, Kyungpook National University, Daegu 41404, South Korea
| | - Shin Yup Lee
- Department of Internal Medicine, Kyungpook National University, Daegu 41404, South Korea
| | - Sun Ha Choi
- Lung Cancer Center, Kyungpook National University Chilgok Hospital, Daegu 41404, South Korea
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13
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Braghetto A, Marturano F, Paiusco M, Baiesi M, Bettinelli A. Radiomics and deep learning methods for the prediction of 2-year overall survival in LUNG1 dataset. Sci Rep 2022; 12:14132. [PMID: 35986072 PMCID: PMC9391464 DOI: 10.1038/s41598-022-18085-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 08/04/2022] [Indexed: 11/08/2022] Open
Abstract
In this study, we tested and compared radiomics and deep learning-based approaches on the public LUNG1 dataset, for the prediction of 2-year overall survival (OS) in non-small cell lung cancer patients. Radiomic features were extracted from the gross tumor volume using Pyradiomics, while deep features were extracted from bi-dimensional tumor slices by convolutional autoencoder. Both radiomic and deep features were fed to 24 different pipelines formed by the combination of four feature selection/reduction methods and six classifiers. Direct classification through convolutional neural networks (CNNs) was also performed. Each approach was investigated with and without the inclusion of clinical parameters. The maximum area under the receiver operating characteristic on the test set improved from 0.59, obtained for the baseline clinical model, to 0.67 ± 0.03, 0.63 ± 0.03 and 0.67 ± 0.02 for models based on radiomic features, deep features, and their combination, and to 0.64 ± 0.04 for direct CNN classification. Despite the high number of pipelines and approaches tested, results were comparable and in line with previous works, hence confirming that it is challenging to extract further imaging-based information from the LUNG1 dataset for the prediction of 2-year OS.
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Affiliation(s)
- Anna Braghetto
- Physics and Astronomy Department "Galileo Galilei", University of Padova, Via Marzolo 8, 35131, Padua, Italy.
- INFN, Sezione di Padova, Via Marzolo 8, 35131, Padua, Italy.
| | - Francesca Marturano
- Medical Physics Department, Veneto Institute of Oncology-IOV IRCCS, Padua, Italy
| | - Marta Paiusco
- Medical Physics Department, Veneto Institute of Oncology-IOV IRCCS, Padua, Italy
| | - Marco Baiesi
- Physics and Astronomy Department "Galileo Galilei", University of Padova, Via Marzolo 8, 35131, Padua, Italy
- INFN, Sezione di Padova, Via Marzolo 8, 35131, Padua, Italy
| | - Andrea Bettinelli
- Medical Physics Department, Veneto Institute of Oncology-IOV IRCCS, Padua, Italy
- Department of Information Engineering, University of Padova, Padua, Italy
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14
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EMM-LC Fusion: Enhanced Multimodal Fusion for Lung Cancer Classification. AI 2022. [DOI: 10.3390/ai3030038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Lung cancer (LC) is the most common cause of cancer-related deaths in the UK due to delayed diagnosis. The existing literature establishes a variety of factors which contribute to this, including the misjudgement of anatomical structure by doctors and radiologists. This study set out to develop a solution which utilises multiple modalities in order to detect the presence of LC. A review of the existing literature established failings within methods to exploit rich intermediate feature representations, such that it can capture complex multimodal associations between heterogenous data sources. The methodological approach involved the development of a novel machine learning (ML) model to facilitate quantitative analysis. The proposed solution, named EMM-LC Fusion, extracts intermediate features from a pre-trained modified AlignedXception model and concatenates these with linearly inflated features of Clinical Data Elements (CDE). The implementation was evaluated and compared against existing literature using F1 score, average precision (AP), and area under curve (AUC) as metrics. The findings presented in this study show a statistically significant improvement (p < 0.05) upon the previous fusion method, with an increase in F-Score from 0.402 to 0.508. The significance of this establishes that the extraction of intermediate features produces a fertile environment for the detection of intermodal relationships for the task of LC classification. This research also provides an architecture to facilitate the future implementation of alternative biomarkers for lung cancer, one of the acknowledged limitations of this study.
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15
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Saraboon C, Siriphorn A. Effects of foam pad balance exercises on cancer patients undergoing chemotherapy: A randomized control trial. J Bodyw Mov Ther 2021; 28:164-171. [PMID: 34776136 DOI: 10.1016/j.jbmt.2021.07.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 06/01/2021] [Accepted: 07/12/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study sought to investigate the effects of foam pad balance exercises on balance, physical performance, peripheral neuropathy symptoms, and quality of life in cancer patients undergoing taxane-based chemotherapy. METHODS Thirty cancer patients receiving chemotherapy were randomly divided into 2 groups (n = 15/group): control group (CG) and balance exercise group (BG). The BG were asked to perform foam pad balance exercises 60 min/day, twice/week for 6 weeks, along with conventional therapy. The CG only received conventional therapy. The Fullerton Advanced Balance (FAB) Score, Short Physical Performance Battery (SPPB), Michigan Diabetic Neuropathy Score (MDNS), and Functional Assessment of Cancer Therapy-Taxane (FACT-Taxane) were used to assess balance, physical performance, peripheral neuropathy symptoms, and quality of life, respectively, at baseline and after 4 and 6 weeks of treatment. RESULTS At 4 and/or 6 weeks, the CG showed a decline in FAB and SPPB Scores, while the BG maintained their baseline levels. There were significant differences in the FAB Scores between the groups at the 4th and 6th week (p = 0.04 and p < 0.01, respectively) and significant differences in SPPB Scores at only the 6th week (p = 0.03). MDNS showed no significant changes between or within groups. For FACT-Taxane between groups, the CG and BG showed significant decreases (p < 0.01) and increases (p < 0.01), respectively, at 6th week. CONCLUSIONS Foam pad balance exercises during chemotherapy can be used to alleviate declining balance and enhance physical performance and quality of life of cancer patients.
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Affiliation(s)
- Chanatsupang Saraboon
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Akkradate Siriphorn
- Human Movement Performance Enhancement Research Unit, Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand.
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16
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Faruqui N, Yousuf MA, Whaiduzzaman M, Azad AKM, Barros A, Moni MA. LungNet: A hybrid deep-CNN model for lung cancer diagnosis using CT and wearable sensor-based medical IoT data. Comput Biol Med 2021; 139:104961. [PMID: 34741906 DOI: 10.1016/j.compbiomed.2021.104961] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 12/25/2022]
Abstract
Lung cancer, also known as pulmonary cancer, is one of the deadliest cancers, but yet curable if detected at the early stage. At present, the ambiguous features of the lung cancer nodule make the computer-aided automatic diagnosis a challenging task. To alleviate this, we present LungNet, a novel hybrid deep-convolutional neural network-based model, trained with CT scan and wearable sensor-based medical IoT (MIoT) data. LungNet consists of a unique 22-layers Convolutional Neural Network (CNN), which combines latent features that are learned from CT scan images and MIoT data to enhance the diagnostic accuracy of the system. Operated from a centralized server, the network has been trained with a balanced dataset having 525,000 images that can classify lung cancer into five classes with high accuracy (96.81%) and low false positive rate (3.35%), outperforming similar CNN-based classifiers. Moreover, it classifies the stage-1 and stage-2 lung cancers into 1A, 1B, 2A and 2B sub-classes with 91.6% accuracy and false positive rate of 7.25%. High predictive capability accompanied with sub-stage classification renders LungNet as a promising prospect in developing CNN-based automatic lung cancer diagnosis systems.
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Affiliation(s)
- Nuruzzaman Faruqui
- Institute of Information Technology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
| | - Mohammad Abu Yousuf
- Institute of Information Technology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
| | - Md Whaiduzzaman
- Institute of Information Technology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh; Queensland University of Technology, 2 George St, Brisbane City, QLD, 4000, Australia.
| | - A K M Azad
- Faculty of Science, Engineering & Technology, Swinburne University of Technology Sydney, Australia.
| | - Alistair Barros
- Queensland University of Technology, 2 George St, Brisbane City, QLD, 4000, Australia.
| | - Mohammad Ali Moni
- School of Health and Rehabilitation Sciences, Faculty of Health and Behavioural Sciences, The University of Queensland, St Lucia, QLD, 4072, Australia.
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17
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Kuehne N, Hueniken K, Xu M, Shakik S, Vedadi A, Pinto D, Brown MC, Bradbury PA, Shepherd FA, Sacher AG, Leighl NB, Xu W, Lok BH, Liu G, O'Kane GM. Longitudinal Assessment of Health Utility Scores, Symptoms and Toxicities in Patients with Small Cell Lung Cancer Using Real World Data. Clin Lung Cancer 2021; 23:e154-e164. [PMID: 34688531 DOI: 10.1016/j.cllc.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Recent advances in small cell lung cancer (SCLC) treatments necessitate a better understanding of real-world health utility scores (HUS) in patients treated under current standards to facilitate robust pharmaco-economic assessments. METHODS In this single institution cohort observational study, HUS were evaluated in patients with SCLC through EQ-5D questionnaires at outpatient visits (encounters). In addition, patients completed questionnaires relating to treatment toxicities and cancer symptoms. Clinical and pathological variables were abstracted from electronic medical records and disease status at each patient visit was documented. The impact of these variables on HUS were explored. RESULTS There were 282 clinical encounters (12% newly diagnosed; 37% stable on treatment; 22% progressing on treatment; 29% stable off therapy/other) in 111 SCLC patients (58% male; 64% extensive stage (ES) SCLC). At the first encounter 29% of patients had an ECOG performance status (PS) ≥ 2. ES-SCLC, bone metastases, female sex, progressive disease and/or PS were each significantly associated with decreased HUS in multivariable analyses. Patients clinically stable on first line therapy had generally steady HUS longitudinally, with differences in HUS between limited disease (LD) and ES patients emerging as treatment progressed. Decreased HUS were associated with increased severity of the majority of measured symptoms (fatigue/tiredness, loss of appetite, pain, drowsiness, shortness of breath, anxiety, depression, and overall well-being; each p<0.001), supporting the value of EQ-5D-derived HUS in assessing health utility. CONCLUSION Our HUS values in chemotherapy-treated SCLC are clinically relevant and are associated with specific clinico-demographic, symptom and toxicity factors.
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Affiliation(s)
- Nathan Kuehne
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Katrina Hueniken
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada; Biostatistics, Applied Clinical Research Unit, Princess Margaret Cancer Center, Toronto, Canada
| | - Maria Xu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada; Biostatistics, Applied Clinical Research Unit, Princess Margaret Cancer Center, Toronto, Canada
| | - Sharara Shakik
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Ali Vedadi
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Dixon Pinto
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada; McMaster University, Hamilton, ON, Canada
| | - M Catherine Brown
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Penelope A Bradbury
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Frances A Shepherd
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Adrian G Sacher
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Natasha B Leighl
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Wei Xu
- Biostatistics, Applied Clinical Research Unit, Princess Margaret Cancer Center, Toronto, Canada; Department of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Benjamin H Lok
- Radiation Medicine Program, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
| | - Geoffrey Liu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada; McMaster University, Hamilton, ON, Canada.
| | - Grainne M O'Kane
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada
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18
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Holland-Hart D, McCutchan GM, Quinn-Scoggins HD, Brain K, Hill L, Shanbag S, Abel M, White K, Evans A, Rees S, Bowen S, Gemine R, Collier G. Feasibility and acceptability of a community pharmacy referral service for suspected lung cancer symptoms. BMJ Open Respir Res 2021; 8:e000772. [PMID: 34376398 PMCID: PMC8354290 DOI: 10.1136/bmjresp-2020-000772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 07/11/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Lung cancer survival rates in the UK are among the lowest in Europe, principally due to late-stage diagnosis. Alternative routes to earlier diagnosis of lung cancer are needed in socioeconomically deprived communities that are disproportionately affected by poor lung cancer outcomes. We assessed the feasibility and acceptability of a community-based pharmacy referral service to encourage earlier symptomatic referral for chest X-rays. METHODS Seventeen community pharmacies located in a deprived area of Wales participated between March 2019 and March 2020. Stakeholder interviews were conducted with four patients, seven pharmacy professionals and one general practitioner. Four focus groups were conducted, including one with healthcare professionals (n=6) and three with members of the public who were current and former smokers (n=13). Quantitative data regarding patient characteristics and clinical outcomes were collected from hospital records and patient referral questionnaires completed by pharmacists and analysed using descriptive statistics. Qualitative data sets were analysed thematically and triangulated. RESULTS Twelve patients used the pharmacy referral service, all of whom were male. Average length of the pharmacy consultation was 13 min, with a mean 3 days to accessing chest X-rays in secondary care. Patients experienced a mean 46-day wait for results, with no lung cancer detected. Participants found the service to be acceptable and considered the pharmacy element to be broadly feasible. Perceived barriers included low awareness of the service and concerns about the role and capacity of pharmacists to deliver the service. Facilitators included perceived approachability and accessibility of pharmacists. A well-publicised, multifaceted awareness campaign was recommended. CONCLUSIONS A community pharmacy referral service for lung symptoms was considered an acceptable alternative pathway to symptomatic diagnosis of lung cancer in deprived communities. Wider implementation of the service would require workforce capacity and training to be addressed to ensure optimum utilisation and promotion of the service.
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Affiliation(s)
- Daniella Holland-Hart
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Grace M McCutchan
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | | | - Kate Brain
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, Wales, UK
| | - Lucy Hill
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
| | - Savita Shanbag
- Medical Directorate, Hywel Dda University Health Board, Llanelli, Carmarthenshire, UK
| | - Michael Abel
- Public Patient Representative, Ceredigion, Wales, UK
| | - Kelly White
- Hywel Dda University Health Board, Felinfoel Community Resource Centre, Llanelli, Carmarthenshire, UK
| | - Angela Evans
- Hywel Dda University Health Board, Felinfoel Community Resource Centre, Llanelli, Carmarthenshire, UK
| | - Sarah Rees
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
| | - Sarah Bowen
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
| | - Rachel Gemine
- Research and Development, Hywel Dda University Health Board, Prince Philip Hospital, Llanelli, Carmarthenshire, UK
- Swansea University College of Medicine, Swansea University, Swansea, Wales, UK
| | - Gareth Collier
- Department of Respiratory Medicine, Hywel Dda University Health Board, Llanelli, Carmarthenshire, UK
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Li F, Wang L, Zhang Y, Feng W, Ju T, Liu Z, Wang Z, Du X. A Retrospective Study on Using a Novel Single Needle Cone Puncture Approach for the Iodine-125 Seed Brachytherapy in Treating Patients With Thoracic Malignancy. Front Oncol 2021; 11:640131. [PMID: 34136382 PMCID: PMC8200774 DOI: 10.3389/fonc.2021.640131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 05/06/2021] [Indexed: 12/21/2022] Open
Abstract
Background Patients with progressive thoracic malignancy characterized by large irregular tumors with necrosis and life-threatening symptoms lack effective treatments. We set out to develop a single needle cone puncture method for the Iodine-125 seed (SNCP-125I) brachytherapy, and aim to report the initial results. Methods 294 patients with advanced thoracic malignancy were treated with local SNCP-125I brachytherapy between March 2009 and July 2020, followed by thorough evaluation of clinical outcome, overall survival (OS), progression-free survival (PFS) and procedure-related complications after treatment. Results The overall response rate (ORR) among the treated patients was 81.0% (238/294). Life-threatening symptoms due to tumor oppression, hemoptysis and large irregular tumor with necrosis were successfully alleviated after the SNCP-125I treatment with a remission rate at 91% to 94%. The median OS and PFS were 13.6 months and 5.8 months, respectively. Procedure-related side effects including pneumothorax (32/294), blood-stained sputum (8/294), subcutaneous emphysema (10/294), puncture site bleeding (16/294) and chest pain (6/294) were observed. Patients who were able to follow with chemotherapy or immunotherapy experienced extended OS and PFS, as compared with patients who opted to receive hospice care (16.5 months Vs. 11.2 months). Further pathological and immunological analysis showed that SNCP-125I induced tumor lymphocytes infiltration and long-term tumor necrosis. Conclusion SNCP-125I brachytherapy effectively eliminates life-threatening symptoms due to local tumor oppression, hemoptysis and large irregular and necrotic tumors in patients with unresectable chest malignancy and significantly induces local tumor regression. SNCP-125I brachytherapy combines with chemotherapy significantly prolong OS and PFS compare with SNCP-125I brachytherapy alone.
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Affiliation(s)
- Fenge Li
- Department of Oncology, Tianjin Beichen Hospital, Tianjin, China.,Department of Melanoma Oncology, University of Texas M.D. Anderson Cancer Center, Houston, TX, United States
| | - Liping Wang
- Department of Oncology, Weifang People's Hospital, Weifang, China
| | - Yixiang Zhang
- Pulmonary Medicine, Weifang People's Hospital, Weifang, China
| | - Weihong Feng
- Department of Oncology, Tianjin Beichen Hospital, Tianjin, China
| | - Tao Ju
- Department of Oncology, Tianjin Beichen Hospital, Tianjin, China
| | - Zaiping Liu
- Department of Pathology and Laboratory Medicine, IWK Women's and Children's Health Center, Halifax, NS, Canada
| | - Zhenglu Wang
- Pathology Department, Tianjin First Central Hospital, Tianjin, China
| | - Xueming Du
- Department of Oncology, Tianjin Beichen Hospital, Tianjin, China
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20
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Andugulapati SS, Chheda A, Desai K, Ravat SH. Diagnostic challenges in neoplastic meningitis presenting as intracranial hypertension. BMJ Case Rep 2021; 14:14/3/e238808. [PMID: 33692049 PMCID: PMC7949390 DOI: 10.1136/bcr-2020-238808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A diagnosis of idiopathic intracranial hypertension should be considered only after careful exclusion of all possible aetiologies. We report a case of neoplastic meningitis presenting as intracranial hypertension with inconclusive repeated cerebrospinal fluid (CSF) cytology and MRI of brain, emphasising the importance of meticulous CSF analysis and role of early whole-body PET-CT scan for diagnosis of systemic malignancy.
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Affiliation(s)
| | - Akash Chheda
- Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, Maharastra, India
| | - Karan Desai
- Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, Maharastra, India
| | - Sangeeta Hasmukh Ravat
- Department of Neurology, Seth GS Medical College and KEM Hospital, Mumbai, Maharastra, India
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21
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Araujo LH, Baldotto CS, Monteiro MR, Aguiar PN, Andrade MC, Longo CL, Batista M, Lima R, Azevedo D, Carvalho N, Andrade P, Zukin M, Teich N. Patient-centered outcomes in non-small-cell lung cancer: a real-world perspective. Future Oncol 2021; 17:1721-1733. [PMID: 33626916 DOI: 10.2217/fon-2020-0991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aims: To assess non-small-cell lung cancer (NSCLC) patient-centered outcomes in the real world. Methods: This is a prospective study of NSCLC patients treated at a private cancer care institution in Brazil between 2014 and 2019. Results: The report comprises 337 patients. Advanced stage was associated with higher symptom burden - fatigue (p = 0.03), pain (p < 0.001) and arm pain (p = 0.022) - and worse global, social and physical functioning (all p < 0.001). In the first 2 years, most factors evolved to either improvement or stability: cough (p = 0.02), pain (p = 0.002), global functioning (p < 0.001) and emotional functioning (p < 0.001). Staging (p < 0.001), fatigue (p = 0.001) and gender (p = 0.004) were independently associated with overall survival. Conclusions: Our results demonstrate the feasibility of conducting real-world prospective analysis of patient-centered outcomes.
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Affiliation(s)
- Luiz H Araujo
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil.,Instituto Nacional de Câncer (INCA), Rua André Cavalcanti, 37, Quinto Andar Prédio Anexo, Centro, Rio de Janeiro, 20.230-050, Brazil
| | - Clarissa S Baldotto
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil
| | - Mariana R Monteiro
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil
| | - Pedro N Aguiar
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil
| | - Maria Clara Andrade
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil
| | - Cecília L Longo
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil
| | - Mayara Batista
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil
| | - Raphaela Lima
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil
| | - Débora Azevedo
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil
| | - Natalia Carvalho
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil
| | - Perla Andrade
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil
| | - Mauro Zukin
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil
| | - Nelson Teich
- Instituto COI de Educação e Pesquisa, Avenida das Américas, 6205 Loja F Barra da Tijuca, Rio de Janeiro, 22793-080, Brazil.,Americas Centro de Oncologia Integrado, Av. Jorge Curi, 550 Barra da Tijuca, Rio de Janeiro, 22775-001, Brazil
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Miyashita Y, Hanawa K, Kobayashi H, Kumagai T, Inomata K, Tsutsui T, Kakizaki Y, Oyama T. A case of ALK-rearranged lung adenocarcinoma associated with syndrome of inappropriate antidiuretic hormone. Respir Med Case Rep 2020; 30:101136. [PMID: 32612920 PMCID: PMC7322342 DOI: 10.1016/j.rmcr.2020.101136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/16/2020] [Accepted: 06/16/2020] [Indexed: 11/17/2022] Open
Abstract
A 60-year-old man with a history of smoking was transferred to our hospital for consciousness disorder. A diagnosis of ALK-rearranged lung adenocarcinoma associated with a paraneoplastic electrolytic disorder was made following a cutaneous needle biopsy. Both the primary lung lesion and multiple metastases shrunk and his electrolytic disorder resolved after the introduction of a first-line molecular-targeted drug chemotherapy with crizotinib. We herein report a case of ALK-rearranged lung adenocarcinoma accompanied by SIADH, successfully treated with crizotinib.
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Affiliation(s)
- Yoshihiro Miyashita
- Department of Pulmonary Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Kotaro Hanawa
- Department of Pulmonary Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Hiroaki Kobayashi
- Department of Pulmonary Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Takashi Kumagai
- Department of Pulmonary Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Kie Inomata
- Department of Pulmonary Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Toshiharu Tsutsui
- Department of Pulmonary Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Yumiko Kakizaki
- Department of Pulmonary Medicine, Yamanashi Prefectural Central Hospital, Japan
| | - Toshio Oyama
- Department of Pathology, Yamanashi Prefectural Central Hospital, Japan
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Predictive values of lung cancer alarm symptoms in the general population: a nationwide cohort study. NPJ Prim Care Respir Med 2020; 30:15. [PMID: 32265450 PMCID: PMC7138801 DOI: 10.1038/s41533-020-0173-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/12/2020] [Indexed: 11/30/2022] Open
Abstract
We aimed to firstly determine the 1-year predictive values of lung cancer alarm symptoms in the general population and to analyse the proportion of alarm symptoms reported prior to diagnosis, and secondly analyse how smoking status and reported contact with general practitioners (GPs) regarding lung cancer alarm symptoms influence the predictive values. The study was a nationwide prospective cohort study of 69,060 individuals aged ≥40 years, randomly selected from the Danish population. Using information gathered in a survey regarding symptoms, lifestyle and healthcare-seeking together with registry information on lung cancer diagnoses in the subsequent year, we calculated the predictive values and likelihood ratios of symptoms that might be indicative of lung cancer. Furthermore, we analysed how smoking status and reported contact with GPs regarding the alarm symptoms affected the predictive values. We found that less than half of the patients had reported an alarm symptom six months prior to lung cancer diagnosis. The positive predictive values of the symptoms were generally very low, even for patients reporting GP contact regarding an alarm symptom. The highest predictive values were found for dyspnoea, hoarseness, loss of appetite and for current heavy smokers. The negative predictive values were high, all close to 100%. Given the low positive predictive values, our findings emphasise that diagnostic strategies should not focus on single, specific alarm symptoms, but should perhaps focus on different clusters of symptoms. For patients not experiencing alarm symptoms, the risk of overlooking lung cancer is very low.
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Hirpara DH, Gupta V, Davis LE, Zhao H, Hallet J, Mahar AL, Sutradhar R, Doherty M, Louie AV, Kidane B, Darling G, Coburn NG. Severe symptoms persist for Up to one year after diagnosis of stage I-III lung cancer: An analysis of province-wide patient reported outcomes. Lung Cancer 2020; 142:80-89. [PMID: 32120228 DOI: 10.1016/j.lungcan.2020.02.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Lung cancer is associated with significant disease- and treatment-related morbidity. The Edmonton Symptom Assessment System (ESAS) is a tool developed to elicit patients' own assessment of the severity of common cancer-associated symptoms. The objective of this study was to examine symptom severity in the 12 months following diagnosis of lung cancer, and to identify predictors of high symptom burden. MATERIALS AND METHODS This was a retrospective population-based cohort study, including patients with stage I-III lung cancer diagnosed between 2007-2016, and who had symptom screening in the 12 months following diagnosis. The proportion of patients reporting severe symptoms (ESAS ≥ 7) in the year following diagnosis was plotted over time. Multivariable regression models were constructed to identify factors associated with severe symptoms. RESULTS 69,440 unique symptom assessments were reported by 11,075 lung cancer patients. Tiredness was the most prevalent severe symptom (47.3 %), followed by shortness of breath (39.4 %) and poor wellbeing (36.5 %) among all disease stages. Patients diagnosed with higher stage disease reported more severe symptoms, but symptom trajectories were similar for all stages in the year following diagnosis. Disease stage (RR 1.10-2.01), comorbidity burden (RR 1.17-1.51), degree of socioeconomic marginalization (RR1.15-1.45), and female sex (RR 1.15-1.50) were associated with reporting severe symptoms in the year following diagnosis. CONCLUSION Severe physical and psychological symptoms persist throughout the first year following lung cancer diagnosis, regardless of disease stage. Those at risk of experiencing high symptom burden may benefit from targeted supportive care interventions, including psychosocial support aimed at improving health-related quality of life.
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Affiliation(s)
- Dhruvin H Hirpara
- Department of Surgery, University of Toronto, 149 College St., Toronto, ON M5T 1P5, Canada
| | - Vaibhav Gupta
- Department of Surgery, University of Toronto, 149 College St., Toronto, ON M5T 1P5, Canada
| | - Laura E Davis
- Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada
| | - Haoyu Zhao
- ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada
| | - Julie Hallet
- Department of Surgery, University of Toronto, 149 College St., Toronto, ON M5T 1P5, Canada; Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada; ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada
| | - Alyson L Mahar
- Manitoba Centre for Health Policy, University of Manitoba, 727 McDermot Ave., Winnipeg, MB R3B 3P5, Canada
| | - Rinku Sutradhar
- Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada; ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada
| | - Mark Doherty
- Division of Medical Oncology, University of Toronto, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada
| | - Alexander V Louie
- Division of Radiation Oncology, University of Toronto, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada
| | - Biniam Kidane
- Section of Thoracic Surgery, University of Manitoba, 820 Sherbrook St., Winnipeg, MB R3A 1R9, Canada
| | - Gail Darling
- Division of Thoracic Surgery, Toronto General Hospital, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada
| | - Natalie G Coburn
- Department of Surgery, University of Toronto, 149 College St., Toronto, ON M5T 1P5, Canada; Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada; ICES, 2075 Bayview Ave., Toronto, ON M4N 3M5, Canada.
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Khan S, Ali S, Muhammad. Exhaustive Review on Lung Cancers: Novel Technologies. Curr Med Imaging 2020; 15:873-883. [PMID: 32013812 DOI: 10.2174/1573405615666181128124528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/30/2018] [Accepted: 11/07/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Lung cancers or (Bronchogenic-Carcinomas) are the disease in certain parts of the lungs in which irresistible multiplication of abnormal cells leads to the inception of a tumor. Lung cancers consisting of two substantial forms based on the microscopic appearance of tumor cells are: Non-Small-Cell-Lung-Cancer (NSCLC) (80 to 85%) and Small-Cell-Lung-Cancer (SCLC) (15 to 20%). DISCUSSION Lung cancers are existing luxuriantly across the globe and the most prominent cause of death in advanced countries (USA & UK). There are many causes of lung cancers in which the utmost imperative aspect is the cigarette smoking. During the early stage, there is no perspicuous sign/symptoms but later many symptoms emerge in the infected individual such as insomnia, headache, pain, loss of appetite, fatigue, coughing etc. Lung cancers can be diagnosed in many ways, such as history, physical examination, chest X-rays and biopsy. However, after the diagnosis and confirmation of lung carcinoma, various treatment approaches are existing for curing of cancer in different stages such as surgery, radiation therapy, chemotherapy, and immune therapy. Currently, novel techniques merged that revealed advancements in detection and curing of lung cancer in which mainly includes: microarray analysis, gene expression profiling. CONCLUSION Consequently, the purpose of the current analysis is to specify and epitomize the novel literature pertaining to the development of cancerous cells in different parts of the lung, various preeminent approaches of prevention, efficient diagnostic procedure, and treatments along with novel technologies for inhibition of cancerous cell growth in advance stages.
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Affiliation(s)
- Sajad Khan
- Center for Biotechnology and Microbiology, University of Swat, Swat, Pakistan
| | - Shahid Ali
- Centre for Biotechnology and Microbiology, University of Swat, Swat, Pakistan
| | - Muhammad
- Department of Microbiology, University of Swabi, Swabi, KP, Pakistan
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The usefulness and prognostic value of Memorial Symptom Assessment-Short Form and Condensed Memorial Symptom Assessment Scale in assessment of lung cancer patients. Support Care Cancer 2019; 28:2005-2014. [DOI: 10.1007/s00520-019-05003-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 07/17/2019] [Indexed: 12/25/2022]
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Xing P, Zhu Y, Wang L, Hui Z, Liu S, Ren J, Zhang Y, Song Y, Liu C, Huang Y, Liao X, Xing X, Wang D, Yang L, Du L, Liu Y, Zhang Y, Liu Y, Wei D, Zhang K, Shi J, Qiao Y, Chen W, Li J, Dai M. What are the clinical symptoms and physical signs for non-small cell lung cancer before diagnosis is made? A nation-wide multicenter 10-year retrospective study in China. Cancer Med 2019; 8:4055-4069. [PMID: 31150167 PMCID: PMC6639195 DOI: 10.1002/cam4.2256] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 04/27/2019] [Accepted: 05/03/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Most lung cancer patients are diagnosed after the onset of symptoms. However, whether the symptoms of lung cancer were independently associated with the diagnosis of lung cancer is unknown, especially in the Chinese population. METHODS We conducted a 10 years (2005-2014) nationwide multicenter retrospective clinical epidemiology study of lung cancer patients diagnosed in China. As such, this study focused on nonsmall cell lung cancer (NSCLC). We calculated the odds ratios (ORs) for variables associated with the symptoms and physical signs using multivariate unconditional logistic regressions. RESULTS A total of 7184 lung cancer patients were surveyed; finally, 6398 NSCLC patients with available information about their symptoms and physical signs were included in this analysis. The most common initial symptom and physical sign was chronic cough (4156, 65.0%), followed by sputum with blood (2110, 33.0%), chest pain (1146, 17.9%), shortness of breath (1090, 17.0%), neck and supraclavicular lymphadenectasis (629, 9.8%), weight loss (529, 8.3%), metastases pain (378, 5.9%), fatigue (307, 4.8%), fever (272, 4.3%), and dyspnea (270, 4.2%). Patients with squamous carcinoma and stage III disease were more likely to present with chronic cough (P < 0.0001) and sputum with blood (P < 0.0001) than patients with other pathological types and clinical stages, respectively. Metastases pain (P < 0.0001) and neck and supraclavicular lymphadenectasis (P = 0.0006) were more likely to occur in patients with nonsquamous carcinoma than in patients with other carcinomas. Additionally, patients with stage IV disease had a higher percentage of chest pain, shortness of breath, dyspnea, weight loss, and fatigue than patients with other stages of disease. In multivariable logistic analyses, compared with patients with adenocarcinoma, patients with squamous carcinoma were more likely to experience symptoms (OR = 2.885, 95% confidence interval [CI] 2.477-3.359) but were less likely to present physical signs (OR = 0.844, 95% CI 0.721-0.989). The odds of having both symptoms and physical signs were higher in patients with late-stage disease than in those with early-stage disease (P < 0.0001). CONCLUSIONS The symptoms and physical signs of lung cancer were associated with the stage and pathological diagnosis of NSCLC. Patients with squamous carcinoma were more likely to develop symptoms, but not signs, than patients with adenocarcinoma. The more advanced the stage at diagnosis, the more likely that symptoms or physical signs are to develop. Further prospective cohort studies are needed to explore these results.
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Affiliation(s)
- Pu‐Yuan Xing
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yi‐Xiang Zhu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Affiliated Hospital of Guizhou Medical University, Guizhou Province Tumor HospitalGuiyangP.R. China
| | - Le Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Zhou‐Guang Hui
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Shang‐Mei Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jian‐Song Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ye Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yan Song
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Cheng‐Cheng Liu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | | | | | | | | | - Li Yang
- Guangxi Medical UniversityNanningP.R. China
| | | | - Yu‐Qin Liu
- Gansu Provincial Cancer HospitalLanzhou, GansuP.R. China
| | | | - Yun‐Yong Liu
- Liaoning Cancer Hospital & InstituteShenyangP.R. China
| | | | - Kai Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Ju‐Fang Shi
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - You‐Lin Qiao
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Wan‐Qing Chen
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jun‐Ling Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Min Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Iams WT, Shiuan E, Meador CB, Roth M, Bordeaux J, Vaupel C, Boyd KL, Summitt IB, Wang LL, Schneider JT, Warner JL, Zhao Z, Lovly CM. Improved Prognosis and Increased Tumor-Infiltrating Lymphocytes in Patients Who Have SCLC With Neurologic Paraneoplastic Syndromes. J Thorac Oncol 2019; 14:1970-1981. [PMID: 31201935 DOI: 10.1016/j.jtho.2019.05.042] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/22/2019] [Accepted: 05/31/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Approximately 10% of patients with SCLC develop a paraneoplastic syndrome (PNS). Neurologic PNS are thought to improve prognosis, which we hypothesized is related to increased tumor-infiltrating lymphocytes and immune recognition. METHODS We queried 2,512,042 medical records from a single institution to identify patients who have SCLC with and without PNS and performed manual, retrospective chart review. We then performed multiplexed fluorescence immunohistochemistry and automated quantitative analysis (AQUA Technology) on tumors to assess CD3, CD4, and CD8 T cell infiltrates and programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) interactions. T cell infiltrates and PD-1/PD-L1 interaction scores were compared among patients with neurologic PNS, endocrinologic PNS, and a control group without PNS. Clinical outcomes were analyzed using the Kaplan-Meier method and Cox proportional hazards models. RESULTS We evaluated 145 SCLC patients: 55 with PNS (25 neurologic and 30 endocrinologic) and 90 controls. Patients with neurologic PNS experienced improved overall survival compared to patients with endocrinologic PNS and controls (median overall survival of 24 months versus 12 months versus 13 months, respectively). Of the 145 patients, we identified tumor tissue from 34 patients that was adequate for AQUA analysis. Among 37 specimens from these 34 patients, patients with neurologic PNS had increased T cell infiltrates (p = 0.033) and PD-1/PD-L1 interaction (p = 0.014) compared to tumors from patients with endocrinologic PNS or controls. CONCLUSIONS Tumor tissue from patients with SCLC with neurologic PNS showed increased tumor-infiltrating lymphocytes and PD-1/PD-L1 interaction consistent with an inflamed tumor microenvironment.
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Affiliation(s)
- Wade T Iams
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Eileen Shiuan
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | | | - Marc Roth
- Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Jennifer Bordeaux
- Navigate Biopharma Services, Inc., a Novartis Subsidiary, Carlsbad, California
| | - Christine Vaupel
- Navigate Biopharma Services, Inc., a Novartis Subsidiary, Carlsbad, California
| | - Kelli L Boyd
- Department of Pathology, Immunology, and Microbiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - IlaSri B Summitt
- Navigate Biopharma Services, Inc., a Novartis Subsidiary, Carlsbad, California
| | - Lucy L Wang
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Joseph T Schneider
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jeremy L Warner
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zhiguo Zhao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Christine M Lovly
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
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Schlaeger JM, Weng LC, Huang HL, Tsai HH, Takayama M, Ngamkham S, Yao Y, Wilkie DJ. Pain Quality by Location in Outpatients with Cancer. Pain Manag Nurs 2019; 20:425-431. [PMID: 31160180 DOI: 10.1016/j.pmn.2019.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/21/2019] [Accepted: 04/24/2019] [Indexed: 01/17/2023]
Abstract
BACKGROUND The McGill Pain Questionnaire (MPQ) pain quality descriptors have been analyzed to characterize the sensory, affective, and evaluative domains of pain, but have not been differentiated by pain location. AIM To examine MPQ pain quality descriptors by pain location in outpatients with lung or prostate cancer. DESIGN Cross sectional. SETTINGS Eleven oncology clinics or patients' homes. SUBJECTS 264 adult outpatients (80% male; mean age 62.2 ± 10.0 years, 85% White). METHODS Subjects completed a 100 mm visual analogue scale of pain intensity and MPQ clinic or home visit, marking sites where they had pain on a body outline and circling from 78 verbal descriptors those that described their pain. A researcher noted next to the descriptor spontaneous comments about sites feeling like a selected word and queried the subjects about any other words to obtain the site(s). RESULTS Pain quality descriptors were assigned to all 7 pain locations marked by ≥ 20% of 198 lung or 66 prostate cancer patients. Four pain locations were marked with pain quality descriptors significanlty (p < .05) more frequently for lung cancer (53% chest-aching, burning; 58% back-aching, stabbing; 48% head-aching, sharp; and 19% arms-aching, stabbing) than for prostate cancer, which had significantly more frequent pain locations in the abdomen (64%-aching, burning) and lower back/buttocks (55%-aching, burning). CONCLUSIONS This type of pain characterization is innovative and has the potential to help implement targeted treatments for patients with cancer and other chronic pain conditions.
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Affiliation(s)
- Judith M Schlaeger
- Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois
| | - Li-Chueh Weng
- Chang Gung University School of Nursing, College of Medicine, Taoyuan, Taiwan, ROC
| | - Hsiu-Li Huang
- National Taipei University of Nursing and Health Sciences, Department of Long-term Care, College of Health Technology, Taipei, Taiwan, ROC
| | - Hsiu-Hsin Tsai
- Chang Gung University School of Nursing, College of Medicine, Taoyuan, Taiwan, ROC
| | - Miho Takayama
- Tokyo Ariake University of Medical and Health Sciences, Department of Acupuncture and Moxibustion, Tokyo, Japan
| | - Srisuda Ngamkham
- Boromarajonani College of Nursing Sawanpracharak Nakhonsawan, Paknampho, Maung, Nakhonsawan, Thailand
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida
| | - Diana J Wilkie
- Department of Biobehavioral Nursing Science, University of Florida College of Nursing, Gainesville, Florida.
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DiBonaventura MD, Shah-Manek B, Higginbottom K, Penrod JR, Yuan Y. Adherence to recommended clinical guidelines in extensive disease small-cell lung cancer across the US, Europe, and Japan. Ther Clin Risk Manag 2019; 15:355-366. [PMID: 30881001 PMCID: PMC6400139 DOI: 10.2147/tcrm.s183216] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose This study compared real-world treatment patterns of patients with extensive disease small-cell lung cancer (ED-SCLC) across regions and by platinum resistance/platinum sensitivity (PR/PS) and established if these patterns were in line with published guidelines. Patients and methods The data source was the Oncology Monitor, a global database using retrospective medical chart reviews of oncology patients treated with anticancer drugs. All patients diagnosed with ED-SCLC from January 2014 through December 2016 in the US, and in France, Germany, Italy, Spain, and the UK (European Union; EU5), and Japan were included. Results Of 5,849 treated patients, 73.4%, 19.8% and 6.8% received first, second, or third/later lines (1L, 2L, 3L) of therapy, respectively. The most frequent 1L treatment, platinum + etoposide, was significantly more common in the US (87.0%) than in the EU5 (82.1%) or Japan (73.3%) (P<0.05). Platinum + irinotecan was a common 1L treatment in Japan (22.7%) but not in the US (2.0%) or EU5 (0.5%, P<0.0001). Topotecan was the most common 2L treatment in the US and EU5, but amrubicin was the most common in Japan. Among PR patients, 27.3%, 10.8%, and 36.4% received a platinum-based 2L therapy in the US, EU5, and Japan, respectively. Among PS patients, approximately half were not re-challenged with a 2L platinum-based therapy across all regions. Conclusion In contrast to treatment guidelines, a significant proportion of real-world PR patients were re-challenged with a 2L platinum-based therapy, while conversely, many PS patients did not receive platinum-based therapies in 2L. This study highlights a lack of a consistent paradigm for 2L ED-SCLC treatment, limited therapeutic options, and an unmet need among SCLC patients.
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Affiliation(s)
| | - Bijal Shah-Manek
- Global Evidence Value and Access (GEVA), Ipsos Healthcare, San Francisco, CA, USA,
| | - Karen Higginbottom
- Global Evidence Value and Access (GEVA), Ipsos Healthcare, Mahwah, NJ, USA
| | - John R Penrod
- Worldwide Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA
| | - Yong Yuan
- Worldwide Health Economics and Outcomes Research, Bristol-Myers Squibb, Princeton, NJ, USA
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Seo YJ, Park H. Factors influencing caregiver burden in families of hospitalised patients with lung cancer. J Clin Nurs 2019; 28:1979-1989. [DOI: 10.1111/jocn.14812] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/11/2018] [Accepted: 12/04/2018] [Indexed: 01/15/2023]
Affiliation(s)
- Ye Ji Seo
- College of Nursing, Research Institute of Nursing Science Keimyung University Daegu Korea
| | - Heeok Park
- College of Nursing, Research Institute of Nursing Science Keimyung University Daegu Korea
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Abdolmohammadi J, Faeghi F, Arefan D, Zali A, Haghighatkhah H, Amiri J. The Role of Single Voxel MR Spectroscopy, T2 Relaxation Time and Apparent Diffusion Coefficient in Determining the Cellularity of Brain Tumors by MATLAB Software. Asian Pac J Cancer Prev 2018; 19:2891-2895. [PMID: 30362318 PMCID: PMC6291043 DOI: 10.22034/apjcp.2018.19.10.2891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Introduction: Brain tumors if timely diagnosed are sure to be treated through shorter processes. MRI amongst
others is of Para clinical methods greatly effective in diagnosis phase. Diffusion-weighted imaging (DWI) and apparent
diffusion coefficient (ADC) maps provide some information that could reflect tissue cellularity. Neurosurgeons, in
particular to detect the tumor cellularity, must send the specimens taken through biopsy to the pathology unit. This
study is aimed at determining the tumor cellularity in brain. Materials and Methods: In this cross-sectional study, 32
patients (18 males and 14 females of the range 18 – 77 y/o) between April 2014 and February 2016 who were referred
to the neurosurgery department of Shohada-E Tajrish Hospital of Tehran participated. Imaging was made using single
voxel MR Spectroscopy, ADC and T2W Multi Echo Pulse Sequence in addition to routine pulse sequences and the
images were analyzed using MATLAB software to determine the cellularity of brain tumors in comparison to the biopsy.
Results: findings showed that by decreasing T2 relaxation time, the amount of ADC, N-Acetyl Aspartate (NAA) and
also, increase Choline metabolite, lead to registering tumors in the lower class on the designed table and these tumors
have a higher degree of consistency and cellularity. T2 Relaxation time, the tumors will stand at higher class on the
designed table. Also the results indicated that 85% diagnostic weight of T2 relaxation time and 83% diagnostic weight
of ADC compared with biopsy could reveal the brain tumor cellularity (P>0.05). Conclusion: some cellular metabolite
changes such as NAA and Choline, ADC value and T2 relaxation time feature could effectively be used to distinguish
and illustrate the degree of cellularity of brain tumors especially Intra-axial brain tumors (with about 85%. vs. biopsy).
We recommend to more data should be used to increase the accuracy percentage of this technique.
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Affiliation(s)
- Jamil Abdolmohammadi
- Department of Radiology, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Sclerotic Bone Metastasis in Pulmonary Adenocarcinoma. Case Rep Med 2018; 2018:1903757. [PMID: 30079090 PMCID: PMC6020462 DOI: 10.1155/2018/1903757] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/22/2018] [Accepted: 05/24/2018] [Indexed: 12/20/2022] Open
Abstract
Pulmonary adenocarcinoma is one of the major types of lung cancers in which metastasis is very common and it accounts approximately to one-third of all primary pulmonary cancers. Although a minority of patients with lung cancer are asymptomatic, which gets usually detected in routine chest radiography, most of the patients present with some symptoms. Lung cancer metastasis may occur virtually in every organ system. Patients with non-small-cell lung cancer commonly have extrathoracic metastases to the adrenal glands, liver, brain, bones, and lymph nodes at presentation. Approximately one-third of patients with lung cancer will present with symptoms related to extrathoracic spread. Metastasis to the bone is not uncommon in lung cancer; however, osteoblastic bone metastasis is very rare. Here we present a 30-year-old female diagnosed to have pulmonary adenocarcinoma with multiple sclerotic bony lesions in the vertebra.
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Annakkaya AN, Arbak P, Balbay O, Bilgin C, Erbas M, Bulut I. Effect of Symptom-To-Treatment Interval on Prognosis in Lung Cancer. TUMORI JOURNAL 2018; 93:61-7. [PMID: 17455873 DOI: 10.1177/030089160709300111] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aims and background To evaluate the relationship between delayed diagnosis and the degree of invasion and survival in lung cancer. Methods One hundred and three patients (96 men) with lung cancer were included. Stages in the diagnosis of lung cancer were classified as follows: symptom-to-doctor interval, i.e., the interval from the first symptoms related to the presence of lung cancer to the first consultation with a medical professional; doctor-to-diagnosis interval, i.e., the interval between the first medical visit and confirmation of the diagnosis; and diagnosis-to-treatment interval, i.e., the interval between diagnosis and complete TNM staging and treatment. The symptom-to-treatment interval (STI) was the sum of the 3 intervals. The degree of invasion was determined by the TNM classification. Results The patients were followed up for a mean period (± SD) of 7.4 ± 8.7 months. Seventy-six (74%) patients were diagnosed with non-small cell lung cancer (NSCLC) and 27 patients (26%) with small cell lung cancer (SCLC). The mean length of STI was 120 ± 101 days (median, 90). The mean length of the symptom-to-doctor interval was 63 ± 62 days (median, 45), while the doctor-to-diagnosis and diagnosis-to-treatment intervals were 41 ± 82 days (median, 10) and 16 ± 12 days (median, 12), respectively. When the STIs of the patients were correlated with tumor stage, tumor invasion, lymph node involvement and metastasis, no significant differences were found. Patients with an STI longer than 60 days had a significantly longer survival. Regarding the type of lung cancer and STI, the median survival was shorter in patients with an STI of less than 60 days both in NSCLC and SCLC, although this was not statistically significant in SCLC. Conclusions The shorter the diagnostic interval, the shorter was the median survival in our study. The reason for the apparent discrepancy between poor prognosis of lung cancer patients in spite of early diagnosis might be much faster progression of the disease itself.
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Affiliation(s)
- All Nihat Annakkaya
- Department of Chest Diseases, Faculty of Medicine, Abant Izzet Baysal University, Duzce, Turkey.
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Støchkel Frank M, Schou Nørøxe D, Nygård L, Fredberg Persson G. Fractionated palliative thoracic radiotherapy in non-small cell lung cancer - futile or worth-while? BMC Palliat Care 2018; 17:15. [PMID: 29304789 PMCID: PMC5756366 DOI: 10.1186/s12904-017-0270-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 12/28/2017] [Indexed: 12/25/2022] Open
Abstract
Background Palliative thoracic radiotherapy (PTR) can relieve symptoms originating from intra-thoracic disease. The optimal timing and fractionation of PTR is unknown. Time to effect is 2 months. The primary aim of this retrospective study was to investigate survival after PTR, hypothesizing that a significant number of patients received futile fractionated PTR. The secondary aim was to find prognostic factors to guide treatment decisions. Methods Patients with non-small-cell lung cancer (NSCLC) planned for PTR in the period of 2010-2011 at the University Hospital of Copenhagen were included. We noted pathology, tumor, node and metastasis (TNM) classification of malignant tumors, stage, indication, start date, schedule for PTR, completed y/n, performance status (PS) and time of death. Analyses were performed as an intention-to-treat using Cox regression, Fishers exact test and Kaplan Meier. Results A total of 159 patients were included. Median overall survival (OS) was 4.2 months. Sixteen patients (10%) did either not begin or finish PTR. Of these, eight (5%) died prior to or during PTR. Of the 151 patients receiving PTR, sixteen patients (11%) died within 14 days, thirty-three (22%) within 30 days and fifty (33%) within 2 months. PS 0-1 and squamous cell carcinoma were correlated with a better survival. Conclusions Our study show that a significant number of patients who received PTR died before they could achieve optimal effect of the treatment. PS and histology were significant prognostic factors favoring PS 0-1 and squamous cell carcinoma. Based on our study, we suggest that patients with PS 0-1 should be considered for fractionated PTR whereas patients with PS ≥ 2 should be considered for high dose single fraction only or supportive palliative care. Electronic supplementary material The online version of this article (10.1186/s12904-017-0270-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Malene Støchkel Frank
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Dorte Schou Nørøxe
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.
| | - Lotte Nygård
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark.,Section of Radiotherapy, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
| | - Gitte Fredberg Persson
- Department of Oncology, Finsen Center, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen, Denmark
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Ao X, Zhou J, Liang HL, Jiang M, Li HS. Expression profile of Oct-4 lung cancer-specific marker prior and subsequent to a salirasib treatment regime. Oncol Lett 2017; 14:5145-5148. [PMID: 29142598 PMCID: PMC5666668 DOI: 10.3892/ol.2017.6868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 01/17/2017] [Indexed: 11/22/2022] Open
Abstract
Lung cancer is one of the leading types of cancer that lead to mortalities in the male and female populations. The existing lung cancer-specific markers are not able to accurately predict the condition of the disease, and the response of these markers can vary under various pathological conditions. The ability for tumors to regenerate following treatment can be more aggressive, and this may be due to the remaining lung cancer-specific stem cells, which are resistant to chemotherapeutic drugs. Evaluating cancer stem cells under various pathological conditions, as well as prior and subsequent to treatment, can help to increase the understanding of the underlying mechanisms. In the present study, a mouse model with initial and advanced forms of lung cancer was developed using tobacco smoke carcinogen. It was observed from tissue sections that there were many actively dividing cells spread throughout the mouse lung tissue with the initial stages of lung cancer, and these cells aggregated in advanced stages of lung cancer. Furthermore, immunohistochemical staining indicated that there was an increased number of octamer-binding protein 4 (Oct-4)-positive cells present in mouse tissues with advanced stages of the disease compared with tissues without lung cancer or at the initial stages of disease. The cancer stem cell population following salirasib treatment was also investigated in two groups. The mice in the early treatment group were administered with salirasib following 1 month of tumor growth, and the delayed treatment group was treated following 2 months of tumor growth. The number of cancer stem cells was markedly reduced in the early treatment group. However, salirasib failed to have any observable effect in the delayed treatment group. Cancer stem cells were analyzed using the marker Oct-4 to improve an understanding of the proliferative ability of cancer stem cells under various pathological conditions, which may lead to the development of novel cancer therapeutics.
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Affiliation(s)
- Xiang Ao
- Department of Thoracic and Breast Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Jie Zhou
- Department of Thoracic and Breast Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Hong Ling Liang
- Department of Thoracic and Breast Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Ming Jiang
- Department of Thoracic and Breast Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
| | - Hong Sheng Li
- Department of Thoracic and Breast Oncology, Affiliated Cancer Hospital and Institute of Guangzhou Medical University, Guangzhou, Guangdong 510095, P.R. China
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Effectiveness of Bronchofiberoscopy in Diagnosis of Lung Lesions. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017. [PMID: 28236122 DOI: 10.1007/5584_2017_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register]
Abstract
Lung cancer is the most common cause of cancer-related deaths. A short survival rate often results from belated diagnosis made in advanced stages. Therapy individualization requires the collection of a viable material for histopathological examination, which often brings difficulties. This study was performed in a group of 110 patients suspected of malignancy in chest computed tomography. All subjects underwent bronchofiberoscopy. Bronchoalveolar lavage (BAL) and endobronchial brushing were performed in all cases, whereas forceps tissue biopsy was taken if mucous membrane abnormalities were observed. In case of a negative result of bronchofiberoscopy invasive methods were implemented. A malignant neoplasm was diagnosed in 106 cases. Overall, cancer cells (positive result) were found in 45 patients (42.0%) subjected to bronchofiberoscopy. Cytology was positive in 38 (35.8%) and histopathological examination in 30 (28.3%) specimens. Eleven samples of BAL (10.3%) were positive. Endobronchial brushing was more effective, with 27 positive samples (25.5%). Forceps tissue biopsy was performed in 33 cases with 90% sensitivity. The most frequent cancer subtype found was squamous cell carcinoma. No severe complications of bronchofiberoscopy were observed. We conclude that bronchofiberosocpy is a safe diagnostic procedure for lung lesions, but its sensitivity and specificity are low. Only when there are mucous macroscopic changes observed, a precise diagnosis is possible.
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Demiray G, Değirmencioğlu S, Uğurlu E, Yaren A. Effects of Serum Leptin and Resistin Levels on Cancer Cachexia in Patients With Advanced-Stage Non-Small Cell Lung Cancer. CLINICAL MEDICINE INSIGHTS-ONCOLOGY 2017; 11:1179554917690144. [PMID: 28469508 PMCID: PMC5395268 DOI: 10.1177/1179554917690144] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 01/01/2017] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Cancer cachexia is one of the most frequent effects of malignancy, is often associated with poor prognosis, and may account for up to 20% of cancer deaths. The aim of our study was to evaluate the relationship of cancer cachexia and serum levels of resistin and leptin in patients with advanced non-small cell lung cancer. METHODS A total of 67 chemotherapy-naïve patients with advanced-stage non-small cell cancer and a control group containing 20 healthy individuals without a known chronic disease were enrolled in this study. All individuals in the control group were age and sex matched. Demographic, anthropometric, laboratory data and serum levels of adipokines were measured for 2 groups. Progression-free survival and overall survival were estimated using the Kaplan-Meier method. Survival among various factors was calculated using the log-rank test. RESULTS Patients presented significantly higher serum resistin (P = .0001) and lower serum leptin levels (P = .025) than the control group. Lower serum levels of leptin were correlated with overall survival (P = .011). CONCLUSIONS Serum leptin and resistin levels play key role as proinflammatory cytokines in lung cancer and cancer cachexia; however, their use as diagnostic or prognostic markers is not possible yet, and further large-scale studies are required to confirm our findings.
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Affiliation(s)
- Gökcen Demiray
- Medical Oncology Department, Zafer Goksin Oncology Center, Denizli State Hospital, Denizli, Turkey
| | - Serkan Değirmencioğlu
- Medical Oncology Department, Fahri Goksin Oncology Center, Pamukkale University Hospital, Denizli, Turkey
| | - Erhan Uğurlu
- Thoracic Oncology Department, Pamukkale University Hospital, Denizli, Turkey
| | - Arzu Yaren
- Medical Oncology Department, Fahri Goksin Oncology Center, Pamukkale University Hospital, Denizli, Turkey
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Abdolmohammadi J, Shafiee M, Faeghi F, Arefan D, Zali A, Motiei-Langroudi R, Farshidfar Z, Nazarlou AK, Tavakkoli A, Yarham M. Determination of intra-axial brain tumors cellularity through the analysis of T2 Relaxation time of brain tumors before surgery using MATLAB software. Electron Physician 2016; 8:2726-2732. [PMID: 27757181 PMCID: PMC5053452 DOI: 10.19082/2726] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 04/09/2016] [Indexed: 12/04/2022] Open
Abstract
Introduction Timely diagnosis of brain tumors could considerably affect the process of patient treatment. To do so, para-clinical methods, particularly MRI, cannot be ignored. MRI has so far answered significant questions regarding tumor characteristics, as well as helping neurosurgeons. In order to detect the tumor cellularity, neuro-surgeons currently have to sample specimens by biopsy and then send them to the pathology unit. The aim of this study is to determine the tumor cellularity in the brain. Methods In this cross-sectional study, 32 patients (18 males and 14 females from 18–77 y/o) were admitted to the neurosurgery department of Shohada-E Tajrish Hospital in Tehran, Iran from April 2012 to February 2014. In addition to routine pulse sequences, T2W Multi echo pulse sequences were taken and the images were analyzed using the MATLAB software to determine the brain tumor cellularity, compared with the biopsy Results These findings illustrate the need for more T2 relaxation time decreases, the higher classes of tumors will stand out in the designed table. In this study, the results show T2 relaxation time with a 85% diagnostic weight, compared with the biopsy, to determine the brain tumor cellularity (p<0.05). Conclusion Our results indicate that the T2 relaxation time feature is the best method to distinguish and present the degree of intra-axial brain tumors cellularity (85% accuracy compared to biopsy). The use of more data is recommended in order to increase the percent accuracy of this techniques.
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Affiliation(s)
- Jamil Abdolmohammadi
- M.Sc. of Medical Imaging Technology (MRI), Department of Radiology, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohsen Shafiee
- M.Sc. of Medical Physics, Cellular and Molecular Research Center, Yasuj University of Medical sciences, Yasuj, Iran
| | - Fariborz Faeghi
- Ph.D. in Medical Physics, Radiology Technology Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Douman Arefan
- Department of Radiation Medicine Engineering, Shahid Beheshti University, Evin, Tehran, Iran
| | - Alireza Zali
- Neurosurgeon, Head of Neurosurgery Department of Shohada-E Tajrish Hospital, Chairman of the Medical Council of Iran, Tehran, Iran
| | - Rouzbeh Motiei-Langroudi
- Department of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Zahra Farshidfar
- M.Sc. of Medical Imaging Technology (MRI), Radiology Department of Paramedical School, Shiraz University of Medical Science, Shiraz, Iran
| | - Ali Kiani Nazarlou
- M.Sc. of Medical Imaging Technology, Department of Radiology, Imam Reza Medical Research and Training Hospital, Golgasht Ave., Tabriz, Iran
| | - Ali Tavakkoli
- M.Sc. of Medical Imaging Technology (MRI), Bahonar Medical Research and Training Hospital, Alborz University of Medical Science, Karaj, Iran
| | - Mohammad Yarham
- M.Sc. of Medical Imaging Technology (MRI), Radiology Department of Paramedical School, Shiraz University of Medical Science, Shiraz, Iran
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Shih WMJ, Hsu HC, Jiang RS, Lin MH. Lived Experience among Patients Newly Diagnosed with Lung Adenocarcinoma Stage IV within One Year. Asian Pac J Cancer Prev 2016; 16:6633-8. [PMID: 26434887 DOI: 10.7314/apjcp.2015.16.15.6633] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND lung cancer (LC) is the fifth of the 10 leading causes of death in the world. LC is in first place for cancer-related mortality for both males and females in Taiwan. It is one of the most difficult cancers to treat and is often diagnosed at a late stage. Patients with stage IV are often unprepared for the diagnosis. MATERIALS AND METHODS To explore lived experience among patients newly diagnosed with lung adenocarcinoma stage IV within one year. RESULTS Twelve participants were recruited in this study. Content analysis of the interviews revealed four themes: (1) emotional roller coaster, (2) trying to find out causes, (3) adjusting my lifestyle, and (4) cancer fighter. CONCLUSIONS This study provides new insight into the experiences of lung cancer patients y with newly diagnosed lung adenocarcinoma stage 4. These results will inform future supportive care service development and intervention research for patients with advanced stage cancer.
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Affiliation(s)
- Whei-Mei Jean Shih
- Graduate Institute of Health Care, Chang Gung University of Science and Technology , Tao-Yuan, Taiwan E-mail :
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Review of the Diagnostic Challenges of Lambert–Eaton Syndrome Revealed Through Three Case Reports. Can J Neurol Sci 2016; 43:635-47. [DOI: 10.1017/cjn.2016.268] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
AbstractLambert–Eaton syndrome (LES) is a rare immune-mediated disorder characterized by proximal leg weakness, autonomic symptoms and hypoactive tendon reflexes. The paraneoplastic form is associated with small-cell lung cancer in 50-60% of cases, whereas the remaining cases are found in younger adults with a higher likelihood of coexisting autoimmune disease. The early recognition of LES is crucial for improving clinical outcomes but remains a major challenge. In this review, we analyze the clinical characteristics and diagnostic considerations in treating LES through a series of three case studies, one of which showed definitive response to pyridostigmine and corticosteroid combination therapy, followed by spontaneous remission. Patients were assessed by image-based screening, serological testing and electrophysiological evaluations, which included respiratory and autonomic testing. A better understanding of the common pitfalls in the clinical, serological and neurophysiologic diagnosis of LES through assessment of typical LES dysfunction throughout the nervous system should enable improved recognition and treatment of this syndrome.
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Shen L, Yang M, Lin Q, Zhang Z, Zhu B, Miao C. COL11A1 is overexpressed in recurrent non-small cell lung cancer and promotes cell proliferation, migration, invasion and drug resistance. Oncol Rep 2016; 36:877-85. [PMID: 27373316 DOI: 10.3892/or.2016.4869] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 12/07/2015] [Indexed: 11/05/2022] Open
Abstract
Collagen type XI α1 (COL11A1), a minor fibrillar collagen, has been demonstrated to be involved in cell proliferation, migration and the tumorigenesis of many human malignancies. Previous studies have shown that COL11A1 may be a valuable diagnostic marker for non-small cell lung carcinoma (NSCLC). However, its biological function in NSCLC progression remains largely unclear. In the present study, we investigated the expression levels of COL11A1 in different human NSCLC samples, and found that COL11A1 was overexpressed in NSCLC with lymph node metastasis and in recurrent NSCLC tissues. We also revealed that COL11A1 promoted the cell proliferation, migration and invasion of NSCLC cell lines in vitro. Furthermore, our results highlighted the importance of COL11A1 in chemoresistance to cisplatin. Mechanistically, we found that the effects of the overexpression of COL11A1 in NSCLC cells were mediated by Smad signaling. Collectively, our findings suggest that COL11A1 may sever as a biomarker for metastatic NSCLC, and can be used to predict recurrence after surgical resection. Therapeutic approaches targeting COL11A1 may facilitate the optimization of cisplatin treatment of NSCLC by overcoming chemoresistance.
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Affiliation(s)
- Lihua Shen
- Department of Anaesthesia, Critical Care and Pain Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
| | - Min Yang
- Department of Respiratory Diseases, Tianjin First Center Hospital, Tianjin 300192, P.R. China
| | - Qionghua Lin
- Department of Anaesthesia, Critical Care and Pain Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
| | - Zhongwei Zhang
- Department of Anaesthesia, Critical Care and Pain Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
| | - Biao Zhu
- Department of Anaesthesia, Critical Care and Pain Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
| | - Changhong Miao
- Department of Anaesthesia, Critical Care and Pain Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
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Sele LMF, Elnegaard S, Balasubramaniam K, Søndergaard J, Jarbøl DE. Lifestyle factors and contact to general practice with respiratory alarm symptoms-a population-based study. BMC FAMILY PRACTICE 2016; 17:47. [PMID: 27098846 PMCID: PMC4839152 DOI: 10.1186/s12875-016-0444-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 04/13/2016] [Indexed: 11/10/2022]
Abstract
Background A prerequisite for early lung cancer diagnosis is that individuals with respiratory alarm symptoms (RAS) contact a general practitioner (GP). This study aims to determine the proportion of individuals in the general population who contact a GP with RAS and to analyse the association between lifestyle factors and contact to GPs with RAS. Methods A web-based survey of 100 000 individuals randomly selected from the Danish Civil Registration System. Items regarding experience of RAS (prolonged coughing, shortness of breath, coughing up blood, and prolonged hoarseness), GP contacts, and lifestyle factors (smoking status, alcohol intake, and body mass index) were included. Results In total 49 706 (52.5 %) individuals answered the questionnaire. Overall 7870 reported at least one respiratory alarm symptom, and of those 39.6 % (3 080) had contacted a GP. Regarding specific symptoms, the proportion of individuals that had contacted a GP varied from 27.4 % (prolonged hoarseness) to 47.9 % (shortness of breath). Being a woman and increasing age were significantly associated with a higher proportion of GP contacts. For both genders, current smoking and alcohol intake were significantly associated with lower odds of contacting a GP. Conclusion Among individuals with RAS, less than one-half contacted a GP. Gender, age, smoking status, and alcohol intake significantly influenced whether individuals with RAS contacted a GP. Trial registration The project has been approved by the Danish Data Protection Agency (journal no. 2011-41-6651).
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Affiliation(s)
- Lisa Maria Falk Sele
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark.
| | - Sandra Elnegaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark
| | - Kirubakaran Balasubramaniam
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark
| | - Dorte Ejg Jarbøl
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9A, 5000, Odense C, Denmark
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Scott JM, Hornsby WE, Lane A, Kenjale AA, Eves ND, Jones LW. Reliability of maximal cardiopulmonary exercise testing in men with prostate cancer. Med Sci Sports Exerc 2016; 47:27-32. [PMID: 24781891 DOI: 10.1249/mss.0000000000000370] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE To accurately assess exercise interventions and to evaluate acute and chronic cardiovascular effects in patients with early-stage cancer, consistently reliable functional outcome measures must be obtained. An incremental cardiopulmonary exercise test (CPET) with gas exchange measurement to assess peak oxygen consumption (V˙O2peak) provides the gold standard outcome of cardiorespiratory fitness. METHODS In the context of a randomized controlled trial, 40 patients with prostate cancer (mean age, 59 ± 7 yr) after radical prostatectomy performed two maximal CPET within 5.6 ± 5.5 d of each other. Incremental treadmill tests were performed in the morning under identical laboratory conditions. Reliability and within-subject variability from test 1 to test 2 for peak and submaximal variables were assessed by correlation coefficients, intraclass correlations (ICC), Bland-Altman plots, coefficient of variation, and paired t-tests. RESULTS There was high reliability between CPET for V˙O2peak (r = 0.92; P < 0.001; ICC, 0.900), ventilatory threshold (r = 0.88; P < 0.001; ICC, 0.927), minute ventilation-carbon dioxide production relation (V˙E/V˙CO2) (r = 0.86; P < 0.001; ICC, 0.850), and peak heart rate (r = 0.95; P < 0.001; ICC, 0.944). However, high within-subject variability was observed for all CPET parameters (mean coefficient of variation, 4.7%). Compared with those for test 1, significantly higher mean values were observed for V˙O2peak (27.0 ± 5.6 vs 28.1 ± 5.3 mL·kg·min, P < 0.05), ventilatory threshold (1.91 ± 0.5 vs 1.97 ± 0.4 L·min, P < 0.05), and V˙E/V˙CO2 (31.3 ± 5.8 vs 32.8 ± 3.4, P < 0.05) in test 2. CONCLUSIONS These findings indicate the presence of significant, and potentially clinically important, variability in CPET procedures in men with clinically localized prostate cancer and have important implications for the application and use of CPET to evaluate the efficacy of interventions to improve aerobic capacity in the oncology setting.
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Affiliation(s)
- Jessica M Scott
- 1Universities Space Research Association, Houston, TX; 2Duke University Medical Center, Durham, NC; 3Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia, Kelowna, British Columbia, CANADA; and 4Cardiology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Nadpara P, Madhavan SS, Tworek C. Guideline-concordant timely lung cancer care and prognosis among elderly patients in the United States: A population-based study. Cancer Epidemiol 2015; 39:1136-44. [PMID: 26138902 PMCID: PMC4679644 DOI: 10.1016/j.canep.2015.06.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 06/18/2015] [Accepted: 06/22/2015] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Elderly carry a disproportionate burden of lung cancer in the US. Therefore, its important to ensure that these patients receive quality cancer care. Timeliness of care is an important dimension of cancer care quality but its impact on prognosis remains to be explored. This study evaluates the variations in guideline-concordant timely lung cancer care and prognosis among elderly in the US. MATERIALS AND METHODS Using the Surveillance, Epidemiology, and End Results (SEER)-Medicare database (2002-2007), we identified elderly patients with lung cancer (n=48,850) and determined time to diagnosis and treatment. We categorized patients by receipt of timely care using guidelines from the British Thoracic Society and the RAND Corporation. Hierarchical generalized logistic model was constructed to identify variables associated with receipt of timely care. Kaplan-Meier analysis and Log Rank test was used for estimation and comparison of the three-year survival. Multivariable Cox proportional hazards model was constructed to estimate lung cancer mortality risk associated with receipt of delayed care. RESULTS Time to diagnosis and treatment varied significantly among the elderly. However, majority of them (77.5%) received guideline-concordant timely lung cancer care. The likelihood of receiving timely care significantly decreased with NSCLC disease, early stage diagnosis, increasing age, non-white race, higher comorbidity score, and lower income. Paradoxically, survival outcomes were significantly worse among patients receiving timely care. Adjusted lung cancer mortality risk was also significantly lower among patients receiving delayed care, relative to those receiving timely care (Hazard ratio (HR)=0.68, 95% Confidence interval (CI)=(0.66-0.71); p ≤ 0.05). CONCLUSION This study highlights the critical need to address disparities in receipt of guideline-concordant timely lung cancer care among elderly. Although timely care was not associated with better prognosis in this study, any delays in diagnosis and treatment should be avoided, as it may increase the risk of disease progression and psychological stress in patients. Furthermore, given that lung cancer diagnostic and management services are covered under the Medicare program, observed delays in care among Medicare beneficiaries is also a cause for concern.
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Affiliation(s)
- Pramit Nadpara
- Virginia Commonwealth University, School of Pharmacy, Department of Pharmacotherapy & Outcomes Science, Richmond, VA 23298-0533, USA.
| | - S Suresh Madhavan
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems & Policy, Morgantown, WV 26506-9500, USA
| | - Cindy Tworek
- West Virginia University, School of Pharmacy, Department of Pharmaceutical Systems & Policy, Morgantown, WV 26506-9500, USA
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Liu R, Xu KP, Tan GS. Cyclooxygenase-2 inhibitors in lung cancer treatment: Bench to bed. Eur J Pharmacol 2015; 769:127-33. [DOI: 10.1016/j.ejphar.2015.11.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/27/2015] [Accepted: 11/04/2015] [Indexed: 01/09/2023]
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Sele LMF, Balasubramaniam K, Elnegaard S, Søndergaard J, Jarbøl DE. Lifestyle factors and experience of respiratory alarm symptoms in the general population. BMJ Open Respir Res 2015; 2:e000101. [PMID: 26448866 PMCID: PMC4593171 DOI: 10.1136/bmjresp-2015-000101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Revised: 09/05/2015] [Accepted: 09/07/2015] [Indexed: 11/29/2022] Open
Abstract
Background The first step in the diagnosis of lung cancer is for individuals in the general population to recognise respiratory alarm symptoms (RAS). Knowledge is sparse about RAS and factors associated with experiencing RAS in the general population. This study aimed to estimate the prevalence of RAS in the general population, and to analyse possible associations between lifestyle factors and experiencing RAS. Methods A web-based survey comprising 100 000 individuals randomly selected from the Danish Civil Registration System. Items regarding experience of RAS (prolonged coughing, shortness of breath, coughing up blood and prolonged hoarseness) and self-reported lifestyle factors (smoking status, alcohol intake and body mass index) were included in the analysis. Results A total of 49 706 individuals completed the questionnaire. 16 per cent reported at least one RAS. Prolonged coughing (8.4%) and shortness of breath (8%) were most prevalent, while coughing up blood was least prevalent (0.1%). More men than women reported RAS (p<0.001). Odds of reporting RAS increased with age (Ptrend<0.001). In men and women, former and current smoking was associated with reporting at least one RAS (former smoking: ORmen=1.42, 95% CI 1.39 to 1.56; ORwomen=1.25, 95% CI 1.15 to 1.36; current smoking: ORmen=2.58, 95% CI 2.35 to 2.83; ORwomen=2.45, 95% CI 2.25 to 2.68). Individuals who were underweight or obese were significantly more likely to report at least one RAS. Odds of reporting at least one RAS increased with increasing alcohol intake for both genders (Ptrend<0.001). Conclusions RAS are common in the general population. Men experience more symptoms than women, and prevalence increases with age. Being a former or current smoker and being underweight or obese are positively associated with experiencing RAS. The likelihood of experiencing RAS increases with increasing alcohol intake. Future research should investigate healthcare seeking for RAS among individuals with different lifestyles.
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Affiliation(s)
- Lisa Maria Falk Sele
- Department of Public Health, Research Unit of General Practice , University of Southern Denmark , Odense C , Denmark
| | - Kirubakaran Balasubramaniam
- Department of Public Health, Research Unit of General Practice , University of Southern Denmark , Odense C , Denmark
| | - Sandra Elnegaard
- Department of Public Health, Research Unit of General Practice , University of Southern Denmark , Odense C , Denmark
| | - Jens Søndergaard
- Department of Public Health, Research Unit of General Practice , University of Southern Denmark , Odense C , Denmark
| | - Dorte Ejg Jarbøl
- Department of Public Health, Research Unit of General Practice , University of Southern Denmark , Odense C , Denmark
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Mosher CE, Ott MA, Hanna N, Jalal SI, Champion VL. Coping with physical and psychological symptoms: a qualitative study of advanced lung cancer patients and their family caregivers. Support Care Cancer 2015; 23:2053-60. [PMID: 25527242 PMCID: PMC4449810 DOI: 10.1007/s00520-014-2566-8] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Advanced lung cancer patients have high rates of multiple physical and psychological symptoms, and many of their family caregivers experience significant distress. However, little is known about strategies that these patients and their family caregivers employ to cope with physical and psychological symptoms. This study aimed to identify strategies for coping with various physical and psychological symptoms among advanced, symptomatic lung cancer patients and their primary family caregivers. METHODS Patients identified their primary family caregiver. Individual semi-structured qualitative interviews were conducted with 21 advanced, symptomatic lung cancer patients and primary family caregivers. Thematic analysis of interview data was framed by stress and coping theory. RESULTS Patients and caregivers reported maintaining a normal routine and turning to family and friends for support with symptom management, which often varied in its effectiveness. Whereas support from health-care professionals and complementary and alternative medicine were viewed favorably, reactions to Internet and in-person support groups were mixed due to the tragic nature of participants' stories. Several cognitive coping strategies were frequently reported (i.e., changing expectations, maintaining positivity, and avoiding illness-related thoughts) as well as religious coping strategies. CONCLUSIONS Results suggest that advanced lung cancer patients and caregivers may be more receptive to cognitive and religious approaches to symptom management and less receptive to peer support. Interventions should address the perceived effectiveness of support from family and friends.
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Affiliation(s)
- Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, 402 North Blackford Street, LD 124, Indianapolis, IN, 46202, USA,
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Nadpara PA, Madhavan SS, Tworek C. Disparities in Lung Cancer Care and Outcomes among Elderly in a Medically Underserved State Population-A Cancer Registry-Linked Database Study. Popul Health Manag 2015; 19:109-19. [PMID: 26086239 DOI: 10.1089/pop.2015.0027] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Despite availability of guidelines for lung cancer care, variations in lung cancer care among the elderly exist across the nation and are a cause for concern in rural and medically underserved areas. Therefore, the purpose of this study was to evaluate the patterns of lung cancer care and associated health outcomes among elderly residing in a rural and medically underserved area. The authors identified 1924 elderly lung cancer patients from the West Virginia Cancer Registry-Medicare linked database (2002-2007) and categorized them by receipt of guideline-concordant (appropriate and timely) care using guidelines from the American College of Chest Physicians, British Thoracic Society, and the RAND Corporation. Hierarchical generalized logistic models were constructed to identify variables associated with receipt of guideline-concordant care. Kaplan-Meier analysis and log-rank test were used to compare 3-year survival outcomes. Multivariate Cox proportional hazards models were constructed to estimate lung cancer mortality risk associated with nonreceipt of guideline-concordant care. Although guideline-concordant appropriate care was received by fewer than half of all patients (46.5%), of those receiving care, 78.7% received it in a timely manner. Delays in diagnosis and treatment varied significantly. Survival outcomes significantly improved with appropriate care (799 vs. 366 days; P≤0.05), but did not improve with timely care. This study highlights the critical need to address disparities in receipt of guideline-concordant lung cancer care among the elderly residing in rural and medically underserved areas. Although lung cancer diagnostic and management services are covered under the Medicare program, underutilization of these services is a concern. (Population Health Management 2016;19:109-119).
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Affiliation(s)
- Pramit A Nadpara
- 1 Virginia Commonwealth University , School of Pharmacy, Department of Pharmacotherapy & Outcomes Science, Richmond, Virginia
| | - S Suresh Madhavan
- 2 West Virginia University , School of Pharmacy, Department of Pharmaceutical Systems & Policy, Morgantown, West Virginia
| | - Cindy Tworek
- 2 West Virginia University , School of Pharmacy, Department of Pharmaceutical Systems & Policy, Morgantown, West Virginia
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