Archive for the ‘Cancer’ Category


Quality of Life in Patients With Lung Cancer: Conclusion

Apr 27, 2014 Author: Walter Mcneil | Filed under: Cancer

Although there are still deficiencies in both quality of life measurement and research design, this review clearly shows that during the last 25 years, there have been promising developments in many areas of quality of life-related research. For example, there now are several valid instruments to measure quality of life, quality of life is increasingly becoming integrated as part of clinical trials, and quality of life by itself is becoming an issue of interest both for patients and clinicians. Patients themselves have expressed a wish for more emphasis on research into quality of life issues. In contrast, the explosion of so many new instruments without critical appraisal, poor presentation of their data in published articles, complex statistical analyses, and lack of guidelines all can be seen as major causes of confusion. However, these recent developments should not prevent clinicians and oncologists from using the new instruments, provided that they have evaluated them critically. buy asthma inhalers online
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  • Quality of Life in Patients With Lung Cancer: Discussion

    Apr 25, 2014 Author: Walter Mcneil | Filed under: Cancer

    Quality of Life in Patients With Lung Cancer: DiscussionAlthough clinical findings in these studies are important and have been discussed, the emphasis of this review was on general aspects of the findings concerning the quality of life. These findings constitute a crucial role in the treatment of lung cancer patients and reflect a wide spectrum of issues that should be integrated into clinical practice.
    Several topics in this article have been highlighted: first, that quality of life assessment can be a prognostic factor and predictor of survival; second, that the need for inclusion of quality of life as a valid end point in evaluation of the treatment of lung cancer patients has been emphasized. Since most lung cancer patients live for a short time, the need for palliation of symptoms is the first priority. Data from clinical studies of lung cancer clearly indicate that, for example, of 100 lung cancer patients, 86 suffer from pain, 70 have dyspnea, and 68 have anorexia. These findings suggest that to improve the quality of life in lung cancer patients, resources should be directed to palliative care, and this has implications for lung cancer care purchasers. (more…)

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  • Quality of Life in Patients With Lung Cancer: Surgery

    Apr 23, 2014 Author: Walter Mcneil | Filed under: Cancer

    Surgery is the treatment of choice for stage I and II non-small cell lung cancer. To our knowledge, the only study that has been reported so far is the one that was carried out by Dales et al. They studied 117 patients, 92 patients with and 25 patients without a confirmed postoperative diagnosis of lung cancer. They found that preoperatively, the prevalence of dyspnea was four times higher in the cancer group, but other global quality of life indicators were similar. Dyspnea worsened in both groups at 1 and 3 months postoperatively. Quality of life deteriorated postoperatively in those with cancer and returned to preoperative levels at 6 to 9 months, but showed no deterioration postoperatively in those without cancer even at 1 and 3 months. They concluded that surgery resulted in deterioration in the quality of life during the first 3 months postoperatively in those with final diagnosis of cancer, but improvement back to baseline can be expected thereafter. flovent inhaler
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  • Quality of Life in Patients With Lung Cancer: Quality of Life in Patients With Non-small Cell Lung Cancer: RadiotherapyThe value of radiotherapy in controlling specific cancer-related symptoms is undisputed and can be achieved with unsophisticated and undemanding schedules. Yet, more research is needed to answer the critical issues of the role of radiotherapy in the treatment of non-small cell lung cancer As far as quality of life studies are concerned, there are several studies to help answer some of these issues. Kaasa et al randomised 95 patients to receive either radiotherapy or chemotherapy. They found significant differences in psychosocial well-being and global quality of life in favor of radiotherapy. There were no significant group differences in physical functioning and daily activities. A British study has shown that conventional and experimental radiotherapy policies are the same both in survival time and quality of life. The study suggested that dysphagia and reduction in physical activities were the most important side effects of the radiotherapy. Considering these side effects that affect a patient’s quality of life, consequent studies indicated that there were no survival benefits with multiple or even two fractions as compared with single-fraction radiotherapy. (more…)

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  • There are various policies in the management of non-small cell lung cancer and aspects of the treatment related to quality of life outcome are discussed (Table 4).
    Chemotherapy
    As Thatcher et al pointed out, non-small cell lung cancer can no longer be regarded as resistant to chemotherapy. Early studies of quality of life in patients receiving chemotherapy suggested that treatment-related toxicity reactions and the deterioration of patient’s well-being offset any potential survival advantage for most patients. In a more systematic assessment of quality of life, change in quality of life scores, as measured by FLI-C, correlated with performance status change and weight loss, but not with treatment regimen, side effects of treatment, or change of pain. Consequent studies pointed out that after chemotherapy, patients had marked relief of symptoms. Recent studies, however, have shown that improved or stable quality of life mainly depends on tumor response. For example, Pujot et al, in a study of 54 patients, found a stable quality of life in responders as compared to those who had not responded to treatment. (more…)

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  • Quality of Life in Patients With Lung Cancer: Radiotherapy

    Apr 17, 2014 Author: Walter Mcneil | Filed under: Cancer

    Quality of Life in Patients With Lung Cancer: RadiotherapyAlthough these findings are not consistent, the results suggest that when there is no clinical benefit, for example in survival time or tumor response, perceptions and attitudes of patients toward different treatment policies could provide additional information. Therefore, measuring quality of life becomes essential, and it seems that it is the most reasonable way of judging the clinical outcomes. As Hopwood and Cull remind us, there is no guarantee that adding quality of life measures makes the choice of treatment policy easier, but it does serve to clarify the potential trade-offs that need to be discussed with patients. There is evidence that physical functioning, treatment side effects, disease-related symptoms, psychological distress, fatigue, and malaise are the most relevant aspect of quality of life in patients receiving chemotherapy. Furthermore, fatigue and malaise were found to be global indicators of quality of life. Using such findings may provide a better understanding of clinical achievements. It is argued that it is important to ascertain what patients feel about the trade-offs between improved quality of life and toxicity where there is a significant potential for long-term side effects that may result in less than an optimum quality of life. cialis professional
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  • In a similar study (standard vs palliative chemotherapy), a significantly better survival was observed in patients receiving standard treatment, despite its greater toxicity. Assessment of quality of life using the EORTC 42-item QLQ demonstrated no significant difference in most areas measured. Less mucositis and alopecia were reported by the patients receiving palliative treatment, while patients in the standard group had better values for sleep disturbance, fatigue, and psychological distress. It is argued that regular chemotherapy, although producing unpleasant side effects, also could be palliative and may control the effects of the progression of cancer. Several studies have shown that different management policies resulted in no major survival benefit. Studying early vs late alternating chemotherapy in a group of 127 patients showed that there was no significant survival difference between treatment groups, but patients receiving early alternating chemotherapy had a better quality of life as measured by the EORTC QLQ questionnaire. Acute Respiratory (more…)

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  • Quality of Life in Patients With Lung Cancer: Quality of Life in Patients With Small Cell Lung CancerCombination chemotherapy with or without radiotherapy is the treatment of choice in small cell lung cancer. Thus, most studies, both randomized trials and descriptive ones, evaluated chemotherapy and its effects on quality of life (Table 3). In reviewing quality of life studies in patients with small cell lung cancer, the following results could be identified. Diastolic Filling
    Tumor Response
    In a study of 321 patients with small cell lung cancer (of those, 195 patients were entered into the quality of life study), quality of life was found to be dependent on tumor stage and tumor response. Using the Sickness Impact Profile (SIP) in measuring quality of life in 62 patients, Bergman et al found that tumor response correlated with SIP summary scores and anxiety. The same authors with the same patients using the EORTC QLQ-C36 reported that there was good correlation between changes of the QLQ-C36 scores over a given time period and clinical variables as measured by tumor response and performance status.
    These findings, however, indicate that early detection of lung cancer is an important issue. (more…)

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