Quality of Life in Patients With Lung Cancer: Surgery

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

Discussion and Conclusions
Survival in lung cancer patients is poor and has improved little over time. Despite the increasing research, there remains among many physicians a high degree of pessimism about the gains made in clinical care, especially when one considers the side effects of treatments and the costs involved. However, there are those who believe that using both traditional outcomes (survival and tumor response) and patient-based quality of life assessment may offer a more comprehensive approach to evaluating the relative risks and benefits associated with treatment. It is argued that if there is no gain in survival time from clinical investigations, there are several other ways to improve health-care delivery for lung cancer patients and add quality to their lives. Strategies for supportive care or inclusion of quality of life measures as an end point in clinical practice are a few examples of such proposals.
The review highlights both the progress and the shortcomings of the research activities on the subject. Despite 25 years of investigations and existence of nearly 150 articles and reviews, discrepancies are obvious. Many studies are built on common-sense conclusions. For example, in a study of 455 patients, it was found that performance status and extent of disease had a significant association with reported distress as measured by Profile of Mood States (POMS). The study concluded that the extent of disease can be seen as a risk factor for distress. When there is no insight into the patients daily experiences or to their living conditions, little is gained from studying such limited aspects of quality of life. In addition, many researchers included a restricted sample of patients in their studies. In these studies, mostly, there is generally no explanation of why the other patients were not included. It is not possible to be sure that these investigations are unbiased. Again, as these tables show, studies have used ad hoc instruments to measure quality of life, and the findings in such assessments should be interpreted with caution. However, the achievements of researchers in this field should not be underestimated, especially the efforts of the clinicians and the oncologists who enthusiastically conducted the research.

Category: Cancer

Tags: chemotherapy, lung cancer, non-small cell lung