Advanced Lung Cancer: Supportive Care
{"Image DocumentName": "Advanced Lung Cancer: Supportive Care", "Image ImageDescription": "Treatment Modalities for Palliation. Chemotherapy. Radiation. Symptom Management. Dyspnea. Fatigue. Pain. In light of the poor prognosis for patients with advanced lung cancer, effective palliation is an important objective. One study of inoperable patients with non-small cell lung cancer found that two-thirds needed immediate local palliation and one-half of those with no thoracic symptoms at presentation required subsequent local treatment. Furthermore, since palliation is more difficult once local complications such as superior vena cava obstruction, obstructive pneumonia, or lobar collapse become serious, a watch and wait approach is appropriate for only a minority of patients. Chemotherapy often improves the quality of life when used for palliation in patients with advanced lung cancer even in the absence of a measurable tumor response. Those more likely to achieve palliative benefit from chemotherapy are those with good performance status, females, age 70 years or older, low tumor burden, normal lactate dehydrogenase and serum calcium levels, and a hemoglobin greater than 11 g/dL. Radiotherapy is also of demonstrated, sustainable palliative benefit. Symptoms such as hemoptysis and pain are more effectively palliated, while dyspnea and poor performance status tend to be refractory. While numerous symptoms and paraneoplastic syndromes may be experienced by patients with advanced lung cancer, dyspnea, fatigue, and pain, are appropriate targets for palliative treatment. Ginsberg RJ, Vokes EE, Rosenzweig K. Non-small cell lung cancer. In: DeVita VT Jr , Hellman S, Rosenberg SA, eds. Cancer Principles and Practice of Oncology. 6th ed. Philadelphia, Pa: Lippincott-Raven; 2001: Murren J, Glatstein E, Pass HI. Small cell lung cancer. In: DeVita VT Jr , Hellman S, Rosenberg SA, eds. Cancer Principles and Practice of Oncology. 6th ed. Philadelphia, Pa: Lippincott-Raven; 2001: Feld R, Ginsberg RJ, Payne DG, Shepherd FA. Lung. In: Abeloff MD, Armitage JO, Lichter AS, Niederhuber JE, eds. Clinical Oncology. 2nd ed. New York, NY: Churchill Livingstone; 2000:", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}