Patients with Metastatic Lung Cancer and Oncologists’ Views on Achievement of Treatment Goals and Making the Right Treatment Decision: A Prospective Multicenter Study

Background Previous studies have investigated patients’ treatment goals before starting a treatment for metastatic lung cancer. Data on the evaluation of treatment goals are lacking. Aim To determine if patients with metastatic lung cancer and their oncologists perceive the treatment goals they defined at the start of systemic treatment as achieved after treatment and if in hindsight they believe it was the right decision to start systemic therapy. Design and Participants A prospective multicenter study in 6 hospitals across the Netherlands between 2016 and 2018. Following systemic treatment, 146 patients with metastatic lung cancer and 23 oncologists completed a questionnaire on the achievement of their treatment goals and whether they made the right treatment decision. Additional interviews with 15 patients and 5 oncologists were conducted. Results According to patients and oncologists, treatment goals were achieved in 30% and 37% for ‘quality of life,’ 49% and 41% for ‘life prolongation,’ 26% and 44% for ‘decrease in tumor size,’ and 44% for ‘cure’, respectively. Most patients and oncologists, in hindsight, felt they had made the right decision to start treatment and also if they had not achieved their goals (72% and 93%). This was related to the feeling that they had to do ‘something.’ Conclusions Before deciding on treatment, the treatment options, including their benefits and side effects, and the goals patients have should be discussed. It is key that these discussions include not only systemic treatment but also palliative care as effective options for doing ‘something.’

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Relatives of patients with metastatic lung cancer’s views on the achievement of treatment goals and the choice to start treatment: an interview study

10.21203/rs.3.rs-18948/v1 ◽

2020 ◽

Author(s):

Adinda Mieras ◽

Bregje D. Onwuteaka-Philipsen ◽

Annemarie Becker-Commissaris ◽

Jose C.M. Bos ◽

H.Roeline W. Pasman

Keyword(s):

Lung Cancer ◽

Side Effects ◽

Tumour Size ◽

Treatment Decision ◽

Interview Study ◽

Treatment Choice ◽

Treatment Goals ◽

Metastatic Lung Cancer ◽

Loved One ◽

Metastatic Lung

Abstract Purpose. Lung cancer has a high impact on both patients and relatives. Previous studies looked into treatment goals patients have before starting a treatment. However, studies on relatives’ perceptions of treatment at the end of life are scarce. Therefore, we studied the perspectives of relatives in hindsight on the achievement of treatment goals and the choice to start treatment for metastatic lung cancer of their loved one.Methods. We conducted a semi-structured telephone interview study in six hospitals across the Netherlands, one academic and five non-academic hospitals between February 2017 and November 2019. We included 118 relatives of deceased patients diagnosed with metastatic lung cancer who started a systemic treatment and who completed a questionnaire on their treatment goals before start of the treatment and when treatment was finished. We asked the relatives about the achievement of patients’ treatment goals and relatives’ satisfaction with the choice to start treatment.Results. Relatives reported the goals ‘quality of life’, ‘decrease tumour size’ and ‘life prolongation’ as achieved in 21%, 37% and 41% respectively. Most of the relatives (78%) were satisfied with the choice to start a treatment. Also, when none of the goals were achieved, 70% of the relatives were satisfied. About one in two relatives who were satisfied with the patient’s choice did mention negative aspects of the treatment choice, such as that the treatment did not work, that there were side effects or that it would not have been the relatives choice. This was four in five for relatives who were not satisfied. Most mentioned positive aspects were that they tried everything and that it was the patient’s choice. Conclusion. Relatives reported patients’ treatment goals as not achieved in a majority of cases. They were, however, in majority of the cases satisfied about the treatment choice. Being satisfied does not provide a full picture of their experience with the treatment decision as a majority mentions negative aspects of this decision. At the time of making the treatment decision it is important to manage expectations about chance of success and possible side effects of the treatment.

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Comorbidity: Usage of, and survival after chemotherapy for advanced lung cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e19157 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e19157-e19157

Author(s):

Anders Mellemgaard ◽

Philomena Bredin ◽

Maria Iachina ◽

Anders Green ◽

Mark Krasnik ◽

...

Keyword(s):

Lung Cancer ◽

Performance Status ◽

Advanced Lung Cancer ◽

Advanced Stage ◽

Metastatic Lung Cancer ◽

Cancer Data ◽

Co Morbidity ◽

Metastatic Lung ◽

Advanced Stage Lung Cancer ◽

Stage Lung Cancer

e19157 Background: Comorbidity may influence prognosis in lung cancer, affect performance status (PS) of patients as well as complicate treatment. The present study examines usage and outcome of chemotherapy (CT) for advanced-stage lung cancer, and focuses on the role of comorbidity. Methods: Patients with advanced-stage lung cancer were identified in the Danish Lung Cancer Registry. A total of 22,999 patients with non-resectable, advanced-stage lung cancer were identified. Data on stage, PS, Charlson comorbidity score (ChS), age, histology and type of first treatment (if any) were avaliable. First treatment was categorized as chemotherapy (n=7,346), chemo-radiotherapy (2,636), radiotherapy (n=4,155) or no therapy (n=8,862). Survival was examined separately for 0-1 year and 1-5 years, and further distinction was made between metastatic and non-metastatic lung cancer. Data are presented for the subgroup of patients receiving chemotherapy as first treatment only. All estimates are derived from logistic regression model adjusting for the effect of performance status, pulmonary function and histological type, except for usage where models included same variables plus stage. Results: Use of chemotherapy was less frequent for more comorbid patients (OR 0.86, 0.64, 0.56 for Charlson score 1, 2, 3+ respectively compared to no comorbidity). Older patients and men were less likely to receive CT. For patients receiving CT as first treatment for non-metastatic lung cancer, survival in the first year was slightly worse for those with co-morbidity (HR 0-1year, non metastatic =0.91, 0.92, 0.87 for ChS 1,2,3+ respectively). For 1-5years and for metastatic lung cancer no correlation between comorbidity and survival was noted. In contrast, PS and sex was strongly associated with survival. Conclusions: With increasing co morbidity, chemotherapy was used less often. Comorbidity is not an important prognostic factor in advanced lung cancer treated with chemotherapy. However, sex and especially performance status remain as strong prognostic factors in this patient group.

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Maximized nanodrug-loaded mesenchymal stem cells by a dual drug-loaded mode for the systemic treatment of metastatic lung cancer

Drug Delivery ◽

10.1080/10717544.2017.1375580 ◽

2017 ◽

Vol 24 (1) ◽

pp. 1372-1383 ◽

Cited By ~ 15

Author(s):

Sen Yao ◽

Xuqian Li ◽

Jingxuan Liu ◽

Yuqing Sun ◽

Zhuanhe Wang ◽

...

Keyword(s):

Lung Cancer ◽

Stem Cells ◽

Mesenchymal Stem Cells ◽

Systemic Treatment ◽

Metastatic Lung Cancer ◽

Metastatic Lung ◽

Dual Drug

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Unilateral Facial Pain as The First Symptom of Lung Cancer: Are There Diagnostic Clues?

Cephalalgia ◽

10.1046/j.1468-2982.1992.1203178.x ◽

1992 ◽

Vol 12 (3) ◽

pp. 178-179 ◽

Cited By ~ 15

Author(s):

Jean Schoenen ◽

René Broux ◽

Gustave Moonen

Keyword(s):

Lung Cancer ◽

Early Diagnosis ◽

Vagus Nerve ◽

Facial Pain ◽

Metastatic Lung Cancer ◽

Digital Clubbing ◽

Metastatic Lung ◽

Mediastinal Adenopathy ◽

The Right

We describe three patients with unilateral facial pain due to non-metastatic lung cancer and review 11 published cases. Pain, most frequently located on the right side and around the ear, as well as digital clubbing can be clues to an early diagnosis. Compression of the vagus nerve by the tumour or by mediastinal adenopathy is most likely responsible for the facial pain and could play a role in pulmonary osteoarthropathy.

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Asbestosis Mimicking Metastatic Lung Cancer: Case Report

Medicina ◽

10.3390/medicina57050402 ◽

2021 ◽

Vol 57 (5) ◽

pp. 402

Author(s):

Jin An ◽

Minjeong Song ◽

Boksoon Chang

Keyword(s):

Lung Cancer ◽

Interstitial Fibrosis ◽

Lower Lobe ◽

Lung Lesion ◽

Cancer Case ◽

Metastatic Lung Cancer ◽

Pleural Thickening ◽

Metastatic Lung ◽

The Right ◽

Thoracoscopic Biopsy

The clinical diagnosis of asbestosis is primarily based on chest radiographic evidence of pleural thickening and interstitial fibrosis combined with a history of exposure to asbestos. We report herein the case of a 65-year-old man with asbestosis pathologically diagnosed after surgical lung biopsy. He had a work history including farming, cementing, and casting and was admitted with dyspnea. Chest computed tomography revealed multiple well-defined nodules in both lungs and a 4.1 cm peribronchial consolidation with fibrotic changes in the right lower lobe. We suspected metastatic lung cancer and video-assisted thoracoscopic biopsy was performed in the lung lesion of the right lower lobe. Asbestosis was confirmed following histological examination. The patient is currently completing outpatient visits without significant changes.

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Atypical metastatic lung cancer of the right ventricle on FDG PET/CT

Radiology Case Reports ◽

10.1016/j.radcr.2021.07.092 ◽

2021 ◽

Vol 16 (11) ◽

pp. 3569-3573

Author(s):

James Yuheng Jiang ◽

Marco Lee ◽

Christine Kang ◽

Veronica Chi Ken Wong ◽

Robert Mansberg

Keyword(s):

Lung Cancer ◽

Right Ventricle ◽

Fdg Pet ◽

Metastatic Lung Cancer ◽

Pet Ct ◽

Metastatic Lung ◽

The Right ◽

Fdg Pet Ct

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Erythema Nodosum Revealing Metastatic Lung Cancer

European Journal of Case Reports in Internal Medicine ◽

10.12890/2021_002539 ◽

2021 ◽

Author(s):

Anis Mzabi ◽

Wafa Benzarti ◽

Wiem Romdhane ◽

Wafa Baya ◽

Sana Aissa ◽

...

Keyword(s):

Lung Cancer ◽

Erythema Nodosum ◽

Subcutaneous Fat ◽

Metastatic Lung Cancer ◽

Common Cause ◽

Paraneoplastic Disease ◽

Metastatic Lung ◽

Immunological Investigation ◽

Bronchial Biopsies ◽

The Right

Erythema nodosum (EN) is an inflammatory condition of the subcutaneous fat and has been reported in patients with haematological malignancies (lymphomas) or solid tumours. Lung cancer is the most common cause of paraneoplastic syndrome. We report a case of EN occurring as a paraneoplastic disease. A 48-year-old Tunisian woman, a non-smoker with no relevant medical history, presented with painful, erythematous, firm nodules on her legs with ankle swelling. The patient did not report any other symptoms. There were no abnormalities on examination except for moderate fever. An extensive infectious and immunological investigation was negative. Antistreptolysin antibodies were undetectable. Chest radiography showed a focal opacity in the right lung and a CT scan revealed a mass in the lower right pulmonary lobe with hilar and mediastinal lymphadenopathies, a nodule in the right adrenal gland, condensation in the iliac bone and multiple bilateral nodular cerebral expansive processes. Bronchial biopsies revealed a primitive and moderately differentiated adenocarcinoma. No argument for tuberculosis or sarcoidosis was found.

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