Targeting the Symptoms of Lung Cancer, Not Just the Disease
- Steven I. Robinson, MBBS
- Timothy J. Moynihan, MD
- Available online 23 September 2011.
- http://dx.doi.org/10.1016/j.suponc.2011.07.003
Lung cancer accounts for a large percentage of cancer deaths worldwide. In the United States, an estimated 222,520 new diagnoses and 157,300 deaths associated with lung cancer were projected for 2010. 1 Even with the best approaches available to us today, median 5-year survival rates range from 10% to 15% in advanced disease. 2 The majority of our efforts have been aimed at prolonging survival, focusing on optimizing tumor-specific options. Unfortunately, we are prone to overlook symptoms that negatively impact quality of life. McCannon and Temel highlight approaches to managing the respiratory symptoms associated with advanced lung cancer, explaining the pathophysiology behind the common symptoms and critiquing the evidence behind these management approaches.
The authors emphasize the fact that multiple causes contribute to respiratory symptoms in patients with lung cancer. It is essential to perform a thorough history and clinical evaluation in order to elucidate the underlying insult(s) and not simply assume symptoms are due to progressive disease. The table gives an excellent framework to guide the approach to these patients. Reversible causes should always be sought and aggressively treated.