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Lung cancer is the most common cause of cancer death. The vast majority of patients present with non-small cell lung cancer (NSCLC) in advanced inoperable stages. The current first-line treatment [...]

Key words: bronchoscopy-associated infection; flexible bronchoscopy; infection prevention Abbreviations: AER = automated endoscope reprocessor; BAI = bronchoscopy-associated infection; CDC = Centers for Disease Control and Prevention. FB = flexible bronchoscopy; [...]

Study objectives: The American College of Chest Physicians has published guidelines recommending minimum competency requirements for 17 interventional pulmonary procedures. Our aim was to assess what procedures are offered to [...]

Background: Patients at the Philadelphia Veterans Affairs Medical Center frequently voice concern that air exposure during lung cancer surgery might cause tumor spread. Several African-American patients asserted that this belief was common in the African-American community. Objective: To assess the prevalence of the belief that air exposure during lung cancer surgery might cause tumor spread and gauge the influence of this belief on the willingness of African-American and white patients to have lung cancer surgery. Design: Prospective questionnaire survey. Setting: Philadelphia Veterans Affairs Medical Center and University of Pennsylvania, Philadelphia, Pennsylvania; Los Angeles Veterans Affairs Medical Center, Los Angeles, California; and Medical University of South Carolina, Charleston, South Carolina. Patients: 626 consecutive patients in pulmonary and lung cancer clinics. Measurements: None. Results: 38% of patients (61% of whom were African American and 29% of whom were white) stated that they believe air exposure at surgery causes tumor spread. The most significant predictor of belief was African-American race (odds ratio, 3.5 [95% CI, 1.9 to 6.5]), even after controlling for other relevant variables in a multivariable analysis. Nineteen percent of African Americans state that this belief was a reason for opposing surgery, and 14% would not accept their physicians' assertion that the belief is false. These rates were also statistically significantly higher among African-American than white patients. Conclusions: Belief in accelerated tumor spread at surgery is prevalent among general pulmonary outpatients and lung cancer clinic patients facing lung surgery, particularly among African-American patients. Our findings may pertain to key racial disparities in lung cancer surgery and survival rates and suggest that culturally sensitive physician training or outreach programs directed at disparate beliefs and attitudes may help to address racial discrepancies in health care outcomes.

Key words: airways; bronchoscopy; guidelines; interventional pulmonology; pleural disease; procedures Abbreviations: ACCP = American College of Chest Physicians; APC = argon plasma coagulation; EBUS = endobronchial ultrasound; PDT = percutaneous [...]

A variety of invasive staging tests are available, including mediastinoscopy, thoracoscopy (video-assisted thoracoscopic surgery), transbronchial needle aspiration (TBNA), transthoracic needle aspiration (TTNA), and endoscopic ultrasound with fine needle aspiration (EUS-NA). [...]

Correctly staging lung cancer is extremely important because the treatment options and the prognosis differ significantly by stage. Several noninvasive imaging studies are available to aid in identifying disease both [...]

Key words: chemotherapy; hospice; lung cancer; pain management; palliation; radiation therapy One of the worse aspects of cancer pain is that it is a constant reminder of the disease and [...]

Objective: To compare baseline preoperative and 6-month postoperative functional health status and quality of life in patients undergoing lung cancer resection. Methods: Lung cancer surgery patients from three hospitals were [...]

Introduction Lung cancer is a common disease that is difficult to treat successfully. In the United States each year about 178 000 people are diagnosed with lung cancer and about [...]

Objective: A push toward care provided by generalists as opposed to specialists has occurred in the health-care marketplace despite a lack of provider specific outcome data. The objective of this [...]

Objective: To estimate the cost-effectiveness of CT for detecting brain lesions in patients with lung cancer without clinical evidence of metastases. Design: Decision analysis model comparing two different strategies for [...]

Objective: To determine whether, during the staging of newly diagnosed bronchogenic carcinoma, clinical indicators predict the presence or absence of adrenal metastases detected by computerized tomographic (CT) scans. Design: Retrospective review of charts and roentgenograms. Setting: Academic medical center. Patients: Two hundred five consecutive patients diagnosed with bronchogenic carcinoma, of whom 173 had sufficient data available for analysis. Measurements: Charts were reviewed for abnormalities in three clinical categories (signs, symptoms, and routine laboratory tests) and the presence of extrapulmonary tumor spread. The CT scans were reviewed for evidence of adrenal involvement by radiologists blinded to clinical findings. Main Results: Thirty patients had abnormal adrenal glands on CT scan. In 26 the abnormality was believed to represent adrenal metastasis, whereas in four the CT findings were consistent with adrenal adenomas. The frequency of adrenal metastases varied with the number of positive clinical findings ([X.sup.2] = 105.4; p, Postmortem studies have shown that the adrenal glands are a common site of metastasis in bronchogenic carcinoma.[1-3] Clinicians have difficulty recognizing adrenal metastases, because they perceive them to be clinically [...]

The pulmonologist is the focal point for the diagnosis and staging of lung cancer. Accurate staging is imperative because of the implications that stage has on different treatment modalities and [...]

Lung cancer is the leading cause of cancer-related death worldwide. At the time of initial presentation, most patients are at an advanced stage of disease with an associated poor prognosis. Those diagnosed and treated at earlier stages have a significantly better outcome, with 5-year survival for stage I disease approaching 75%. Ideally, a screening strategy for lung cancer would detect disease at an earlier stage and allow for potential surgical cure in those with cancer and avoid unnecessary morbidity in those without. Until recently, there had not been a screening test that demonstrated a mortality reduction in lung cancer. The National Lung Cancer Screening Trial showed that screening high-risk persons with low-dose CT scanning could significantly reduce lung cancer mortality; however, there are difficulties in generalizing these results to the community. Several new testing techniques, including measurement of volatile organic compounds in exhaled breath, an airway epithelial gene expression biomarker, and serum sampling for antibodies to tumor-associated antigens, are currently being evaluated and may prove useful as part of a screening algorithm for lung cancer., Introduction Lung cancer is responsible for the largest number of cancer-related deaths worldwide. In the United States in 2011, it was expected that there would be 221,130 new cases of [...]

John R Handy, MD(*); James W Asaph, MD; Laurie Skokan, PhD; Gerard Silvestri, MD and Carolyn Reed, MD. Cardiothoracic Surgery, Providence Portland Medical Center, Portland, OR and Cardiothoraic Surgery and [...]