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Objective: The objective was to evaluate the effects of transcutaneous acupoint electric stimulation (TAES) and gastric electrical stimulation (GES) on cancer patients with chemotherapy-induced gastrointestinal (GI) symptoms. Methods: A total of 122 lung cancer patients receiving chemotherapy were assigned randomly to the following two groups: control group (usual care group, n = 61) and intervention group (TAES plus GES, n = 61). TAES involved two acupoints such as Neiguan (PC6) and Zusanli (ST36). GES was performed at gastric pacing sites on the body surface such as the places of projection of gastric antrum and corpus on the body surface. GES was performed on these sites for 14 days continuously (25 min every time, once daily). The effects of TAES and GES on GI symptoms were assessed using the Memorial Symptom Assessment Scale on the day prior to chemotherapy (time point 1) and days 14 (time point 2) and 28 (time point 3) after chemotherapy. Results: No significant differences in the demographic and disease-related variables were detected between the two groups. Differences in symptom occurrence and severity at time point 1 were not statistically significant between the two groups (both P > 0.05). At time points 2 and 3, GI symptoms such as loss of appetite, nausea, vomiting, diarrhea, and constipation in the stimulation group had statistically significantly improved compared with the control group (all P < 0.05). Conclusions: TAES and GES were efficacious in relieving GI discomfort in lung cancer patients after chemotherapy. TAES combined with GES is a safe and easy-to-use tool to manage GI symptoms in practice.

Background/Aim: A considerable number of patients with lung cancer are scheduled for definitive or adjuvant radiotherapy. Prevalence and potential risk factors of preradiotherapy sleep disturbances were evaluated. Patients and Methods: Nineteen factors were retrospectively investigated for associations with pre-radiotherapy sleep disturbances in 77 lung cancer patients. Factors included COVID-19 pandemic; age; gender; performance score; comorbidity index; history of another malignancy; distress score; number of emotional, physical or practical problems; patient's request for psychological support; histology; tumor stage; upfront surgery; chemotherapy; and type of radiotherapy. Results: Thirty-one patients (40.3%) reported sleep disturbances that were significantly associated with distress score 6-10 (p=0.019), ≥2 emotional problems (p=0.001), ≥5 physical problems (p

Objectives To identify subgroups of patients with lung cancer receiving chemotherapy based on the severity dimension of symptom experience, and to examine changes in membership between these subgroups over time. Methods Patients who were scheduled to receive chemotherapy completed the Chinese version of the MD Anderson Symptom Inventory and the revised lung cancer module with a total of 19 symptom items. Data were collected at three time points: two weeks before chemotherapy (T1), after chemotherapy cycle 1 (T2), and after chemotherapy cycle 3 or above (T3). The latent profile analysis and latent transition analysis were used to identify underlying subgroups and describe changes in subgroup membership over time. Results From the total sample (N = 195), 160 patients completed the symptom assessment at T1, T2, and T3. Two distinct latent symptom profiles of patients could be identified at T1, T2, and T3, which were classified as "Mild" and "Moderate-Severe" profiles. From T1 to T2 and T3, members in the Mild profile were more likely to move to the Moderate-Severe profile. Chemotherapy protocols, prior surgery treatment, and level of education can predict the transitions. Conclusion Results provide a better understanding of the patient's different symptom experiences and characteristics. These could help clinicians to anticipate symptom patterns and develop interventions in lung cancer patients who were scheduled to receive chemotherapy for the first time.

BACKGROUND: Lung cancer is the most frequently found cancer among men around the world and is is the main cause of cancer deaths. The occurrence of lung cancer is particularly associated with smoking habit around men, along with environmental tobacco smoke in the workplace. It is diagnosed in patients with the varied clinical and demographical profile. AIM: We aimed to determine the clinical profile of men with non-small cell lung cancer in Adam Malik Hospital Medan based on age, smoking habits, occupation, clinical symptoms, clinical stage, and type of lung cancer histopathology MATERIAL AND METHODS: This is a descriptive study using medical record from 2012 to 2015 of all men with non-small cell lung cancer at Adam Malik Hospital Medan, Indonesia RESULTS: Most men with lung cancer are aged 51-60 years old (43.5%) and work like entrepreneurs. More than 80% of men with lung cancer are heavy smokers. Adenocarcinoma is the most common type of lung cancer, and 2/3 of lung cancer patients are diagnosed at an advanced stage. CONCLUSION: Lung cancer occurs most often in active smokers in the age group above 50 years. The most dominant type of histopathology is adenocarcinoma and is frequently diagnosed in the late stages.

本研究の目的は，肺がん手術後の身体的不快症状の実態とそれらが生活に及ぼす影響について，退院時から術後6 カ月までの経時的推移を明らかにすることである．術後肺がん患者41 名（平均年齢67.0 歳）を対象とし，自記記入式質問紙法と診療録からデータ収集を行った． 分析の結果，肺がん手術後6 カ月を経過しても約6 割の患者が2 つ以上の不快症状を抱えていた．創部に関連する不快症状は，退院時は創部表面の訴えが最も多く，術後1 カ月以降は創部内部の訴えへと変化した．創部以外の不快症状は，術後1 カ月以降では半数以上の患者に術後の息苦しさが出現しており，経時的変化はみられなかったが，術式や喫煙経験により日常生活への影響の程度に関連がみられた．また術後1 カ月が経過しても，術後術側急性肩部不快症状が約17％の患者に存在し，術後6 カ月が経過しても約半数の患者に咳嗽が出現していた． 以上より，患者へ術後出現する可能性のある不快症状の回復過程やその機序に関する情報提供を行い，患者自身に不快症状に対するセルフモニタリングの実施を促し，自らの症状に対する認識を深めることで，セルフケア支援へと繋げる必要がある．今後は，患者の不快症状体験を加味した周手術期肺がん看護プログラム開発の必要性が示唆された．, The purpose of this study was to evaluate changes in discomfort over 6 postoperative months in patients with lung cancer and determine the influence of this discomfort on their daily life. Data was collected from 41 patients who underwent surgery for non-small cell lung cancer (mean age 67.0 years) through a self-administered questionnaire and medical records. The results indicated that approximately 60% of patients experienced two or more symptoms of discomfort, even at 6 months after surgery. The most common wound-related discomfort was at the wound surface at the time of hospital discharge and inside the wound 1 month after surgery. In addition, choking was a common complaint in > 50% of patients 1 month after surgery and its incidence did not change over time, although the influence on the patientsʼ daily life varied depending on the type of surgical procedure and smoking history. Furthermore, acute shoulder discomfort on the operated side remained in approximately 17% of patients 1 month after surgery, while coughing was experienced by approximately 50% patients at 6 months after surgery. These results suggest that surgeons should educate patients with lung cancer about the recovery process and possible postoperative discomfort and encourage self-monitoring to gain a better understanding of symptoms and promote self-care. Perioperative nursing programs should be established for these patients in the future.

Background: The incidence of catastrophic expenditure due to health-care costs is growing and is estimated to be one of the major contributors to poverty. The need to pay out-of-pocket can also mean that households do not seek care when they need it. The total economic burden of cancer therapy amounts to the mean of 36,812 Indian National Rupee (INR). Out of this, 40% comprises expenditure incurred before coming to the hospital. Objectives: This study assessed the total out-of-pocket expenditure (OOPE) of lung cancer patients before they seek services for treatment at a tertiary care center. Materials and Methods: This was an institution-based cross-sectional survey in newly diagnosed and registered lung cancer patients > 18 years old. Self-designed, pretested, semi-structured questionnaire for sociodemographic details and direct costs incurred under various subsets was used. Data were analyzed using Epi Info version 7.2.0.1. Results: Out of 91 patients registered, 73 (80.2%) were male. The median OOPE was 19000 INR (range: 8000–40,000). We found that the total mean expenditure (19,516.48 ± 6488.22) was almost ten times their per capita income (2012.444 ± 1283.09). The total mean direct medical costs incurred were 8974.73 ± 5252 INR and direct nonmedical costs incurred were 10,574.73 ± 4414 INR. This study further showed that the direct nonmedical costs incurred were significantly higher (P = 0.02) than the direct medical costs. Similarly, the costs incurred on diagnostics were significantly higher (P < 0.001) as compared to the cost incurred on medicines. Conclusion: Lung cancer patients face the burden of OOPE at every stage, starting from the initial visit to a local health facility till the final diagnosis and treatment at a tertiary health-care facility. More measures are warranted to curtail preregistration and pretreatment expenses such as preventing people from traveling long distances just for imaging and diagnostic facilities and hence curtailing nonmedical cataclysmic expenditure.

Background Pain management has been considered as significant contributor to broad quality-of-life improvement for cancer patients. Modulating serum cholesterol levels affects analgesia abilities of opioids, important pain killer for cancer patients, in mice system. Thus the correlation between opioids usages and cholesterol levels were investigated in human patients with lung cancer. Methods Medical records of 282 patients were selected with following criteria, 1) signed inform consent, 2) full medical records on total serum cholesterol levels and opioid administration, 3) opioid-naïve, 4) not received/receiving cancer-related or cholesterol lowering treatment, 5) pain level at level 5–8. The patients were divided into different groups basing on their gender and cholesterol levels. Since different opioids, morphine, oxycodone, and fentanyl, were all administrated at fixed low dose initially and increased gradually only if pain was not controlled, the percentages of patients in each group who did not respond to the initial doses of opioids and required higher doses for pain management were determined and compared. Results Patients with relative low cholesterol levels have larger percentage (11 out of 28 in female and 31 out of 71 in male) to not respond to the initial dose of opioids than those with high cholesterol levels (0 out of 258 in female and 8 out of 74 in male). Similar differences were obtained when patients with different opioids were analyzed separately. After converting the doses of different opioids to equivalent doses of oxycodone, significant correlation between opioid usages and cholesterol levels was also observed. Conclusions Therefore, more attention should be taken to those cancer patients with low cholesterol levels because they may require higher doses of opioids as pain killer. Electronic supplementary material The online version of this article (doi:10.1186/s12944-016-0212-9) contains supplementary material, which is available to authorized users.

Background The roles of carcinoembryonic antigen (CEA), cytokeratin 19 fragments (CYFRA21-1) and neuron-specific enolase (NSE) in metastases occurrence and poor diagnosis in specific histological classifications of lung cancer need further exploring. In this study, we investigated relationship between elevated levels of three biomarkers of CEA, CYFRA21-1 and NSE (individually and in combination) and metastasis, survival status and prognosis in lung cancer patients. Methods Eight hundred and sixty eight lung cancer patients including adenocarcinoma (ADC, N = 445), squamous cell carcinoma (SCC, N = 215), small cell lung cancer (SCLC, N = 159) and other types (N = 49) were categorized into negative, moderate and high groups according to serum levels of biomarkers, and were then categorized into negative, single, double and triple groups according to any positive combination of three biomarkers. The cutoff values of three biomarkers for groupings were developed on the training group (N = 432) and verified in a validation group (N = 436). Clinical and laboratory characteristics were then assessed for correlation with occurrence of metastasis, survival status and prognosis between the two groups. Further correlation analyses were also conducted by different subtypes (ADC, SCC and SCLC) and tumor stages (I + II, III and IV) of lung cancers. Results The consistent results between training and validation group confirmed the rationality of grouping methods. CYFRA21-1 levels had stronger association with metastases and survival status than CEA and NSE in all lung cancer patients. When stratified by subtypes, these significances only existed in ADC patients for CYFRA21-1. Cox regression analyses showed that CYFRA21-1 and NSE were independent prognostic factors for lung cancer patients. However, only CYFRA21-1 was an independent prognostic factor in ADC and SCLC patients subtypes. Cox-regression results also indicated that CYFRA21-1 could act as independent prognostic factor in different stages (I + II, III and IV) of lung cancer. Conclusion CYFRA21-1 was more important in metastasis occurrence and in predicting poor prognosis in lung cancer patients than CEA, NSE and positive numbers of biomarkers. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3070-6) contains supplementary material, which is available to authorized users.

Background: The Chronic Respiratory Questionnaire short form (SF-CRQ) is frequently used in patients with obstructive pulmonary disease and it has demonstrated excellent psychometric properties. The CRQ (both in its original or short form) has not been previously used in the assessment of lung cancer patients’ HRQL. Therefore this study, being part of a larger therapeutic trial, aims to evaluate the psychometric properties of the SF-CRQ in patients diagnosed with thoracic malignancies. Methods: Forty-six patients were assessed at two time points (with a four-week interval) using the SF-CRQ, the modified Borg Scale, five numerical rating scales related to perceived severity of breathlessness, and the Hospital Anxiety & Depression Scale. Internal consistency reliability was investigated by Cronbach’s α reliability coefficient, test-retest reliability by Spearman-Brown reliability coefficient (p) and convergent validity by Pearson’s correlation coefficient between the SF-CRQ, and the conceptual similar scales mentioned above and content validity was also explored. A principal component factor analysis was performed.Results: The internal consistency was high, indicated by an α=0.88 (baseline) and 0.91 (after one month). The SF-CRQ had good stability with test-retest reliability ranging from r=0.64 to r=0.78, p

[研究目的]肺癌化学療法を受けている患者の心理的変化を明らかにすることである。[研究方法]調査対象は,肺癌のために化学療法を受ける患者で研究参加に同意を得た6名。方法は(1)フィンクの危機モデルを基に作成された藤野の項目を参考にした危機質問紙,(2)市賑のProfile of Mood States (POMS)質問紙(金子書房)を用いた。(1)(2)を用いて,化学療法開始前日を1回目とし,2回目(7日目),3回目(14日目),4回目(21日目)の計4回,購査を行った。症状や治療経過や受け止め方についてはカルテ・看護師から情報を得た。[研究結果]対象6名の年齢は40代から70代で,性別は男性が5名,女性が1名であった。全員に肺癌関連症状が見られ,さらに化学療法に伴う副作用症状も認めた。 POMS得点は「抑うつ」尺度,「混乱」尺度が経過に伴い低下していたが,「怒り・敵意」尺度の毎回の平均値は変化を認めなかった。「疲労」尺度は1, 2, 3回目と比べ,4回目に低下していた。調査の3,4回目における危機段階は,4名が適応の段階に達し,2名が承認の段階であった。

Contains fulltext : 136872.pdf (Publisher’s version ) (Open Access) BACKGROUND: Lung cancer is the leading cause of cancer death worldwide and characterized by a poor prognosis. It has a major impact on the psychological wellbeing of patients and their partners. Recently, it has been shown that Mindfulness-Based Stress Reduction (MBSR) is effective in reducing anxiety and depressive symptoms in cancer patients. The generalization of these results is limited since most participants were female patients with breast cancer. Moreover, only one study examined the effectiveness of MBSR in partners of cancer patients. Therefore, in the present trial we study the effectiveness of MBSR versus treatment as usual (TAU) in patients with lung cancer and their partners. METHODS/DESIGN: A parallel group, randomized controlled trial is conducted to compare MBSR with TAU. Lung cancer patients who have received or are still under treatment, and their partners are recruited. Assessments will take place at baseline, post intervention and at three-month follow-up. The primary outcome is psychological distress (i.e. anxiety and depressive symptoms). Secondary outcomes are quality of life (only for patients), caregiver appraisal (only for partners), relationship quality and spirituality. In addition, cost-effectiveness ratio (only in patients) and several process variables are assessed. DISCUSSION: This trial will provide information about the clinical and cost-effectiveness of MBSR compared to TAU in patients with lung cancer and their partners.

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