Clinical manifestations of carcinoma of the lung

237

Coping

strategies

Wilkie

DJ, Keefe

of patients

with

lung cancer-related

mediastinum.

pain

ofPhysiological Nursmg.

FJ. Departmenf

SM-28.

Unwersiry of Washington, Seattle. WA 98195. Clin J Pain 1991;7:292-

nodal

9.

metastasis, Prevuxs

findings

relationship Although

in patients

between

with

nonmalignanl

pain coping strategws

coping strategies have been explored

pain, reladonships lo examine

wlh

between

selected

in patients with cancer pain

variables and Ihe use of pam coping strategies. pain related u) lung cancer indicated State-Trail

Anxiety

and the Copmg

a

factors.

such factors have not been reported. We wished

relauonships

others and completed

pain Indicate

and psychological

Strategies

not telling

Visual

Pain Quewonnaire

Analogue

Ques1ionnaire

(MPQ),

was assouated

(CSQ).

with

Forty-two

perccnl of

more

frequent

pam

attempts for all CSQ subscales bu1 those of calasuophizing preting pain sensation. State anxiety wth

calaslrophizing

tlon wth

ability

number 0.34).

dcmonslrated

and remlcr-

positive correlation correla-

and decrease (I = -0.50) pain. The

of pain sites was correlated

with coping

and state anxiety

self-sta1emenLs (r =

demonstrated

similar

rclauon-

ships. Painquality

as measured with theMPQdemonslratcdmodcra1ely

strong correlauon

wtb

trophizing,and expanding

a pauem’s

conslderaoon quahty,

diverling

attention.

increasedactivity.

not affect

N2 disease was affected levels of meuslases,

praying

pain coping repertmre

Wakabayashi

anxiety

A. Cardiothoracic

that extensive

high (99%).

manifestations

of carcinoma

of the lung

than 140,000deaths.Onereasonforthis

rate is our inability Carcinoma

to diagnose carcinoma

of the lung IS associated

Becausemanyofthesearesubde be overlooked

tations

and therapeutic

until more obvious signs of malignancy

of carcinoma

of the lung

UC1

Medical Cenrer, PO&v

direct

by CT

ment m rhoracoscopy

wll

were performed. operating

Recent

instruments

alert

diagnosis

and prolonged

intervention

chemotherapy

inlo

mitomycin,

has been performed or operative

at an increasing

procedures

of chemotherapeutic

are reporled.

Muladrug

chemotherapy

cisplatin,

cyclophosphamide

All pa1iens

had symplomatic

was no incidence

improvement

of pneumothorax

were mild. The authors believe

motherapy

such as carbon ordiffuse

bullous

laser vapowation pleurec-

resection. Furrhcrtechnologic

advance-

involvement

impact on the future of

and the prognosis

of non-small

cell

lung cancer Y. Hayasht

Surgery, Kanazawa

Y. Shimizu

J. Oda M. Iwa

School

Universily

chi, Kanazawa 920. Chest 199l;lOO: We evaluated

Ihe effect of mediastinal

surwval

in 233 non-small

and N3 disease in 34 patients).

dwase,

I44 underwent

curative

of lung cancer is an effective

that direct

tumor.

the noncuratively

mediastmum

Patiems

with

supenor mediastinum to the inferior worse survival

Of the 199 patients which

of the location

N2

lesions

had a worse survival In contrast,

to tbe inferior

than those with

survival

was significantly

resected N2 groupor

N2 rate

better

the N3 group. superior

of the primary

and metastases

to the

than those wtth metastases patients

mediastinum

lesions

on

in 199 with

resected patients mvolved

irrespective

right-sided

mediasunum.

lcslons metastasizmg

7h!uua-ma-

node metastasis

The five-year

metartawing

with

with tumor

and other side intervention

and safe treatment

chc-

of choice m

advanced cases.

Survival

for clinical

Comparison Sobue

T,

between Suzuki

T,

Stage

I lung

cancer

screen-detected Matsuda

M.

not surgically

left-sided

N2

had a significantly to the superior

treated:

and symptom-detected

Kuroishi

T.

Ikeda

cases

S, Naruke

T.

Deparfment of Field Research, Cenlerfor Adult Diseases, Osaka l-3. 3 Naka- michi, Iligashinari-ku. Osaka 537. Cancer 3992;69:685-92. To assess the extent of overdiagnosis

bias m lung cancer screening,

clinical

Stage I lung cancer cases detected by chest radiograph

nation,

with

from

histologic

20 insdtutions,

or cytologic

ewdence

were followed

42

screen-detected

cases satisfied the study criteria. had no contraindication procedure. detected

lymph

resection.

metastases in Ihe curatively

and Inferior

13-l

cell lung cancer patients (N2 &ease

of these 144 patients was 20.3 percent, Nodal

of Medicine.

of

Deparrmenl

422-8.

patients

than that ofeither

T.

ustng

or 5-Fu was given in a total of

fre-

especially

and rhoracoscope/lascr-aided

have a considerable

intubation

the tumor

There

reactions

proven advanced lung cancer patients

percutaneous

treated by surgical operation,

Walanabe

to its

surwval.

of lung cancer

Among

and 8l%,

median

died

survival

within

up for more than IO years.

survwal indicated

treatment,

but they refused surgical

122

and 67

months,

was stalislically

of the patients

between

of

cases,

dred of lung cancer. The for those in the screen-

groups, respectively.

significant

and symptomrespecuvely,

and symptom-detected

time was 25 and I3 months

detected and symptom-detected

cases collected

and 27 symptom-detected

from the screen-detected

the screen-detected

respectively,

and not

In about half of the cases, the patients

for surgxal

such patients

groups

diagnosis. 80%

All

exami-

of malignancy

Of 1297 screen- detected and 1297 symptom-detected nodal

manifcs-

the clinician

accuracy

thoracxc surgery.

Mediastinal

resection,

the clinical

guided

I I treatments.

Surg 1991;102:72l-

easier and more accurate than 20 years ago.

tumors,

are present. By

to surgical

that may

earlier

effects. they may

Yangpu District Cenrral Hospital, Shanghai. Chin J Oncol

S.

agent

thoracoscopy

years because of its expanded applicaoons,

malignant

systemic

presentation,

1991;13:449-51.

Surgery,

lomy,pericardicctomy,orlung

highmortabty

with numerous

intheirclinical

and the chance for cure is lost. The article reviews

CT guided

neodymium:yttrium-alummum-garner

of pleural

be

of the lung a1 an early slage.

this time, the tumor may be no longer amenable

Wong

diox~delaserueatmentofsponlaneouspneumothorax emphysema,

should

tumor.

In 1991 lung cancer wdl account for 30% of all cancer deaths in this counlry,ormore

pain

rate was low (I %) and the diagnostic

m the areas of therapeutic

dissection

MC

wi1h

systems and endoscopic

Thoracoscopy

quency m went

of

Departmtwr of Medicine. University of 7’ exas MedIcal Branch, Galveston, TX 77550. J Thorac Imaging 1991;7:21-8. Boyars

should be dcvelopcd

1971 to 1990, 3 I5 lhoracoscopies

mortality

mediastmal

of the primary

reducrion.

The operative

with

by Ihe number

of the locaoon

level, pain Intensity,

14091, Orange, CA 92613-1091. JThoracCardiovasc

have made thoracoscopy

level

multilevel

and hopmg, catas-

3. From

radicality,

irrespective

presence and perhaps allow

prefcrencc.

of diagnostic

advances m optic/video

in cases of

that the survival ofpatients

by the operative

The results of 4 pathologically

applications

the survival

and also by the location of 1he nodal involvement.

I( seems appropriate

ueated Expanded

in case of single-

lnterventionsmmedatreinforcingor

gwen 10 the patient’s

and pain expression

for

coping

coping strategies (r = 0.48) and negatwe

to control (r = -0.50)

Pain intcnslty

but did

mctastases. Subcarmal

effect

metastases. Our present study indicaled

Clinical

Scale of pain Intensity,

they 1old others when 1hcy had pam. Prcfcrcnccs

others

had an unfavorable

patients with

the patients reported that lhey tried not 10 lee others know they had pain, and 40% indicated

metastases had a significantly

multilevel

how they expressed their pain 10

the McGill-Melzack Invemory,

Forty-five

rate lhan those with

involvement

performed

and psychological

Patients with single-level

better survival

The difference

the two groups,

the effect of lead time and length-biased

sampling.

in

which

Analysis

of the causes of death other than lung cancer showed that there was no difference

in the observed cumulative

rates of deaths of other causes

between the two groups, and these figures were almost the same as those expected from the general population. bias would be minimal chest radiograph

This indicates thatoverdiagnosis

in screen-detected

examination.

lung cancer cases detected by