Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms

Andersen, Barbara L.; Valentine, Thomas R; Lo, Stephen; Carbone, David P.; Presley, Carolyn J.; Shields, Peter G.

doi:10.1016/j.lungcan.2019.11.015

Cited by 24 publications

(25 citation statements)

References 99 publications

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“…26 Comprehensive geriatric assessment can be resource-and time-consuming; however, there are brief assessment tools that can be implemented in a short amount of time. 27 Using these screening tools, such as the G8 28 and the EQ-5D-5L, or simply asking about activities of daily living and instrumental activities of daily living can uncover functional disability, 29 pain, 30 and psychological 31 impairments that would otherwise go unrecognized and are independently associated with poor patient outcomes. More recently, the ELDERS study demonstrated that older adults with advanced lung cancer or melanoma receiving immunotherapy with a positive G8 screening test ( 14 points) had a higher risk of hospital admissions (p = .03) and death (p = .01), but not a higher incidence of treatment-related toxicity.…”

Section: Assessmentmentioning

confidence: 99%

Care Disparities Across the Health Care Continuum for Older Adults: Lessons From Multidisciplinary Perspectives

Dharmarajan

Presley

Wyld

2021

American Society of Clinical Oncology Educational Book

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Older adults comprise a considerable proportion of patients with cancer in the world. Across multiple cancer types, cancer treatment outcomes among older age groups are often inferior to those among younger adults. Cancer care for older individuals is complicated by the need to adapt treatment to baseline health, fitness, and frailty, all of which vary widely within this age group. Rates of social deprivation and socioeconomic disparities are also higher in older adults, with many living on reduced incomes, further compounding health inequality. It is important to recognize and avoid undertreatment and overtreatment of cancer in this age group; however, simply addressing this problem by mandating standard treatment of all would lead to harms resulting from treatment toxicity and futility. However, there is little high-quality evidence on which to base these decisions, because older adults are poorly represented in clinical trials. Clinicians must recognize that simple extrapolation of outcomes from younger age cohorts may not be appropriate because of variance in disease stage and biology, variation in fitness and treatment tolerance, and reduced life expectancy. Older patients may also have different life goals and priorities, with a greater focus on quality of life and less on length of life at any cost. Health care professionals struggle with treatment of older adults with cancer, with high rates of variability in practice between and within countries. This suggests that better national and international recommendations that more fully address the needs of this special patient population are required and that primary research focused on the older age group is urgently required to inform these guidelines.

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Section: Assessmentmentioning

confidence: 99%

Care Disparities Across the Health Care Continuum for Older Adults: Lessons From Multidisciplinary Perspectives

Dharmarajan

Presley

Wyld

2021

American Society of Clinical Oncology Educational Book

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“…After being diagnosed with cancer, especially during the two weeks immediately following the diagnosis, many patients struggle with adjusting to daily life. 3,4 Therefore, important decisions should be avoided by patients at this time. However, according to a multi-center survey by the Ministry of Health, Labor and Welfare in 2015, 21% of patients who were working at the time of cancer diagnosis resigned immediately after receiving the diagnosis, and more than 40% of patients resigned before the initiation of treatment.…”

Section: F I G U R Ementioning

confidence: 99%

Importance of doctor‐initiated management of the balance between work and treatment for lung cancer patients: Results of a nationwide survey by the Japan Lung Cancer Society

et al. 2020

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Backgrounds Since the recent development of molecular targeted drugs and immune checkpoint inhibitors has improved lung cancer treatment options and outcomes, supporting patients in balancing work and pharmacotherapy have become even more important in the field of lung cancer treatment. This study sought to identify the current status and roles of doctors in balancing work and treatment for lung cancer patients. Methods Patients and doctors were recruited to complete a web‐based questionnaire survey by the Japan Lung Cancer Society. Results About 287 lung cancer patients and 381 doctors were included in the analysis. About 42.9% of patients responded that “there was no discussion” about their working conditions or work before the initiation of pharmacotherapy, while 22.6% responded that “there was an inquiry from a doctor/health care provider and a discussion that included the doctor was held.” About 45.3% of patients took leave or resigned from work at the time of diagnosis. The most common reasons for patients to resign before or during pharmacotherapy were “poor physical condition due to side effects of treatment or illness” and “concern about causing problems in the workplace.” To assist in balancing work and pharmacotherapy, patients desired “increased opportunities to consult about work” (36.9%) and “provision of treatment options with few adverse events” (28.9%). Conclusion This study highlights the importance of doctor‐initiated management of the balance between work and treatment for lung cancer patients. An important first step is for doctors themselves to take an interest in their patients' professions and initiate discussions of work‐related topics with their patients.

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“…Among these factors, second-hand smoking increases the risk for lung cancer among non-smokers by 1.31 (95% confidence interval (CI) of the odds ratio, 1.17-1.45). 19 Air pollution caused by PM2.5 or indoor radon [20][21][22] and depression generated (identified in 40% of patients with advanced NSCLC) 23 have also been associated with lung cancer. Considering the impact of these factors on the incidence of lung cancer, we propose that smoking status might be an "optional" condition to recommend advanced imaging such as thinslice computed tomography, rather than a "compulsory" condition.…”

Section: Discussionmentioning

confidence: 99%

<p>Non-Small Cell Lung Cancer in Young Patients: An Analysis of Clinical, Pathologic and TNM Stage Characteristics Compared to the Elderly</p>

Jin¹,

Zhao²,

Liu³

et al. 2020

RMHP

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Purpose: To compare clinicopathologic factors including tumor-node-metastasis (TNM) stage between young and elderly patients with non-small cell lung cancer (NSCLC). Methods: This retrospective study compared the following characteristics between 52 young patients with NSCLC (<50 years of age) and 67 elderly patients with NSCLC (>60 years): duration of symptoms before medical consultation, smoking index, family history of cancer, Ki-67 index, and pTNM stage. A binary logistic regression analysis was used to identify factors predictive of greater stage NSCLC (stage III/IV compared to stage I/II) within each age group. Results: The incidence of adenocarcinoma was higher in the young than in the elderly (P=0.006). Smoking index (P=0.002) and Ki-67 index (P<0.001) were lower in the young than in the elderly. In young patients with NSCLC, delayed treatment (greater duration from symptoms to medical consultation, P=0.050) and active tumor proliferation (higher Ki-67 index, P=0.003) were predictive of more advanced cancer stage (III/IV), with only symptom duration being predictive of stage III/IV NSCLC among elderly patients. Among young patients, cough (P=0.021) and chest congestion (P=0.040) were the most significant warning symptoms of advanced-stage NSCLC. Conclusion: High tumor proliferation and delayed treatment are predictive of advanced NSCLC on presentation among young individuals. Early diagnosis by imaging, such as with the use of low dose computed tomography (LDCT), for young individuals with coughing and chest congestion over 1 month might be effectiveto improve prognosis and outcomes.

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Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms

Cited by 24 publications

References 99 publications

Care Disparities Across the Health Care Continuum for Older Adults: Lessons From Multidisciplinary Perspectives

Care Disparities Across the Health Care Continuum for Older Adults: Lessons From Multidisciplinary Perspectives

Importance of doctor‐initiated management of the balance between work and treatment for lung cancer patients: Results of a nationwide survey by the Japan Lung Cancer Society

<p>Non-Small Cell Lung Cancer in Young Patients: An Analysis of Clinical, Pathologic and TNM Stage Characteristics Compared to the Elderly</p>

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