EDITORIAL

Lung cancer surgery

Concerns of poor quality of life should not deprive patients of the opportunity of curative surgery

K McManus

Consultant Thoracic Surgeon, Royal Group of Hospitals, Belfast BT12 6AB, UK; mactheknife@utvinternet.com

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Is it worth undergoing lung cancer resection and the resulting poor quality of life when the survival outcomes are not good?

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Keywords: lung cancer; postoperative pain; quality of life

The first 150 words of the full text of this article appear below.

Postoperative pain and breathlessness following lung cancer surgery are important causes of disability. The prospect of such symptoms may influence the decision to proceed with surgery. Incapacitating intercostal neuralgia, unlike other surgical pain, often does not go away. Intolerable breathlessness caused by removing lung tissue from a patient who already has poor lung function can result in severe limitation of exercise tolerance. Is it really worth it when the survival outcomes in lung cancer are so poor anyway?

A surgeon’s main interest is radical clearance of the tumour and long term survival of the patient. Success is judged in terms of operative mortality and 5 year survival. The referring physician, on the other hand, may perceive that the patient will be left physically and emotionally handicapped by surgery and refer him or her for chemotherapy or radiotherapy instead, even though there is little evidence that these treatments . . . [Full text of this article]

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• Schulte, T., Schniewind, B., Dohrmann, P., Kuchler, T., Kurdow, R. (2009). The Extent of Lung Parenchyma Resection Significantly Impacts Long-Term Quality of Life in Patients With Non-Small Cell Lung Cancer. Chest 135: 322-329 [Abstract] [Full Text]  
• Brunelli, A., Socci, L., Refai, M., Salati, M., Xiume, F., Sabbatini, A. (2007). Quality of Life Before and After Major Lung Resection for Lung Cancer: A Prospective Follow-Up Analysis. Ann. Thorac. Surg. 84: 410-416 [Abstract] [Full Text]  
• Barlesi, F., Doddoli, C., Loundou, A., Pillet, E., Thomas, P., Auquier, P. (2006). Preoperative psychological global well being index (PGWBI) predicts postoperative quality of life for patients with non-small cell lung cancer managed with thoracic surgery.. Eur. J. Cardiothorac. Surg. 30: 548-553 [Abstract] [Full Text]