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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
REVIEWS WHAT’S NEW IN RESPIRATORY MEDICINE IN 2010 - PART I
Minerva Pneumologica 2010 September;49(3):185-203
How to manage the long term treatment complications of lung cancer
Petersen H., Mazzone P.
Respiratory Institute at the Cleveland Clinic Foundation, Cleveland, OH, USA
Lung cancer patients will undergo surgical resection, radiotherapy, chemotherapy or some combination of the three based on their histology, stage, and overall fitness. Each of these therapies may produce immediate and long term complications. This review descibes some of the most common long term complications of each therapeutic modality that may arise in the 3 month follow-up period and beyond. Other than acute radiation pneumonitis (RP), there is no standard treatment for any of the complications discussed despite numerous clinical trials. The chronic pain of post thoracotomy pain syndrome may be managed by neuropathic pain agents or standard analgesics. Acute RP is treated with a regime of corticosteroids. Chronic RP management is mostly supportive. Chemotherapy-induced peripheral neuropathy may also be managed with neuropathic pain medications, but studies showing efficacy are lacking. Research into prevention of these complications show promise but there is not enough evidence for biomarkers or compounds to be used clinically. Quality of life (QOL) and sleep are also negatively impacted in lung cancer survivors. Exercise therapy can improve QOL and overall functioning in lung cancer patients. Complementary and alternative medicine therapies may benefit those with chronic pain, fatigue, and depression or anxiety.