Impact of respiratory symptoms and pulmonary function on quality of life of long-term survivors of non-small cell lung cancer.
OBJECTIVE
To describe respiratory symptoms and pulmonary function among long-term survivors of non-small cell lung cancer (NSCLC), and their relationship to quality of life (QOL).


METHODS
Cross-sectional survey of disease-free, 5-year minimum survivors of NSCLC (n = 142; 54% women; average age, 71 years); the majority (74%) had received a lobectomy. Analysis included frequency of self-reported respiratory symptoms (cough, phlegm, wheezing, breathlessness) as measured by the American Thoracic Society questionnaire, pulmonary function findings from hand-held spirometry, and QOL (Short Form-36).


RESULTS
Two thirds of survivors reported at least one respiratory symptom (mean, 1.3; SD, 1.2): 25% cough, 28% phlegm, 31% wheezing, and 39% dyspnea. Twenty-one percent reported that they spent most of the day in bed in the past 12 months because of respiratory symptoms. Average FEV(1) percentage predicted was 68% (SD, 23); 21% had < 50% predicted FEV(1). Based on spirometry results, 36% had a moderate/severe obstructive and/or restrictive ventilatory disorder. Survivors exposed to second-hand smoke (28%) were more than three times as likely to report respiratory symptoms. Respiratory symptom burden contributed to diminished QOL in several domains.


CONCLUSIONS
The majority of these survivors experienced respiratory symptoms, and more than one third reported dyspnea, including one of five patients with seriously diminished pulmonary function. Symptom burden, rather than ventilatory impairment, contributed to diminished QOL. Further study is needed to determine the patterns and effective management of posttreatment respiratory symptoms on survivors of lung cancer.
Sarna
Linda
L
School of Nursing, University of California-Los Angeles, 700 Tiverton Avenue, Box 9569182, Factor 4-262, Los Angeles, CA 90095-6918, USA. lsarna@sonnet.ucla.edu
Evangelista
Lorraine
L
Tashkin
Donald
D
Padilla
Geraldine
G
Holmes
Carmack
C
Brecht
Mary Lynn
ML
Grannis
Fred
F
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D003371:Cough / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000379:methods; D011237:Predictive Value of Tests; D011336:Probability; D011379:Prognosis; D011788:Quality of Life; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D018570:Risk Assessment; D018434:Sickness Impact Profile; D017741:Survivors