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Clinical Investigations: PULMONARY FUNCTION TESTS |

Impact of Respiratory Symptoms and Pulmonary Function on Quality of Life of Long-term Survivors of Non-Small Cell Lung Cancer*

Linda Sarna; Lorraine Evangelista; Donald Tashkin; Geraldine Padilla; Carmack Holmes; Mary Lynn Brecht; Fred Grannis
Author and Funding Information

*From the School of Nursing (Drs. Sarna and Evangelista), University of California, Los Angeles; Department of Medicine (Dr. Tashkin), University of California, Los Angeles; School of Nursing (Dr. Padilla), University of California, San Francisco; Department of Surgery (Dr. Holmes), University of California, Los Angeles; Integrated Substance Abuse Program (Dr. Brecht), University of California, Los Angeles; and Department of Surgery (Dr. Grannis), City of Hope Medical Center, Duarte, CA.

Correspondence to: Linda Sarna, RN, DNSc, School of Nursing, University of California, Los Angeles, 700 Tiverton Ave, Box 9569182, Factor 4-262, Los Angeles, CA 90095-6918; e-mail: lsarna@sonnet.ucla.edu



Chest. 2004;125(2):439-445. doi:10.1378/chest.125.2.439
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Purpose: 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 FEV1 percentage predicted was 68% (SD, 23); 21% had < 50% predicted FEV1. 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.


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