Solitary pulmonary nodules: consequences for patient quality of life

Lemonnier, I.; Baumann, Cédric; Jolly, Damien; Arveux, Patrick; Woronoff‐Lemsi, Marie‐Christine; Velten, Michel; Guillemin, Françis

doi:10.1007/s11136-010-9719-0

Cited by 24 publications

(12 citation statements)

References 36 publications

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“…3,7–10,24,25 Yet, our results differ somewhat from the literature on the impact of screen-detected pulmonary nodules. 15,26–28 Some lung cancer screening trials do suggest that patients experience mild short-term distress, 15 anxiety, 29 or impairments in quality of life 30 after nodule detection.…”

Section: Discussioncontrasting

confidence: 99%

Patients’ Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey

Freiman

Clark

Slatore

et al. 2016

Journal of Thoracic Oncology

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Introduction Pulmonary nodules are detected in over a million Americans each year. Prior qualitative work suggests the detection of incidental pulmonary nodules can be burdensome for patients, but it is unknown whether these findings generalize to a broader sample of patients. We categorized patients’ knowledge, beliefs, and distress associated with detection and evaluation of a pulmonary nodule, and their impressions of clinician communication. Methods We administered a cross-sectional survey to adults with an incidental pulmonary nodule recruited from a rural medical center, an urban safety net hospital, and a Veterans Affairs hospital. Results Of 490 surveys mailed, 244 (50%) responded. Median nodule size was 7 mm; mean patient age was 67 years; 29% were female, and 86% were white. A quarter (26%) of respondents reported clinically significant distress related to their nodule as measured by the Impact of Event scale, our primary outcome. Patients reported multiple concerns including uncertainty about the nodule’s etiology (78%), the possibility of cancer (73%), and the possible need for surgery (64%). Only 25% of patients accurately estimated their lung cancer risk (within 15% of their actual risk); overall there was no correlation between perceived and actual risk (r=−0.007, p=0.93). Among the 23% of patients who did receive cancer risk information from their provider, they were more likely to find this information reassuring (16%) than scary (7%). Conclusion A quarter of patients with incidental pulmonary nodules experienced clinically significant distress. Knowledge about cancer risk and evaluation was poor. Clinician communication may help bridge knowledge gaps and alleviate distress in some patients.

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Section: Discussioncontrasting

confidence: 99%

Patients’ Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey

Freiman

Clark

Slatore

et al. 2016

Journal of Thoracic Oncology

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“…Lemonnier et al compared health-related quality of life measures in 171 patients with pulmonary nodules 1–3 cm in diameter with those of the general population with a similar age 320. They found that patients with pulmonary nodules had worse self-reported health status (as measured by a reduction in score on the Short Form 36 Health Survey of between 11 and 30 points), which was most marked for older people and those who were smokers.…”

Section: Information and Supportmentioning

confidence: 99%

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Callister

Baldwin

Akram

et al. 2015

Thorax

743

724

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“…A prospective multi-center study was conducted in northeastern France (Alsace, Lorraine, Franche-Comté, Bourgogne, and Champagne-Ardenne) as part of research reported elsewhere [22-24]. The study involved 18 health-administrative districts covering 8.22 million people.…”

Section: Methodsmentioning

confidence: 99%

Quality of life after the initial treatments of non-small cell lung cancer: a persistent predictor for patients’ survival

Lemonnier

Guillemin

Arveux

et al. 2014

Health Qual Life Outcomes

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BackgroundHealth-related quality of life (HRQoL) before treatment may predict survival of patients with non-small-cell lung cancer (NSCLC). We investigated the predictive role of HRQoL after the initial treatments, on the survival of these patients.MethodsA prospective multi-center study conducted in northeastern France. The SF-36 and European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core-30 (QLQ C-30) were mailed to patients 3 months after the end of the diagnostic process. High scores for functioning dimensions on both questionnaires indicated better QoL, and low scores for symptom dimensions on the QLQ C-30 indicated few symptoms. Cox regression modeling was used to identify predictive factors of survival.ResultsIn total, 230 (63.5%) patients responded to the SF-36 and QLQ C-30. Before completing the questionnaires, almost 60% of patients had undergone some chemotherapy, about 10% underwent radio/chemotherapy or both and more than 30% underwent surgery or surgery plus chemo/radiotherapy.On SF-36, the highest mean score was for social functioning dimension (55.5 ± 28), and the lowest was for the physical role dimension (17.9 ± 32.2).On QLQ C-30, for the functioning dimensions, the highest mean score was for cognitive functioning (74.6 ± 25.9) and the lowest was for role functioning (47.2 ± 34.1). For symptom dimensions, the lowest score was for diarrhoea (11.5 ± 24.2) and the highest was for fatigue (59.7 ± 27.7).On multivariate analysis, high bodily pain, social functioning and general health scores (SF-36) were associated with a lower risk of death (hazard ratio 0.580; 95% confidence interval [0.400–0.840], p = 0.004; HR 0.652 [0.455–0.935], p < 0.02; HR 0.625 [0.437–0.895] respectively). Better general QoL on QLQ C-30 was related to lower risk of death (HR 0.689 [0.501–0.946], p = 0.02).ConclusionAdding to previous knowledge about factors that may influence patients QoL, this study shows a persisting relationship between better perceived health in HRQoL after the initial treatment of NSCLC and better survival.

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Solitary pulmonary nodules: consequences for patient quality of life

Abstract: Six months after receiving a diagnosis of SPNs, whether malignant, patients have worse HRQoL compared to the French general population. It indicates areas where physicians can help patients coping with their disease.

Cited by 24 publications

References 36 publications

Patients’ Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey

Patients’ Knowledge, Beliefs, and Distress Associated with Detection and Evaluation of Incidental Pulmonary Nodules for Cancer: Results from a Multicenter Survey

British Thoracic Society guidelines for the investigation and management of pulmonary nodules: accredited by NICE

Quality of life after the initial treatments of non-small cell lung cancer: a persistent predictor for patients’ survival

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