The lung cancer patient, the pneumologist and palliative care: a developing alliance

Abstract

Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures.This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients.As a consequence, this review particularly draws pneumologists' attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation. @ERSpublications Pneumologists should get more widely involved in palliative care for lung cancer patients

Paradoxical decrease in isoprostane and increase in superoxide dismutase following CPAP withdrawal in OSA

“…Above all, CPAP treatment for at least 2 months is effective in decreasing isoprostane concentration in urine, serum, plasma or exhaled breath condensate [2][3][4]. Consequently, because of their counterintuitive results, STRADLING et al [1] should provide some additional information to reinforce the advanced hypothesis. The first point is about the expression of the urinary F2-isoprostane results.…”

“…Annelies Janssens 1 , Liesbeth Teugels 1,2 , Sisca Kohl 1,3 , Toke Michielsen 1,3 , Bert Leysen 4 and Jan P. van Meerbeeck…”

“…STRADLING et al [1] have recently published an interesting, unprecedented study assessing the effects of a continuous positive airway pressure (CPAP) withdrawal on oxidative stress in patients already treated for moderate-to-severe obstructive sleep apnoea (OSA). Based on a combination of two different studies, the authors showed that stopping CPAP for 2 weeks ("sham-CPAP" group) significantly decreased the urinary F2-isoprostane concentration, while it increased the activity of the blood superoxide dismutase (SOD), compared with uninterrupted treatment ("CPAP" group).…”

Practical tools for implementing early palliative care in advanced lung cancer

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We read with interest the article by BLUM and SCHÖNFELD [1]. Early introduction of palliative care (EPC) in the management of patients with advanced lung cancer is recommended because it improves quality of life and tends to produce better survival [2].

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“…Hospital-based palliative teams mainly focus on terminal care for hospitalised patients. Involvement of the treating pulmonologist in this setting is warranted, as stated by BLUM and SCHÖNFELD [1]. We would like to show you how we started EPC in collaboration with the palliative team in our hospital (table 1).…”