Quality of life and pain syndromes in lung cancer patients

Abstract

In Poland, lung cancer is the most common tumour diagnosed in men and third in women and the first cause of cancer death among both men and women. Due to poor prognosis and unsatisfactory treatment results, numerous symptoms, significant psychological burden, social and spiritual problems, lung tumours significantly decrease patients’ and families’ quality of life (QOL).

Pain is a frequent symptom in lung tumours. Pain may be induced directly by local growth or dissemination of the tumour, indirectly evoked by cancer – paraneoplastic syndromes, oncological treatment and comorbidities. Local pain syndromes most frequently are induced by infiltration by the tumour thoracic cage structures such as pleura, ribs, intercostal nerves and brachial plexus. Patients with tumour dissemination may suffer from pain evoked by bone (especially spine), visceral organs (most frequently liver and suprarenal glands) and brain metastases.

Development of paraneoplastic syndromes, among which anorexia–cachexia–asthenia syndrome leads to muscle atrophy, which may contribute to muscle spasm appearance, whereas hypertrophic osteoarthropathy may be a cause of arthralgia and muscle pain. Pain may be induced by oncology local treatment (mainly surgical interventions – thoracotomy and intercostal nerves damage) and systemic cytotoxic drugs administration, especially platinum derivatives (painful peripheral neuropathy). Pain may also be induced by comorbidities such as spondyloarthrosis or osteoporosis. Cough may induce or intensify pain in the chest.

Treatment of pain in lung tumour patients is based on pharmacotherapy that may be supplemented with interventional techniques, which may significantly improve patients’ QOL also thanks to psychosocial and spiritual support offered to patients and families and introducing integrated model of oncological and supportive/early palliative care.