Lung cancer complications

Paraneoplastic neuropathies often occur in patients with carcinoma. Subacute sensory or sensorimotor axonal polyneuropathy, often with associated limbic encephalitis and cerebellar degeneration, is a common complication of small-cell lung cancer and other carcinomas, occasionally presenting even prior to diagnosis of the underlying neoplasm. Some patients with paraneoplastic neuropathy express anti-Hu antibodies, which recognize epitopes associated with the HuD neuronal RNA binding protein [37,38]. 

Long-term complications of radiotherapy, chemotherapy, and chemora-diotherapy include gonadal dysfunction, secondary malignancies, and cardiac disease. Patients treated for HL are at increased risk of developing leukemia, GI tumors, lung cancer, and breast cancer. 

Toxicity/symptoms Peripheral nervous system (tingling in hands and feet), skin cancer (ingestion), lung cancer (inhalation) hyperpigmentation (keratosis) of palms and soles vascular complications... 

Fowler WC, Langer CJ, Curran WJ, et al. Postoperative complications after combined neoadjuvant treatment of lung cancer. Ann Thorac Surg 1993 55 986-989. 

A complication arises, however, when we consider simultaneous exposure to two or more chemicals, e.g., asbestos and cigarettes. The relative risks (RR) of lung cancer in persons exposed to one or both of these agents (Selikoff, 1977) are as follows ... 

Case study level 1 - Non-small cell lung cancer 171 Case study level 2 - Treatment of advanced colorectal cancer 173 Case study level 3 - Treatment of metastatic breast cancer and its complications 175... 

De Vuyst P, Dumortier P, Jacobovitz D, et al. 1994. Environmental asbestosis complicated by lung cancer. Chest 105 1593-1595. 

Silicosis, a form of pulmonary fibrosis, is the primary health problem resulting from inhalation exposure to particles of crystalline silica (SSDC, 1988 NIOSH, 2002 Castranova, 2000 Castranova and VaUyathan, 2000). Other diseases associated with occupational inhalation exposure to crystalline silica include lung cancer, chronic obstructive pulmonary disease, nonmalignant respiratory disease, auto-immune related diseases (such as rheumatioid arthritis), renal diseases, and (as a complication of silicosis) increased risk of bacterial or fungal infections such as tuberculosis. Skin granulomas or obstructive lymphopathies may result from dermal exposure and uptake of silica particles (NIOSH, 2002). 

There were more frequent adverse effects and an increased death rate due to pulmonary complications, sepsis, or arterial thrombosis in lung cancer patients treated with chemotherapy plus radiotherapy and GM-CSF (SEDA-20, 339). 

The studies just cited address the risk of developing lung cancer following exposure to radon, asbestos, and tobacco. Though estimating these risks are complicated by human exposures to other environmental pollutants, both indoors and outdoors, I42 44 these and other similar studies do definitively establish the enhanced effects of exposure to mixtures on the development of lung cancer and other cancers. This subject is discussed further in Chapter 21. 

CHRONIC HEALTH RISKS increased risk of lung cancer decreased pulmonary function pneumonia bronchitis asthma liver and kidney damage effects on gastrointestinal and immune systems effects on the blood contact dermatitis skin ulcerations sensitivity nasal itching and soreness complications during pregnancy and childbirth chromate salts are suspected carcinogens. 

Technical Considerations Catheterization of the bronchial arteries is best approached from the femoral artery. Since most patients with lung cancer are older and the aorta is tortuous and atherosclerotic, a 5-F catheter with good torque control in a shepherd s crook (reverse curve) or forward seeking configuration is recommended. A finely tapered tip catheter for access which would allow a 3-F microcatheter coaxial system is optimal to bypass the spinal artery. The use of nonionic contrast media should minimize pain and the risk of contrast media-induced complications. The digital subtraction technique is of value for the identification of the anterior spinal artery with small branches to the spinal cord. 

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