Patient and physician delay in the diagnosis and treatment of non-small cell lung cancer in Turkey

Aim: The early diagnosis and treatment of lung cancer are important for the prognosis of patients withlung cancer. This study was undertaken to investigate patient and doctor delays in the diagnosis andtreatment of NSCLC and the factors affecting these delays.Materials and methods: A total of 1016 patients, including 926 (91.1%) males and 90 (8.9%) females with amean age of 61.5 10.1 years, were enrolled prospectively in this study between May 2010 and May2011 from 17 sites in various Turkish provinces.Results: The patient delay was found to be 49.9 96.9 days, doctor delay was found to be 87.7 99.6 days,and total delay was found to be 131.3 135.2 days. The referral delay was found to be 61.6 127.2 days,diagnostic delay was found to be 20.4 44.5 days, and treatment delay was found to be 24.4 54.9 days.When the major factors responsible for these delays were examined, patient delay was found to be morefrequent in workers, while referral delay was found to be more frequent in patients living in villages(p < 0.05). We determined that referral delay, doctor delay, and total delay increased as the number of doctorswho were consulted by patients increased (p < 0.05). Additionally, we determined that diagnostic andtreatment delays were more frequent at the early tumour stages in NSCLC patients (p < 0.05)

Is Tuberculosis a Challenge in the Management of Lung Cancer?

Objective: The coincidence of tuberculosis (TB) and lung cancer (LC) at the initial diagnosis or the development of TB during the course of LC is a challenge in the management of both diseases. Herein we reviewed 10 LC patients who coincidentally had TB and evaluated the challenges in the management of both diseases. Methods: The files of patients were retrieved from an archive, and available study forms were completed. Results: The study included 10 LC and TB patients during a 4 year-period. The sites of TB were the lung (seven patients), mediastinal lymph nodes (LN) (one patient), cervical LN (one patient), and subcutaneous nodules (one patient). LC and TB were simultaneously diagnosed in four patients. The diagnosis of pulmonary TB was confirmed by sputum culture two months after LC diagnosis in four patients. TB was diagnosed later in the follow-up period in two patients. Only one patient with early-stage LC who had undergone surgical resection tolerated anti-TB therapy well. In one patient, TB caused the over-staging of LC. In one patient, LC had progressed during the course of anti-TB therapy. Hepatotoxicity was the leading adverse reaction due to anti-TB therapy. Conclusion: These patients highlighted the importance of considering TB in the course of LC, especially in countries with a high TB prevalence. TB may cause the advanced staging of LC at the initial diagnosis; chemotherapy may worsen the TB course or cause reactivation TB. Reactivation TB may be considered as the progression of LC without tissue diagnosis or sputum analysis. The tolerability of anti-TB therapy is poor in these patients