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)

Factors affecting patients' comfort during fiberoptic bronchoscopy and endobronchial ultrasound.

This study investigated the factors that can affect the comfort of patients who underwent diagnostic fiberoptic bronchoscopy (FOB) and diagnostic endobronchial ultrasonography (EBUS) for the first time and the effect of the patients' anxiety level on their comfort during the procedure

Factors affecting patients' comfort during fiberoptic bronchoscopy and endobronchial ultrasound

Objective: This study investigated the factors that can affect the comfort of patients who underwent diagnostic fiberoptic bronchoscopy (FOB) and diagnostic endobronchial ultrasonography (EBUS) for the first time and the effect of the patients' anxiety level on their comfort during the procedure. Materials and methods: We recorded the demographics of the patients, the medications they used previously, the anesthesia applied during the procedure, the experience of the operator, the insertion technique of the bronchoscope, the types of the bronchoscopic interventions during the procedure, the duration of the procedure, and the anxiety levels of the patients before the session. Patients' discomfort level before and after the procedure and anxiety levels before the procedure were evaluated using a visual analog scale (VAS), and willingness for repeating FOB and EBUS was assessed using a questionnaire. Results: We found that longer examination time, higher anxiety level before the procedure, the nasal insertion of bronchoscope, and higher number of interventions are related to the increased discomfort during FOB and EBUS. Patients' willingness for repeating FOB and EBUS increased as the level of discomfort decreased during the procedure. Conclusion: The patient's anxiety level should be determined using a questionnaire before the FOB and EBUS procedures, and the operator should adjust their procedure according to the patients' anxiety level

Hospitalization costs of lung cancer diagnosis in Turkey: Is there a difference between histological types and stages?

To establish the direct costs of diagnosing lung cancer in hospitalized patients

Analysis of insulin like growth factor 1 and insulin like growth factor binding protein 3 levels in bronchoalveolar lavage fluid and serum of patients with lung cancer

SummaryObjective: Insulin like growth factor 1 (IGF-1) is recognized as a potent mitogen for many cancer cell lines and there is good evidence that lung cancer cells produce both IGF-1 and insulin like growth factor binding protein 3 (IGFBP-3). The aim of this study was to investigate the clinical significance of IGF-1 and IGFBP-3 levels in serum and in bronchoalveolar lavage (BAL) fluid by comparing lung cancer patients with healthy controls.Methods: BAL fluid and serum samples were obtained from 24 lung cancer patients and 12 healthy controls, and were analyzed for IGF-1 and IGFBP-3 levels by a two site immunoradiometric assay. The recovered BAL fluid was standardized by albumin to remove the variable of dilution and the data was expressed in epithelial lining fluid (ELF).Results: Serum IGF-1 and IGFBP-3 levels were lower in lung cancer patients, but the difference between the groups did not reach a statistical significance. IGF-1/IGFBP-3 ratio in ELF was significantly lower in lung cancer patients (P=0.035). Mean IGF-1 level in ELF was determined to be significantly lower in patients with distant metastasis (P=0.04). Serum IGF-1/IGFBP-3 ratio was found to be significantly lower in patients with distant (P=0.04) and nodal metastasis (P=0.03). Tumor stage was negatively correlated with IGF-1 level in ELF (P=0.05, r=-0.4) and serum IGF-1/IGFBP-3 ratio (P=0.04, r=-0.4).Conclusion: IGF-1 and IGFBP-3 levels both in serum and ELF might serve a clinical significance in patients with lung cancer. However, further studies comprising more cases are needed to investigate the cIinical significance of IGF-1 and IGFBP-3 in lung cancer

Is Primary Tumor Metabolic Activity a Risk Factor for Occult Lymph Node Metastasis in T1-2N0M0 Non-small Cell Lung Cancer Patients?

Objective: In our study we aimed to evaluate the potential risk factors for occult lymph node metastasis with PET-CT in patients with clinically stage I NSCLC