EAST LANSING, MichiganA profile for elderly lung cancer
patients at high risk of having major cancer-related losses in
physical functioning has emerged from a Michigan State University
The impact of lung cancer in the elderly is likely to be more severe
in patients who have a higher prior level of physical functioning,
higher symptom severity, and, to a lesser degree, younger age, said
principal investigator Barbara Given, PhD, RN, of the School of
Nursing. Early recognition by physicians and other health care
professionals of this at-risk group would be important in planning
for supportive care to enhance quality of life for these
patients, Dr. Given said.
The study included 129 lung cancer patients between the ages of 65
and 87 (average, 72). Patient interviews were conducted 4 to 6 weeks
after surgery or 2 to 4 weeks after subsequent initial radiation
therapy or chemotherapy.
Physical functioning was measured using a 10-item subscale from the
Medical Outcomes Study 36-item Short Form Health Survey (SF-36).
Symptom severity was measured with the Symptom Experience Scale,
which elicited information on 32 symptoms.
To determine comorbidity, patients were asked to choose from a list
of 13 common comorbid conditions. Prior physical functioning was
taken from patient recall of a period approximately 3 months before
their diagnosis. Disease stage and treatment were culled from the
patients medical records.
most consistent theme observed was that fatigue almost universally
was the most frequently reported symptom, Dr. Given said. The
six most commonly reported symptoms, as shown in the Table, and their
severity did not differ significantly across the various treatment
categories, stages of disease, or by patient sex (J Symptom Pain Manage
In this study, younger patients and those reporting higher levels of
prior physical functioning or higher symptom severities showed
greater losses in physical functioning. Older patients generally had
lower baseline levels of physical functioning and therefore
experienced smaller losses in physical functioning.
Comorbidity did not play a significant role in predicting loss of
physical functioning, nor were there any significant differences in
loss of physical functioning according to stage of disease, type of
treatment, or patient sex.
Dr. Givens co-authors were Margot E. Kurtz, PhD, Department of
Family and Community Medicine; J.C. Kurtz, PhD, Department of
Mathematics; Manfred Stommel, PhD, College of Nursing; and Charles W.
Given, PhD, Department of Family Practice.