Congress Abstracts 2003

44

RESPIRATORY SYMPTOMS AND PULMONARY STATUS OF SURVIVORS OF NON-SMALL CELL LUNG CANCER. Linda Sarna, RN, DNSc, University of California, Los Angeles (UCLA), School of Nursing, Los Angeles, CA; Geraldine Padilla, PhD, University of California, San Francisco, School of Nursing, San Francisco, CA; Carmack Holmes, MD, UCLA Department of Surgery, Los Angeles, CA; Mary-Lynn Brecht, PhD, UCLA Integrated Substance Abuse, Los Angeles, CA; Lorraine Evangelista, PhD, RN, UCLA School of Nursing, Los Angeles, CA; and Donald Tashkin, MD, UCLA Department of Medicine, Los Angeles, CA.

Respiratory symptoms and pulmonary status of long-term survivors of non-small cell lung cancer (NSCLC), and the impact of these consequences on quality of life (QOL) have not been reported.

Purpose: To describe the pulmonary function and respiratory symptoms among long-term survivors of NSCLC and their relationship to QOL.

Methods: Cross-sectional survey of 5-year minimum survivors of NSCLC (n = 142), the majority (54%) female, average age 71 years. A multidimensional model of QOL served as the conceptual framework. Assessments included self-reported demographic and health status variables, frequency of respiratory symptoms as measured by the American Thoracic Society, the Short-Form 36 (SF-36), and hand-held spirometry. Data were analyzed using multivariate logistic regression to determine risk factors associated with presence of symptoms; multiple regression was used to examine the contribution of variables to dimensions of QOL.

Results: Survivors described an average of 1.3 (SD 1.2) symptoms: 25% cough, 28% phlegm, 31% wheezing, and 39% dyspnea at rest. The majority of those reporting cough also reported phlegm, wheezing, and dyspnea at rest. Thirty percent reported that they spent most of the day in bed because of respiratory symptoms; 22% had < 50% FEV 1% predicted; and based upon spirometry results, 50%, severe obstructive/restrictive disease. Risk of symptoms included use of bronchodilators (cough, OR = 2.9, wheeze, OR = 4.7), gender (phlegm, OR = .42), current smoking (phlegm, OR = 3.40), moderate/severe ventilatory disease (phlegm, OR = 2.5, wheeze, OR = 2.5, dyspnea at rest, OR = 3.5), comorbid conditions (dyspnea at rest, OR = 1.4), and exposure to second-hand smoke (presence of respiratory symptoms, OR= 3.6). Marital status, comorbid conditions, number of respiratory symptoms, and dyspnea at rest contributed to physical functioning (R2 = .38) and, excluding number of symptoms, to physical role limits (R2 = .27). Comorbid conditions, respiratory symptoms, and presence of cough and phlegm > 3 months contributed to general health perceptions (R2 = .26). Our findings suggest that the majority of survivors have few respiratory symptoms, but 50% have significant pulmonary impairment. Assessment of potential risk factors and management of respiratory symptoms is essential for survivors of NSCLC.