Symptoms and lung function follow-up after lung cancer resection

INTRODUCTION In recent decades, lung cancer is being diagnosed at ever earlier stages, leading to higher resection rates and improved survival. Therefore, more patients live with the sequelae of thoracic surgery. The standardised Danish follow-up programme after lung cancer resection includes CT and clinical evaluation at set times. METHODS An e-mail survey was conducted to evaluate local practices at lung cancer investigation sites with respect to the setup of follow-up programmes after lung cancer resection. In addition, 50 consecutive patients were seen three months after their lung cancer resection. Spirometry was performed and patients reported on their use of inhalation medicine, smoking status and quality of life. RESULTS The study revealed heterogeneous setups regarding routine spirometry (5/12 sites) and assessment by a respiratory physician (6/12). In a single-centre study including 50 patients three months after lung cancer resection, 22% of patients were using a bronchodilator even though 50% of patients were obstructive on spirometry and 48% reported shortness of breath (SOB). 17% of patients were active smokers, whereas the majority reported symptoms of a physical nature such as fatigue, SOB and cough. CONCLUSIONS It is important to establish the optimal follow-up setup with an emphasis on detection of recurrence, symptom improvement and smoking cessation. This study highlighted the importance of symptom assessment by a respiratory physician/nurse. A spirometry should be performed if patients experience SOB and the potential benefit of inhalation medicine should be assessed.