Cancer patients often have comorbid medical problems in addition to their underlying malignant disorders. In fact, patients older than 65 years bear a disproportionate burden of cancer as well as increased prevalence of medical problems such as chronic obstructive pulmonary disease, heart disease, diabetes, and hypertension. Whether patients are seen in primary care or cancer care settings, unexplained symptoms often frustrate physicians and patients. Because many advanced cancers spread to the thorax, symptoms such as dyspnea, cough, chest pain, or palpitations often present a challenge in sorting out the likely cause of the problem and developing appropriate interventions. Evidence-based recommendations have been published describing various approaches to the problems of cancer-related fatigue, anorexia, depression, and dyspnea. Cancer patients are often also at higher risk for pulmonary infections.
Clinicians caring for cancer patients should be familiar with the assessment and treatment of common conditions that manifest as chest symptoms. In addition, it is important that these clinicians be familiar with some cancer-specific aspects of chest symptoms and syndromes. Dyspnea is a common symptom of certain cancers such as lung cancer and is also common in patients with numerous advanced cancers. It is often multifactorial. Optimal treatment requires an understanding of contributing etiologies and pathophysiologies in order to direct therapeutic interventions as clinically appropriate. Important cardiopulmonary syndromes include malignant pleural effusion, malignant pericardial effusion, superior vena cava syndrome, and lymphangitic carcinomatosis.
There are several types of plasma cell neoplasms. These diseases are all associated with a monoclonal (or myeloma) protein (M protein). They include monoclonal gammopathy of undetermined significance (MGUS), isolated plasmacytoma of the bone, extramedullary plasmacytoma, and multiple myeloma.
(Refer to the Lymphoplasmacytic Lymphoma (Waldenström Macroglobulinemia) section in the PDQ summary on Adult Non-Hodgkin Lymphoma Treatment for more information.)
Incidence and Mortality
In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. The evidence and application to practice related to children may differ significantly from information related to adults. When specific information about the care of children is available, it is summarized under its own heading.
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Komaroff AL: Symptoms: in the head or in the brain? Ann Intern Med 134 (9 Pt 1): 783-5, 2001.
Dy SM, Lorenz KA, Naeim A, et al.: Evidence-based recommendations for cancer fatigue, anorexia, depression, and dyspnea. J Clin Oncol 26 (23): 3886-95, 2008.
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WebMD Public Information from the National Cancer Institute
September 04, 2014
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