Abstract
The purpose of this study was to document the influence of chronic obstructive pulmonary
diseases (COPD) on stage at diagnosis, treatment strategy, and survival for unselected
cancer patients (35 years and older) diagnosed between 1995 and 2004 in the Eindhoven
Cancer Registry. Follow-up of all patients was complete up to January 1st, 2006.
Twelve percent of all cancer patients had COPD at the time of cancer diagnosis, being
about 15% in elderly patients (65+) and up to 30% among lung cancer patients, middle-aged
males and all females with oesophageal and laryngeal cancer, and middle-aged women
with renal cancer. Stage at diagnoses was not significantly different between cancer
patients with or without COPD, except for lung cancer patients who were diagnosed
at an earlier stage. Nevertheless, non-small cell lung cancer (NSCLC) patients with
COPD less frequently underwent surgery, and chemotherapy, and more often radiotherapy.
In the presence of COPD, women with oesophageal cancer underwent surgery less often,
and patients with laryngeal cancer received radiotherapy more often. The effect of
COPD on the type of oncological treatment was not different for middle-aged (35–64
years) and elderly cancer patients. In a multivariate Cox-regression model, COPD was
associated with a significantly worse survival, especially for elderly patients with
colon, rectum, larynx, prostate or urinary bladder cancer.
In conclusion, not surprisingly, COPD is related with age and smoking-associated tumours.
Therapy of cancer patients with COPD was different for head and neck tumours and primary
tumours in the chest organs (above the diaphragm), for whom radiotherapy, as an alternative
treatment option, was available. As COPD, especially at older age, is frequently associated
with a worse prognosis, further prospective investigation of interactions seems warranted.
Further, closer involvement of pulmonologists and COPD nurses in elderly cancer patients
might be warranted.
Keywords
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Article info
Publication history
Published online: September 21, 2007
Accepted:
August 7,
2007
Received in revised form:
August 1,
2007
Received:
July 26,
2007
Identification
Copyright
© 2007 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
