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June 6, 1966

Bronchogenic Carcinoma Stages III and IV

JAMA. 1966;196(10):847. doi:10.1001/jama.1966.03100230091023

The appalling results of treatment in lung cancer must be translated into the suffering of 43,568 individuals each year who will be dying due to the ravages of locally uncontrolled or extensively disseminated lung cancer. Approximately 80% of these patients will suffer and die within the first year and the average survival will be six to nine months following the date of diagnosis.

Palliation is a major problem and the management of advanced lung cancer patients has caused much debate among practitioners. The attitude ranges from aggressive treatment by some surgeons and radiotherapists to therapeutic nihilism and a policy of judicious neglect. This may depend on whether the clinician's definition of palliation is limited to relieving distressful symptoms and increasing comfort, as opposed to the hope of adding to survival and avoiding impending complications.

To answer this difficult question, one needs experience, judgment, compassion, and an intimate knowledge of the

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