Abstract
Upper gastrointestinal bleeding is a frequent and serious problem among patients with advanced lung cancer. Sixty-two cases with lung cancer (Section cases) died during a 7-year period from July 1977 to July 1984,at the 2nd Department of Internal Medicine. Of the 62 cases, 12 cases were complicated by the apperance or reactivation of peptic ulcer. A retrospective study was undertaken to evaluate the clinical course of these 12 cases. These patients with advanced lung cancer included 9 males and 3 females, and they included 6 cases of squamous cell carcinoma, 2 of adenocarcinoma, 2 of small cell carcinoma, 2 of large cell carcinoma. Clinical stage were IV in all cases. A number of causative factors were assumed to be associated with peptic ulcers. Physical factors included : (1) Symptoms Such as pain and dyspnea due to lung cancer and its metastasis; (2) nutritive condition : emaciation and low alubminemia; (3) associated drugs : non steroidal anti-inflamatory drugs (indomethacin, diclofenac sodium, tiaramide hydrocloride) and corticosteroid; (4) past history of peptic ulcer : gastric ulcer or duodenal ulcer; (5) serious complications : metastasis (pleura, bone, liver, kidney, adrenal, brain), pnumonia, cerebral bleeding. Mental factors included : (1) personality such as nervous temperament; (2) mental cause : fear of death, anxiety about family, anguish. It is important to treat the patients with advanced lung cancer with careful consideration of causative factors of peptic ulcer.
