The Sengstaken Blakemore Tube (SBT) is a type of ventilation device used to treat patients with lung cancer. It consists of two tubes connected at one end. One tube leads into the patient’s chest while the other goes down through a catheter inserted in the arm or leg. A vacuum pump forces air out of the first tube and allows it to enter the second tube which then sucks air in from outside. The SBT was developed in the 1970s. Since then, there have been several improvements and modifications made to it.
In the early 1990s, the National Cancer Institute (NCI) began funding research on SBTs to see if they could improve survival rates for patients with advanced lung cancer. They found that some patients had improved outcomes when treated using a SBT rather than surgery alone.
Since its inception, the SBT has been shown to reduce mortality rates among patients with advanced lung cancer. However, many studies have failed to show any benefit of the SBT over standard chemotherapy. Other factors such as side effects and cost make it difficult for doctors to recommend the use of SBTs.
There are currently no FDA approved drugs specifically designed for treating lung cancer. There is also no cure for lung cancer yet so most treatments focus on reducing symptoms and prolonging life expectancy.
Patients with lung cancer may experience a variety of side effects depending on the type and stage of the cancer. Side effects caused by treatment or the cancer itself may cause shortness of breath, fatigue, pain, and an impaired quality of life.
To treat side effects and improve patients’ quality of life, doctors may recommend certain lifestyle changes and medications. Depending on the stage and type of cancer, patients may undergo surgery, radiation therapy, chemotherapy, or other treatments.
There are two types of lung cancer surgery: lobectomy and pneumonectomy. During a lobectomy, the surgeon removes a lobe (a section or lobe) of the lung. During a pneumonectomy, the surgeon removes the entire lung. Surgeons may perform a segmental resection, during which they remove part of the lung and nearby lymph nodes.
Lung cancer patients may experience shortness of breath after a lobectomy or pneumonectomy. Doctors may prescribe pain medication and antibiotics. They may also recommend completing breathing exercises and practicing deep breathing as ways to manage shortness of breath.
Surgery is not a treatment for lung cancer. Some doctors may recommend surgical removal of a tumor if it is in an area that can be safely and easily removed without damaging any vital organs. Chemotherapy may be given before or after surgery to reduce the risk of cancer cells spreading.
Lung cancer patients may experience pain as a result of their tumors, chemotherapy, or other treatments. Doctors may prescribe pain medication as needed. Some patients require stronger pain medication on a regular basis. Common opioid pain medications include morphine (Kadian, MS Contin), hydromorphone (Dilaudid), and oxycodone (Oxycontin).
Common non-opioid pain medications include acetaminophen (Tylenol) and NSAIDs such as ibuprofen (Motrin IB, Advil).
The most common side effects of chemotherapy include sore throat, nausea, constipation, hair loss, and fatigue. Chemotherapy drugs commonly used to treat lung cancer include carboplatin and paclitaxel (Taxol). Because lung cancer patients experience severe side effects from chemotherapy only in certain cases, doctors may decide whether the potential benefits of chemotherapy treatment outweigh the possible risks.
Lung cancer patients may experience fatigue due to the tumor, infection, or other causes. In addition to taking a break from normal activity, there are several measures that can help relieve fatigue. Doctors may suggest getting seven to eight hours of sleep every night and taking short naps during the day. They may also recommend patients eat a healthy diet with foods containing carbohydrates, fats, and proteins.
Patients should also try to maintain a healthy weight and limit alcohol intake.
The outlook for lung cancer patients depends on the type and stage of the cancer. Some patients live less than a year; others survive more than five years. The outlook for each patient is different. Your doctor will discuss the outlook for you as an individual.
Lung cancer is a general term used to describe several different types of cancer that begin in the cells of the lungs. Most cancers that affect the lungs are related to smoking or other exposure to carcinogens (substances that can cause cancer). Some of these cancers are related to heavy smoking, while others can occur in people who have smoked relatively little or not at all. Early detection plays an important role in improving the outlook for lung cancer patients.
There are three main types of lung cancer:
* Small Cell Lung Cancer (also called oat cell carcinoma). This is the most common type of lung cancer, accounting for about 20 percent of all cases. It begins in the cells lining the air sacs (alveoli) of the lungs. This type of cancer typically grows and spreads quickly.
* Non-Small Cell Lung Cancer (also called squamous cell carcinoma). This type accounts for about 80 percent of all lung cancers, and begins in the mucus-producing cells or the cells that line the air sacs (alveoli) of the lungs. This type tends to grow and spread more slowly than small cell lung cancer.
* Mesothelioma. Mesothelioma is a cancer that forms in the pleura or the lining of the lung. It tends to begin in the tissue that surrounds the heart or lungs. This cancer is most often caused by asbestos exposure, but it can also be caused by other factors such as prior chest radiation therapy and certain workplace exposures.
Most lung cancers are found in patients over the age of 55. There are also rare reports of lung cancer occurring in young people whose only risk factor is exposure to secondhand smoke.
While there is no standard type of treatment for all lung cancer patients, some therapies have been found to improve survival rates for certain groups of patients. When doctors determine that a patient has cancer that is unlikely to respond to chemotherapy, they may prescribe a different treatment approach.
Treatment for small cell lung cancer may include: Radiation Therapy, Chemotherapy, Targeted Therapy, Immunotherapy.
Treatment for non-small cell lung cancer may include: Surgery, Radiation Therapy, Chemotherapy, Targeted Therapy, Immunotherapy.
Treatment for malignant pleural mesothelioma may include: Surgery, Radiation Therapy, Chemotherapy.
New therapies are often available for patients with advanced or recurrent cancers. Talk to your doctor about the latest treatment options.
Although lung cancer is rarely found in patients under the age of 40, it is not unknown for people in their 30s and 40s to develop lung cancer. The most common causes of lung cancer in younger patients are exposure to secondhand smoke and air pollution. Doctors recommend that people avoid inhaling tobacco smoke and minimize their exposure to environmental pollutants.
Lung cancer in young people is most often found in ex-smokers exposed to secondhand smoke.
Supportive care is the mainstay of treatment for all stages of lung cancer, although several new therapies have been approved within the past few years to treat earlier stage disease, and a vaccine to prevent lung cancer related to HPV infection is under development.
Surgery may be an option to remove part of the lung or the entire lung if it cannot be treated with radiation therapy.
Chemotherapy uses drugs to kill cancer cells. While this is often given before surgery to shrink the tumor, chemotherapy may also be the primary treatment following surgery. The types of drugs given, the schedules for taking them, and the outcomes are similar to those for patients with other types of cancers.
Targeted therapy is often used when the cancer has a specific genetic abnormality known to be associated with certain types of lung cancer.
Immunotherapy uses the body’s immune system to attack and get rid of cancerous cells. It is usually given in addition to another type of treatment.
There are many clinical trials for lung cancer patients, both for those with early stage disease that has not yet spread and those with later stage or metastatic disease.
The prognosis for patients with lung cancer depends on the stage of disease at the time of diagnosis and the presence or absence of specific genetic abnormalities in the cancer cells. For patients whose disease is confined to the lung and who have not yet developed metastases at the time of diagnosis, the 5-year relative survival rate is approximately 56%. For patients whose disease has metastasized at diagnosis, the 5-year relative survival rate is approximately 15%.
The 5-year relative survival rate is a measure doctors use to indicate the probability of living at least 5 years after diagnosis. For example, a person diagnosed with cancer that has a 5-year relative survival rate of 50% implies that an average of 50 out of every 100 people like the one in question will live at least 5 years after being diagnosed, and that the remaining 50 out of every 100 will pass away within 5 years.
The purpose of a 5-year relative survival rate is to provide a more accurate prediction of the effect of the diagnosis on an individual’s long-term survival prospects by considering the pace at which the particular type of cancer typically progresses. In some situations, a 5-year relative survival rate may also be referred to as a prognosis.
There are many tools available to help people assess their own risk of developing lung cancer. These include risk calculators and checklists designed to generate an estimate of the likelihood of an individual developing lung cancer associated with a known exposure to various types of carcinogens.
It is possible for some people to develop lung cancer without ever having smoked. Those with a history of radon exposure or asbestos exposure are among those at higher risk.
The incidence of lung cancer is approximately 50% higher in men than in women, and rates rise with age for both genders.
Cigarette smoking and exposure to second-hand smoke are the most significant preventable causes of lung cancer. Other risk factors for developing lung cancer include occupational exposure to certain carcinogens, such as arsenic, asbestos, diesel engine exhaust, and radon gas.
Several scientific studies have identified a link between lung cancer and the nuclear radiation released during atomic bomb explosions and nuclear accidents, including the Fukushima nuclear disaster.
Lung cancer was first described in ancient Egypt. The Edwin Smith Surgical Papyrus, the oldest known surgical text, describes eight cases of lung cancer in the seventeenth century BC. In each case, the tumor is localized to the area around the lungs.
The first apparent description of cancer in ancient Greece is found in the works of the physician Hippocrates (c. 460 BC – c. 370 BC). In his “Pneumatica” (“Respiratory Disorders”), he described two kinds of tumor, naming one of them “karkinoma” (carcinoma), the first use of the word.
Although surgery was in its infancy, and only extremely rarely used, Galen of Pergamon (129 AD – c. 200 AD) recognized that cancer (Karcinoma) was not amenable to surgery and wrote extensively about it.
The Middle Ages saw the creation of the first cancer hospitals, which appeared in Europe in the 1200s.
The 14th century Persian polymath, Avicenna (Ibn Sina) (940-1037) described a “malignant growth of the gullet” in his “The Canon of Medicine”, a book regarded as one of the most famous in the history of medicine.
Sources & references used in this article:
Esophageal tamponade for bleeding varices: controlled trial between the Sengstaken-Blakemore tube and the Linton-Nachlas tube by J Terés, A Cecilia, JM Bordas, A Rimola, C Bru… – Gastroenterology, 1978 – Elsevier
Safety and effectiveness of the modified Sengstaken-Blakemore tube: a prospective study by JL Pitcher – Gastroenterology, 1971 – Elsevier
Use of Sengstaken-Blakemore tube in massive postpartum hemorrhage: a series of 17 cases by J Seror, C Allouche, S Elhaik – Acta obstetricia et gynecologica …, 2005 – Taylor & Francis
Successful use of a Sengstaken-Blakemore tube to control massive postpartum haemorrhage by M Katesmark, R Brown, KS Raju – British journal of obstetrics …, 1994 – wwsw.geoscience.net
The use of a Sengstaken-Blakemore tube to control post-partum hemorrhage by C Chan, K Razvi, KF Tham, S Arulkumaran – 1997 – scholarbank.nus.edu.sg
Esophageal rupture due to Sengstaken-Blakemore tube misplacement by CF Chong – World Journal of Gastroenterology: WJG, 2005 – ncbi.nlm.nih.gov