Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive dyspnea, non-pleuritic chest wall pain, and significant unintentional weight loss. History significant for remote asbestos exposure. Symptoms are refractory to standard bronchodilators. No history of fever or productive cough.
Clinical Examination Findings
General: Cachectic appearance, respiratory distress at rest. Chest: Asymmetric chest wall expansion, dullness to percussion over the affected hemithorax, and markedly diminished breath sounds. Palpation reveals localized chest wall tenderness or palpable mass. No peripheral edema or lymphadenopathy.
Treatment Protocol
Multidisciplinary approach initiated. Plan includes surgical evaluation for potential pleurectomy/decortication, systemic chemotherapy (pemetrexed/platinum-based), and palliative radiation therapy for localized pain control. Pain management optimized with long-acting analgesics.