***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose People with lung cancer report a higher burden of unmet needs , specifically psychological and daily living unmet needs . They experience more psychological distress and more physical hardship than other tumour sites . This study examined the levels of unmet need and psychological distress in inoperable lung cancer patients at the start of treatment . Methods A cross-section survey methodology was employed using baseline data from a r and omised controlled trial design ed to evaluate a supportive care intervention .  Eligible lung cancer patients were approached to participate at the start of treatment . Consenting patients completed question naires prior to or just after the commencement of treatment . Reliable and valid measures included Needs Assessment for Advanced Lung Cancer Patients , Hospital Anxiety and Depression Scale and Brief Distress Thermometer . Results Of the 108 patients participating , the top unmet need was ‘ Dealing with concerns about your family ’s fears and worries ’ ( 62 % ) ; with the next four also coming from the psychological/emotional domain , but , on average , most needs related to medical communication . Thirty two percent of patients reported clinical or sub clinical anxiety and 19 % reported HADS scores suggestive of clinical or sub clinical depression . Moreover , 39.8 % of the sample reported distress above the cut-off on the distress thermometer and this was associated with higher needs for each need subscale ( p < 0.05 ) . Conclusions People with lung cancer have high levels of unmet needs especially regarding psychological/emotional or medical communication . People with lung cancer who are classified as distressed have more unmet needs Abstract Purpose To examine the effect of knowledge of radiographic abnormalities on the mental health of asbestos-exposed people with and without pleural abnormalities . Methods Subjects were former asbestos mine and mill workers and residents of the mining town who had participated in an annual health review program . Pleural abnormalities ( pleural plaques , diffuse pleural thickening and asbestosis ) were determined from plain chest X-rays . All Participants completed a question naire on mental health status ( SF-12 ) and locus of control ( LOC ) . Results There were no significant differences between asbestos-exposed people with and without radiographic abnormalities for either the SF-12 mental health score or LOC . However , the asbestos-exposed cohorts had lower mental health scores compared with a r and om sample of the local population . Conclusion The presence of pleural abnormalities did not further affect the mental health of asbestos-exposed people beyond a decrement associated with exposure per se Purpose Malignant pleural mesothelioma ( MPM ) is a highly aggressive and symptomatic disease . We examined the relationship between health-related quality of life ( HRQoL ) and inflammatory markers , and the prognostic role of HRQoL in MPM patients . Methods MPM patients from two parallel phase II studies ( thalidomide alone or thalidomide with chemotherapy ) were included . HRQoL was assessed at baseline using the modified Lung Cancer Symptom Scale ( LCSS ) . Baseline inflammatory markers and cytokines were measured . Spearman correlation was used to examine the relationship between inflammatory markers and HRQoL measures . The prognostic value of the HRQoL domains was examined using Cox proportional hazard model . Results Sixty-three patients were included : median age 61 years ( range 44–79 ) ; 82 % male ; 77 % Eastern Cooperative Oncology Group ( ECOG ) performance status 0–1 ; 44 % epithelial histology subtype .  Baseline systemic symptoms of anorexia and fatigue , the summation symptoms of overall symptomatic distress , interference with normal activity and global QoL and the aggregate score of total LCSS score were all associated with elevated neutrophil-to-lymphocyte ratio , C-reactive protein and vascular endothelial growth factor levels at baseline ( rho ≥ 0.25 ; p < 0.05 ) . Baseline anorexia , fatigue , cough , dyspnoea , pain , overall symptomatic distress , interference with normal activity , global QoL and total LCSS score were all significantly related to survival ( p < 0.05 ) after adjusting for established prognostic factors ( age , gender , histological subtype and performance status ) and treatment effect . Conclusions In conclusion , HRQoL seems to relate to a patient 's systemic inflammatory status and is associated with survival in MPM patients BACKGROUND In patients with malignant pleural mesothelioma undergoing a multimodality therapy , treatment toxicity may outweigh the benefit of progression-free survival . The subjective experience across different treatment phases is an important clinical outcome . This study compares a st and ard with an individual quality of life ( QoL ) measure used in a multi-center phase II trial . PATIENTS AND METHODS Sixty-one patients with stage I-III technically operable pleural mesothelioma were treated with preoperative chemotherapy , followed by pleuropneumonectomy and subsequent radiotherapy .  QoL was assessed at baseline , at day 1 of cycle 3 , and 1 , 3 and 6 months post-surgery by using the  Rotterdam Symptom Checklist  ( RSCL ) and the Schedule for the Evaluation of Quality of Life-Direct Weighting  ( SEIQoL-DW ) , a measure that is based on five individually nominated and weighted QoL-domains . RESULTS Completion rates were 98 % ( RSCL ) and 92 % ( SEIQoL ) at baseline and 98%/89 % at cycle 3 , respectively . Of the operated patients ( N=45 ) RSCL and SEIQoL were available from 86%/72 % , 93%/74 % , and 94%/76 % at months 1 , 3 , and 6 post-surgery . Average assessment time for the SEIQoL was 24min compared to 8min needed for the RSCL . Median changes from baseline indicate that both RSCL QoL overall score and SEIQoL index remained stable during chemotherapy with a clinical ly significant deterioration ( change > or=8 points ) 1 month after surgery ( median change of -66 and -14 for RSCL and SEIQoL , respectively ) . RSCL QoL overall scores improved thereafter , but remained beneath baseline level until 6 months after surgery . SEIQoL scores improved to baseline-level at month 3 after surgery , but worsened again at month 6 . RSCL QoL overall score and SEIQoL index were moderately correlated at baseline ( r=.30 ; p < or=.05 ) and at 6-month follow-up ( r=.42 ; p < or=.05 ) but not at the other time points . CONCLUSION The SEIQoL assessment seems to be feasible within a phase II clinical trial , but may require more effort from staff . More distinctive QoL changes in accordance with clinical changes were measured with the RSCL . Our findings suggest that the two measures are not interchangeable : the RSCL is to favor when mainly information related to the course of disease- and treatment is of interest 
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CONCLUSIONS This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos-exposed subjects .
It confirms that malignant mesothelioma is associated with the physical , emotional , and social functioning of patients , while also suggesting that the risk of developing asbestos-related diseases among asbestos-exposed subjects is associated with high levels of psychological distress , despair , and mental health difficulties