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In the industrial world incidence and prevalence of lung cancer are increasing. At the same time new drugs and new therapies can improve cure rates, prolong survival and procure better quality of life. Nowadays, oncology provides multimodal therapies which may cause psychological and physical stress in the often multimorbid patients. Furthermore, the tumour itself may cause pain and bring about special nutritional and coping problems. Patients may face fear and depression, nicotine withdrawal, socioeconomic problems and the risk of permanent disability. The sequelae of multimodal therapies can vary according to the chosen procedure such as surgery, radiotherapy, chemotherapy, and hormone or immune treatment. After the end of treatment, rehabilitation needs to address the never-ending fear of disease relapse, dyspnoea and suffocation feelings as well as the psychological problems associated with lung cancer. At the initiation of rehabilitation, physical performance is usually limited by the underlying disease as well as the different therapeutic modalities. In Germany, rehabilitation is mainly carried out as in-patient rehabilitation in specialised oncological or pneumological rehabilitation centres. The analysis of published data shows that in-patient rehabilitation has not been evaluated sufficiently for its efficiency so far. This also applies to out-patient rehabilitation, which is largely unavailable in Germany. Oncologists, pneumologists and patient groups agree that rehabilitation should be offered or even strongly recommended to all lung cancer patients.

Background and Objective: The value of pulmonary rehabilitation in the treatment of chronic obstructive pulmonary disease (COPD) is well accepted. However, there are no data on the efficacy of in-patient rehabilitation instituted within 14 days after an acute disease episode, as practised in Germany. It was the purpose of this multi-centre prospective study to assess changes in lung function, exercise capacity, symptoms and disease-related quality of life (QoL) in patients discharged from hospital for an episode of worsening COPD or asthma, pulmonary embolism, pneumonia or treatment of lung cancer., Patients and Methods: 207 patients (mean age 60 13 years) with COPD (n=86), pneumonia (n=42), lung cancer (n=24), asthma (n=14), pulmonary embolism (n=7) or other pulmonary disease (n=34) were included. Measurements of lung function, exercise capacity and disease-related QoL were carried out at the beginning and end of rehabilitation. Socio-economic data and disease-related QoL measurements were recorded again after 2 months., Results: Rehabilitation led to a significant improvement of lung function, exercise capacity and QoL. Patients felt rehabilitation was efficacious (95%), to be recommended (99%) and important (100%). Improvement of QoL was maintained at two 2 months and only 16% of previously working patients had applied for retirement., Conclusions: The data demonstrate the clinically relevant benefit of in-patient pulmonary rehabilitation immediately after a period of acute illness. In view of these result and the known morbidity and mortality of patients with COPD after hospitalization for a period of acute illness, this form of pulmonary rehabilitation should be considered as standard treatment for these patients.

From 1984 to 1988 in the industrial area Most (70,000 workers) an analysis was performed in 138 patients with lung cancer (ICD-Nr. 162). From the results of analysis conclusions with relevance for medical opinion were derived. There are opportunities to incorporate a part of patients in the working process without difficulties, if the patient is free of signs of recidivation. The aim of our procedure is to improve the psychological situation of the patient, to reach a complete resocialization, to ensure the economic standard and to optimize the grant of sick-pay.

Longterm results regarding lung functions after operations for bronchial cancer or tuberculosis are good in those cases where had been no complications after surgery or recurrences of the disease. Nevertheless fewer patients than expected return to their work despite the good functional results.

Report on 14 years experience with the day sanatorium belonging to the 4th pulmonary department of the János-Hospital in Budapest. Therapeutic results correspond to those of the hospital department. The day department has proved a success for examination and treatment of patients with pulmonary disease. In the recent years its importance of treatment of patients with non-specific pulmonary diseases has significantly increased. The day sanatorium is enjoying great popularity as well with the patients as in the Chest Clinics.

In treatment of bronchogenic carcinoma twelve selected patients had economical resections. To avoid a pneumonectomy, lobectomies or bilobectomies were associated twice with bronchial excision, 8 times with bronchial resection (sleeve resection) and twice with resection and anastomosis of pulmonary artery. Nine patients underwent clinical, radiologic and szintigraphic control. Except one case all patients showed good functional results. The anastomosed lobes were perfused and ventilated proportionally to the number of segments. The quality of life after partial pulmonary resections had deteriorated only to a small extent compared with the preoperative state. These results were emphasized by the only poor result which (after atelectasis of the anastomosed lung) corresponded functionally to a pneumonectomy. --The two cases of anastomosis of pulmonary artery showed a short survival. Both corresponded to a stage II of tumor classification. Of the other patients (all stage I) three are alive more than five years.