Communication along Milestones in Lung Cancer Patients with Advanced Disease

Abstract

Patients with advanced lung cancer and their caregivers are confronted with a complex situation as their disease-related burden comprises physical, psychosocial, and spiritual needs. During the illness trajectory with limited prognosis, they are exposed to different multidisciplinary healthcare settings and providers that challenge the continuity and coordination of care. Additionally, decision-making between active cancer treatment and end-of-life care constitutes a continuous balancing act. Several studies have shown that early integration of palliative care and adequate advance care planning improve quality of life and satisfaction with care. For this strategy, the communication skills of healthcare providers and interprofessional collaboration should be strengthened. A longitudinally structured communication approach along pivotal milestones of the disease can empower patients by facilitating coping and prognostic awareness, and achieve early integration of palliative care and advance care planning. Good interprofessional collaboration and communication lead to better coordination and continuity of care.

Consideration of sense of coherence in a structured communication approach with stage IV lung cancer patients and their informal caregivers: a qualitative interview study

“…Families living with cancer experience symptoms of depression and anxiety especially during the palliative phase [7], when they are dependent on external support to deal with this situation. To address specific needs of patients with stage IV lung cancer and their informal caregivers, a communication approach was developed and implemented in oncology care, focused on the challenges and needs over the disease trajectory (Heidelberg Milestone Communication Approach, MCA) [8]. Stage IV lung cancer was chosen for its foreseeable disease trajectory with a limited prognosis of less than 12 months.…”

Effects of an Interprofessional Communication Approach on Support Needs, Quality of Life, and Mood of Patients with Advanced Lung Cancer: A Randomized Trial

“…A Communication Approach for Support Needs [18]. Milestones 2 and 3 could be repeated or omitted depending on the individual development of the disease.…”

“…Particularly, milestone 1 focused on the disclosure of diagnosis and prognosis, and milestone 2 addressed the stable phase treatment with response under cancer-specific treatment. At milestone 3, disease progression with reassessment of options and change or stop of disease-modifying [18]. Milestones 2 and 3 could be repeated or omitted depending on the individual development of the disease.…”

European Cancer Organisation Essential Requirements for Quality Cancer Care (ERQCC): Lung cancer

“…Good communication techniques are also essential for early integration of palliative care, to promote prognostic awareness, and introduce or adapt advance care planning [171].…”