Experience and supportive care needs of metastatic lung cancer survivors living with uncertainty: a brief qualitative report

Petrillo, Laura; Traeger, Lara; Sommer, Robert; Temel, Jennifer S.; Greer, Joseph A.

doi:10.1007/s11764-021-01016-8

Cited by 22 publications

(56 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Reports of impacts in the emotional domain were found in 67% of studies with two subthemes. The unique experience of living with uncertainty was described in various ways by participants, such as "certainty within uncertainty," 5 "playing Russian Roulette," 5,7 simultaneous "hope and worry," 43 "duality," 6 and being "in limbo." 7 Uncertainty was reported by researchers to be destabilizing and persistent 6 and distressing and difficult to deal with.…”

Section: Emotional Impactmentioning

confidence: 99%

A new landscape in illness uncertainty: A systematic review and thematic synthesis of the experience of uncertainty in patients with advanced cancer receiving immunotherapy or targeted therapy

et al. 2023

View full text Add to dashboard Cite

Objective Over the past 20 years, immunotherapy and targeted therapy (TT) have been extending the life expectancy and providing hope for a growing number of patients with advanced and metastatic cancer. However, the efficacy, side effects, and overall prognosis of these treatments are highly unpredictable. Recent research suggests that these patients may be experiencing significant uncertainty which impacts their functioning. This study reviewed the literature on the experiences of uncertainty for individuals with advanced or metastatic cancer patients who are receiving immunotherapy or TT. Method A systematic literature review was conducted. Data was extracted from studies by pairs of reviewers. Literature quality was appraised using the Critical Appraisal Skills Program checklist. Following data extraction, thematic synthesis was used to summarize findings across studies and generate overarching themes. Results Fifteen qualitative studies were included. Findings highlighted impacts of various sources of uncertainty (financial, emotional, social), unmet needs related to uncertainty (practical, informational, communication), and recommendations for the management of uncertainty. Clinical implications and study limitations were indicated. Conclusions Findings were situated within Mishel's Uncertainty in Illness Theory and the literature on supportive care for advanced cancer populations. Recommendations related to improving healthcare provider communication and balancing hope and expectations for treatment outcomes were highlighted. Further research is needed to investigate experiences of uncertainty in this population. Tailored interventions for uncertainty may be warranted.

show abstract

Section: Emotional Impactmentioning

confidence: 99%

A new landscape in illness uncertainty: A systematic review and thematic synthesis of the experience of uncertainty in patients with advanced cancer receiving immunotherapy or targeted therapy

et al. 2023

View full text Add to dashboard Cite

show abstract

“…Yet in the absence of evidence, experts recommend acknowledging the emotion and existential distress that discussing prognosis may provoke as well as supporting patients and caregivers in living with uncertainty 34 . Indeed, in separately reported findings from this study, we found that patients living with lung cancer with targetable mutations struggled with their uncertain futures and desired coping support 35 . Oncologists may find that collaboration with palliative care specialists, psychologists, social workers, or chaplains helps patients to develop prognostic awareness and the ability to cope with uncertainty.…”

Section: Discussionmentioning

confidence: 54%

“…34 Indeed, in separately reported findings from this study, we found that patients living with lung cancer with targetable mutations struggled with their uncertain futures and desired coping support. 35 Oncologists may find that collaboration with palliative care specialists, psychologists, social workers, or chaplains helps patients to develop prognostic awareness and the ability to cope with uncertainty. Finally, our finding that patients with lung cancer receiving targeted therapy often have difficulty in adjusting to end-of-life transitions further underscores the need for a comprehensive approach to prognostic communication that addresses patients' information needs and emotions.…”

Section: Discussionmentioning

confidence: 99%

Prognostic communication about lung cancer in the precision oncology era: A multiple‐perspective qualitative study

Petrillo

Shimer

Sommer

et al. 2022

Cancer

Self Cite

View full text Add to dashboard Cite

BACKGROUND:Although most patients with cancer prefer to know their prognosis, prognostic communication between oncologists and patients is often insufficient. Targeted therapies for lung cancer improve survival yet are not curative and produce variable responses. This study sought to describe how oncologists communicate about prognosis with patients receiving targeted therapies for lung cancer. METHODS: This qualitative study included 39 patients with advanced lung cancer with targetable mutations, 14 caregivers, and 10 oncologists. Semistructured interviews with patients and caregivers and focus groups or interviews with oncologists were conducted to explore their experiences with prognostic communication. One oncology follow-up visit was audio-recorded per patient. A framework approach was used to analyze interview transcripts, and a content analysis of patient-oncologist dialogue was conducted. Themes were identified within each source and then integrated across sources to create a multidimensional description of prognostic communication. RESULTS: Six themes in prognostic communication were identified: Patients with targetable mutations develop a distinct identity in the lung cancer community that affects their information-seeking and self-advocacy; oncologists set high expectations for targeted therapy; the uncertain availability of new therapies complicates prognostic discussions; patients and caregivers have variable information preferences; patients raise questions about progression by asking about physical symptoms or scan results; and patients' expectations of targeted therapy influence their medical decision-making. CONCLUSIONS: Optimistic patient-oncologist communication shapes the expectations of patients receiving targeted therapy for lung cancer and affects their decision-making. Further research and clinical guidance are needed to help oncologists to communicate uncertain outcomes effectively.

show abstract

“…returning to work, financial planning while prognosis uncertain); and support tailored to molecular subtype and treatment approach rather than a ‘one size fits all’ approach. A similar US‐based study of patients receiving targeted therapy and their caregivers likewise highlights the challenge for such patients of living with stable yet incurable cancer ‘reflecting the foot‐in‐both‐worlds experience’ 51 …”

Section: Survivorshipmentioning

confidence: 97%

Developments in systemic therapies for the management of lung cancer

Heynemann

Mitchell

2021

Internal Medicine Journal

View full text Add to dashboard Cite

Lung cancer accounts for approximately 1 in 10 new cancer diagnoses annually and is responsible for the most cancer‐associated deaths in Australia. Despite such figures, there is reason for optimism with many practice‐changing developments to report for the management of patients with thoracic malignancies over the last few years. We outline such changes, including the emerging role of immunotherapy in the neoadjuvant and adjuvant setting for patients with localised non‐small‐cell lung cancer, as well as the established standard of consolidation immunotherapy following definitive chemoradiotherapy for those with locally advanced disease. In the metastatic setting, combination chemotherapy–immunotherapy approaches have become the new paradigm for most patients in the absence of a recognised driver mutation. A range of novel targeted therapies now exist and are Pharmaceutical Benefits Scheme (PBS)‐subsidised for targets such as EGFR, ALK and ROS1, with many others, such as KRAS G12C, NTRK, MET, RET and HER2, also with therapies rapidly being developed. Even among patients with small‐cell lung cancer, who account for the worst prognoses and until recently have received a chemotherapy regimen that has remained unchanged in over 20 years, there is a new standard‐of‐care in combination chemotherapy–immunotherapy. Furthermore, immunotherapy and potentially anti‐vascular endothelial growth factor agents now also play a role in mesothelioma treatment. Last, given recent developments in immunotherapy, targeted therapy and combination approaches in the non‐small‐cell lung cancer space, there is an increasing recognition of the diversity of lived experience for such patients and need for survivorship programmes to acknowledge such nuances.

show abstract

Experience and supportive care needs of metastatic lung cancer survivors living with uncertainty: a brief qualitative report

Cited by 22 publications

References 9 publications

A new landscape in illness uncertainty: A systematic review and thematic synthesis of the experience of uncertainty in patients with advanced cancer receiving immunotherapy or targeted therapy

A new landscape in illness uncertainty: A systematic review and thematic synthesis of the experience of uncertainty in patients with advanced cancer receiving immunotherapy or targeted therapy

Prognostic communication about lung cancer in the precision oncology era: A multiple‐perspective qualitative study

Developments in systemic therapies for the management of lung cancer

Contact Info

Product

Resources

About