Longitudinal Perceptions of Prognosis and Goals of Therapy in Patients With Metastatic Non–Small-Cell Lung Cancer: Results of a Randomized Study of Early Palliative Care

Temel, Jennifer S.; Greer, Joseph A.; Admane, Sonal; Gallagher, Emily R.; Jackson, Vicki A.; Lynch, Thomas J.; Lennes, Inga T.; Dahlin, C.; Pirl, William F.

doi:10.1200/jco.2010.32.4459

Cited by 606 publications

(545 citation statements)

References 41 publications

(11 reference statements)

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“…14,15 However, patients with metastatic cancer often hold inaccurate perceptions of their prognoses and do not understand that chemotherapy is unlikely to be curative. 16,17 To date, there are limited data on prognostic understanding among patients with MBC.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer

Shin

El‐Jawahri

Parkes

et al. 2016

Journal of Palliative Medicine

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Background: Although breast cancer is the second leading cause of cancer-related mortality in women in the United States, few studies focus on the supportive care needs of patients living with metastatic breast cancer (MBC). Objective: We studied quality of life (QOL), depression, anxiety, and prognostic understanding of patients with MBC. Design: We conducted a cross-sectional study of 140 patients with MBC, stratified by receipt of endocrine therapy or chemotherapy. Measurements: We evaluated anxiety and depression using the Hospital Anxiety and Depression Scale (HADS). We assessed QOL using the Functional Assessment of Cancer Therapy-Breast (FACT-B), specifically measuring the FACT-B Trial Outcome Index (TOI), which includes physical and functional well-being and breast cancer-specific symptoms. Higher FACT-B TOI scores represent better QOL. We used a 12-item questionnaire to assess patients' perceptions of their prognosis and goals of therapy. Results: Compared to those taking endocrine therapy (n = 40), patients receiving chemotherapy (n = 100) reported lower scores on the FACT-B TOI (66.1 versus 72.5, p < 0.01) and more depression symptoms (HADS-D >7; 22% versus 7.5%, p = 0.03). Higher scores on the FACT-B TOI were associated with lower depression (b, -0.16; p < 0.01) and anxiety (b, -0.11; p < 0.01), and patients who reported frequent prognostic conversations with their oncologists had less depression (b, -1.28; p < 0.01). Thirty-nine percent (54/140) reported that their cancer was likely curable. Conclusion: Patients with MBC, particularly those treated with chemotherapy, may benefit from interventions to address their physical, functional, and breast cancer-related symptoms. Many do not report accurate prognostic understanding, and more frequent prognostic conversations might address this information gap.

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Section: Introductionmentioning

confidence: 99%

Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer

Shin

El‐Jawahri

Parkes

et al. 2016

Journal of Palliative Medicine

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“…As proof of this, a Medline search produced 7,184,331 citations for the term "diagnosis", 6,244,916 for "therapy", and only 896,636 for "prognosis" [1]. Prognostic data can help physicians to decide whether to continue with antineoplastic therapies (increasingly used with palliative intent in end-of-life care) or whether the time has come to consider hospice and palliative care programs [2][3][4]. In fact, although the use of palliative care in combination with specific antineoplastic treatments in the early stages of the disease is significantly favorable, at a certain point palliative care as the only treatment becomes appropriate [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…(3) How do we judge the impact of a prognostic score in clinical practice? (4) What is the best way of presenting survival data to patients? (5) What is the most user-friendly validated tool?…”

Section: Introductionmentioning

confidence: 99%

Prospective Comparison of Prognostic Scores in Palliative Care Cancer Populations

Maltoni

Scarpi²,

Pittureri³

et al. 2012

The Oncologist

121

113

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“…As many patients are unable to comprehend their expectations at the time of the first diagnosis, early palliative care has definitely been shown to improve patient understanding of their outlook over time, which may have an impact on decision making about care near the end of life [128]. In summary, the evidence appears strong enough to favour an early intervention of palliative care for patients with lung cancer in all stages.…”

Section: Structure Processes and Time Of Integrationmentioning

confidence: 98%

“…For patients, reaching factual decisions on the best therapeutic options could be severely impaired while facing and living with a presumably expedited deadly outcome. TEMEL et al [128] demonstrated in a sequel analysis of their study population of 151 newly diagnosed metastatic NSCLC patients that initial appraisal by patients regarding their own prognosis often appeared inaccurate, whereas this perception in patients could be positively influenced over the course of an early palliative care intervention. However, physicians are equally dependent on a realistic view of lung cancer patients' prognoses in order to prevent over-or under-treatment.…”

Section: Setting Realistic Therapeutic Goalsmentioning

confidence: 99%

The lung cancer patient, the pneumologist and palliative care: a developing alliance

Blum

Schönfeld

2014

Eur Respir J

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Considerable evidence is now available on the value of palliative care for lung cancer patients in all stages and at all times during the course of the disease. However, pneumologists and their institutions seem to be widely in arrears with the implementation of palliative care concepts and the development of integrated structures.This review focuses on the available evidence and experience of various frequently unmet needs of lung cancer patients, especially psychological, social, spiritual and cultural ones. A PubMed search for evidence on these aspects of palliative care as well as on barriers to the implementation, on outcome parameters and effectiveness, and on structure and process quality was performed with a special focus on lung cancer patients.As a consequence, this review particularly draws pneumologists' attention to improving their skills in communication with the patients, their relatives and among themselves, and to establish team structures with more far-reaching competences and continuity than existing multilateral cooperations and conferences can provide. Ideally, any process of structural and procedural improvement should be accompanied by scientific evaluation and measures for quality optimisation. @ERSpublications Pneumologists should get more widely involved in palliative care for lung cancer patients

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Longitudinal Perceptions of Prognosis and Goals of Therapy in Patients With Metastatic Non–Small-Cell Lung Cancer: Results of a Randomized Study of Early Palliative Care

Abstract: Many patients with newly diagnosed metastatic NSCLC hold inaccurate perceptions of their prognoses. Early palliative care significantly improves patient understanding of prognosis over time, which may impact decision making about care near the end of life.

Cited by 606 publications

References 41 publications

Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer

Quality of Life, Mood, and Prognostic Understanding in Patients with Metastatic Breast Cancer

Prospective Comparison of Prognostic Scores in Palliative Care Cancer Populations

The lung cancer patient, the pneumologist and palliative care: a developing alliance

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