Palliative Care in Lung Cancer

Abstract

Lung cancer is the most common cancer worldwide and is the leading cause of cancer death for both men and women in the USA. Symptom burden in patients with advanced lung cancer is very high and has a negative impact on their quality of life (QOL). Palliative care with its focus on the management of symptoms and addressing physical, psychosocial, spiritual, and existential suffering, as well as medically appropriate goal setting and open communication with patients and families, significantly adds to the quality of care received by advanced lung cancer patients. The Provisional Clinical Opinion (PCO) of American Society of Clinical Oncology (ASCO) as well as the National Cancer Care Network's (NCCN) clinical practice guidelines recommends early integration of palliative care into routine cancer care. In this chapter, we will provide an overview of palliative care in lung cancer and will examine the evidence and recommendations with regard to a comprehensive and interdisciplinary approach to symptom management, as well as discussions of goals of care, advance care planning, and care preferences.

Comparison of end-of-life care in people with chronic obstructive pulmonary disease or lung cancer: A systematic review

“…Palliative care focuses on improving the quality of life for patients with advanced disease through the treatment of physical or psychological symptoms to reduce symptom burden at the end of life. 6 Palliative care is often provided to patients with end-stage lung cancer 7,8 but services are lacking for patients with advanced COPD. 9,10 Although the use of palliative care among those with advanced COPD remains low, evidence suggests it is increasing over time.…”

“…16 As patients with advanced stage lung cancer follow a more predictable timeline of disease progression compared to people with COPD, it is recommended that palliative care be initiated early in the treatment of people with lung cancer, accompanying curative measures. 8…”

Evaluating the Time to Palliative Care Referrals in Patients With Small-Cell Lung Cancer: A Single-Centre Retrospective Review

“…The emergence of palliative care (PC) as an adjunct in the care of patients with cancer has expanded in recent years. [13][14][15][16][17] According to the World Health Organization, PC aims to improve the QOL of patients and their families facing the multitude of issues surrounding this life-altering diagnosis, through "the prevention and alleviation of suffering, by means of early identification and impeccable assessment and treatment of pain and other physical, psychosocial and spiritual problems." 18(p94) Early PC input to aid in the management of these symptoms as well as maintaining patients' psychological well-being is a crucial part of their oncological care.…”

Chronic Obstructive Pulmonary Disease: Clinical Implications for Patients With Lung Cancer

“…Patients with lung cancer and COPD benefit from a multidisciplinary disease management approach throughout their illnesses to ensure maximum QOL and functional status (for themselves and their families). In collaboration with a pulmonologist, oncology and advanced practice nurses can help improve these patients’ health outcomes using pharmacologic and nonpharmacologic treatments and symptom management (Shinde & Dashti, 2016; Williams, Grant, Tiep, Kim, & Hayter, 2012). More clinical research is needed to expand understanding of the management of patients with this twofold disease burden, to increase the use of existing evidence-based interventions, and to develop and test new QOL-boosting interventions.…”