Patient-Centered Palliative Care for Patients With Advanced Lung Cancer

Abstract

The evidence base demonstrating the benefits of an early focus on palliative care for patients with serious cancers, including advanced lung cancer, is substantial. Early involvement of specialty-trained palliative care clinicians in the care of patients with advanced lung cancer improves patient-reported outcomes, such as quality of life, and health care delivery, including hospice utilization. Since the time that many of these palliative care trials were conducted, the paradigm of cancer care for many cancers, including lung cancer, has changed dramatically. The majority of patients with advanced lung cancer are now treated with immune checkpoint inhibitors or targeted therapies, both of which have had a significant impact on patient's experience and outcomes. With this changing landscape of lung cancer therapeutics, patients are facing new and different challenges, including dealing with novel side effect profiles and coping with greater uncertainty regarding their prognosis. Patients who are living longer with their advanced cancer also struggle with how to address survivorship issues, such as sexual health and exercise, and decision making about end-of-life care. Although palliative care clinicians remain well-suited to address these care needs, they may need to learn new skills to support patients treated with novel therapies. Additionally, as the experience of patients with advanced lung cancer is becoming more varied and individualized, palliative care research interventions and clinical programs should also be delivered in a patient-centered manner to best meet patient's needs and improve their outcomes. Tailored and technology-based palliative care interventions are promising strategies for delivering patient-centered palliative care.

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“…13 Survivorship care for people with metastatic cancer must acknowledge the varied disease trajectories, including periods of disease stability, disease progression with further therapy possible, and predictable as well as potentially sudden transitions to end-of-life care. 10,11,14…”

“…13 Survivorship care for people with metastatic cancer must acknowledge the varied disease trajectories, including periods of disease stability, disease progression with further therapy possible, and predictable as well as potentially sudden transitions to end-of-life care. 10,11,14 In this commentary, we ask clinicians, researchers, administrators, insurers, and policymakers to expand their cancer survivorship care agenda to encompass people with metastatic cancer. We consider the current literature and highlight priorities for clinical care, policy, and research.…”

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