Surviving with lung cancer: Medication-taking and oral targeted therapy

Abstract

Oral epidermal growth factor receptor inhibitors (EGFRIs) improve survival for non-small cell lung cancer (NSCLC) patients; however, medication-taking implications are unknown. We used grounded theory to explore the process of medication-taking for NSCLC patients receiving oral EGFRIs. Thirty-two interviews were conducted for 13 participants purposively selected for gender, race/ethnicity, age, time in therapy, dose reductions, and therapy discontinuation and theoretically sampled for age and health insurance carrier. The study produced a grounded theory, Surviving with Lung Cancer, in which participants framed EGFRI therapy within recognition of NSCLC as a life-limiting illness without cure. Medication-taking was a “window” into participants’ process of surviving with metastatic cancer that included deciding and preparing to take EGFRIs and treating lung cancer as a chronic condition. Our results contribute to understanding how NSCLC patients view themselves in the context of a life-limiting illness and support development of a theoretically-based intervention to improve medication-taking with EGFRIs.

Patients and informal caregivers’ experiences of burden of treatment in lung cancer and chronic obstructive pulmonary disease (COPD): a systematic review and synthesis of qualitative research

“…In contrast, patients with lung cancer described receiving highly specialised, predominantly hospital-based therapies with little delegation of material treatment tasks 48 50 52 53 65–67 86 89 91 93 97–99 121 131 146. The exception was a study interviewing patients receiving oral targeted therapies who described the rigorous process they underwent when securing and taking medication 87. This paper highlighted the priority patients with lung cancer gave to their treatment because of the recognition of lung cancer’s immediate threat to life as they rigidly adhered to their delegated task 87…”

“…The exception was a study interviewing patients receiving oral targeted therapies who described the rigorous process they underwent when securing and taking medication 87. This paper highlighted the priority patients with lung cancer gave to their treatment because of the recognition of lung cancer’s immediate threat to life as they rigidly adhered to their delegated task 87…”

<p>Side Effects, Self-Management Activities, and Adherence to Oral Anticancer Agents</p>

“…In addition, patients may interpret the occurrence of side effects as a sign that the medication is working and be inspired to be more adherent. 36…”

Conducting Biobehavioral Research in Patients With Advanced Cancer: Recruitment Challenges and Solutions

“…Radiation therapy is associated with increased fatigue and uncomfortable skin reactions (Bray, Simmons, Wolfson, & Nouri, 2016). Targeted therapies such as those that inhibit the epidermal growth factor receptor (EGFR) can cause an itchy, painful rash (Lacouture et al, 2011; Solomon & Jatoi, 2011; Wickersham et al, 2014) and diarrhea. Finally, the stress response associated with living with cancer can lead to chronic activation of the hypothalamic–pituitary–adrenal and sympathetic–adrenal–medullary axes, ultimately leading to a dysfunctional inflammatory response and elevated anxiety, depression, and pain (Subnis, Starkweather, McCain, & Brown, 2014).…”

“…For patients with advanced cancer, symptoms such as pain, fatigue, and skin and hair changes can be extremely upsetting because they hold significant cultural meaning in the context of having a potentially life-threatening diagnosis. For example, the rash patients can experience while receiving targeted therapy with an EGFR inhibitor is often not only painful but also socially isolating due to its visibility (Boone et al, 2007;Joshi et al, 2010;Wickersham et al, 2014), especially for individuals in the workforce. Others may interpret experiencing pain and/or fatigue as a sign of disease progression (Cohen et al, 2004;McCutchan, Wood, Edwards, Richards, & Brain, 2015).…”