The Process of How Elderly Patients with Lung Cancer Who Are Receiving Molecularly Targeted Therapy with Oral Agents Establish Self-Management

Abstract

Purpose: In Japan, many elderly cancer patients are receiving chemotherapy using oral molecularly targeted drugs. They receive treatment in outpatient setting and have a need to self-manage at home. The purpose of this study was to clarify how elderly patients with lung cancer who are undergoing treatment with molecularly targeted drugs in outpatient setting establish self-management. Methods: The study used Kinoshita's Modified Grounded Theory. Semi-structured interviews were conducted with 17 patients (eight males and nine females). Results: This study identified six categories: Accepting life with cancer, Maintaining activities of daily living without feeling shackled by cancer, Reconsidering how to continue being themselves in daily life until life comes to an end, Using trial and error to integrate treatment and daily living, Formulating their criteria for continuing treatment, and Obtaining help from caregivers. Conclusion: The self-management process in elderly patients consisted of maintaining treatment and integrating treatment with daily living. And they are exploring the effects of treatment and side effects in order to live their own life. Implications for Nursing: In many elderly patients with lung cancer the purpose of treatment is curative extension of survival and improved quality of life. Our findings suggest that is important we help patients to identify how patients want to live, identify ways to improve their quality of life, and share the goals of treatment between the patient and the caregiver.

Development of Self-Management Support Program for Elderly Patients with Lung Cancer Receiving Molecularly-Targeted Therapy

“…In our previous study,[ 9 ] we identified the process by which elderly patients with lung cancer were able to achieve self-management. Based on the results, we examined what kinds of support were needed to facilitate the process of self-management.…”

“…In addition, our study revealed that elderly patients with lung cancer receiving molecularly targeted therapy with oral agents in an outpatient setting were able to self-manage based on their views of their own lives and the ways they wanted to live. [ 9 ] Furthermore, these patients need to receive appropriate help and information in accordance with how they wish to live their lives, which in turn makes it possible for them to manifest their strengths and maintain their lives based on personal choices. However, patients who are treated in an outpatient setting do not receive sufficient nursing support.…”

Experience of patients with lung cancer and with targeted therapy-related skin adverse drug reactions: A qualitative study

“…Other studies had explored the factors affecting the occurrence and severity of skin ADRs. As shown by a study, male patients and elderly patients (over 65 years old) tended to experience more severe skin ADRs 19 , and patients with comorbidities had complicated disease conditions and took multiple medications, which easily led to severe skin ADRs or aggravation of ADRs 20 . In addition, the prolonged treatment period may also influence the degree of skin ADRs due to the toxicity of drugs accumulating over time 21 .…”