Back Back
QoL in Advanced NSCLC
Multidisciplinary Approaches to Maximize QoL in Patients With Advanced NSCLC

Released: March 07, 2017

Expiration: March 06, 2018

Activity Information

Activity

Progress
1
Course Completed
Continue

Although lung cancer continues to be the most common cause of cancer-related death in both men and women, rates have declined by 25% since their peak in 1991. This is attributable to fewer people starting smoking, advances in tobacco cessation treatment options, and improved workplace policies to protect from second-hand smoke exposure. In addition, new screening methods using low-dose CT techniques are finding lung cancer earlier in a select population of former and current smokers. Moreover, recently approved treatment options are improving clinical outcomes in patients diagnosed with advanced NSCLC. These changes have led to cancer survivors living longer and healthier lives than previously thought possible, but patients are also having to cope with the adverse events of cancer treatment for prolonged periods of time.

The importance of systematic, evidence-based identification and management of long-term cancer treatment effects was emphasized in the Institute of Medicine’s report, “From Cancer Patient to Cancer Survivor.” The adverse events of lung cancer treatment include multifactorial fatigue, visceral and neuropathic pain, pulmonary dysfunction (eg, dyspnea, cough, decreased lung capacity), cardiotoxicity (eg, cardiomyopathy), and hypertension. It is also important to note that anxiety and depression can arise from lifestyle limitations compared with predisease, existential pain, and living with an “unseen” chronic illness that may not be well understood, or sometimes even acknowledged, by family, friends, and acquaintances. Identifying and addressing these issues is paramount for clinicians, and a comprehensive list of validated screening tools for fatigue, neuropathy, pain, and depression are available from ASCO. Clinical Care Options also has resources to help clinicians identify and address quality-of-life issues experienced by patients with advanced lung cancer, including a checklist for clinicians that covers important discussion points and resources for consultations between patients and their caregivers, an interactive algorithm tool for managing adverse events associated with immunotherapy, and a CE-certified point-of-care resource specifically for oncology nurses provided in partnership with the Oncology Nursing Society.

Following identification of specific issues faced by patients with NSCLC, the next step for clinicians is to define a systematic approach to address them. To meet this need, many cancer centers have developed survivorship clinics and/or cancer rehabilitation programs. These multidisciplinary programs use an evidence-based approach to screen patients for various survivorship needs and then refer them directly to the appropriate specialized care provider (eg, physical therapists, occupational therapists, pain clinic experts, and/or psychiatric services). Community practices that do not have these specialties located within their offices can partner with service providers in their areas to meet these needs.

After patients are seen in specialty consultation, an individualized program is developed to help them progress toward maximum function and wellness. The primary oncologist continues to be an integral part of the survivorship team by following patients for surveillance or active treatment needs. The importance of physical activity on preventing disease recurrence in many cancers is well known, and cancer rehabilitation programs help patients to regain physical activity sooner and maintain it longer. Patients report increased satisfaction with their healthcare providers and improved well-being and function with these interventions. Furthermore, long-term healthcare costs may even be mitigated by early identification and intervention, not to mention that earlier return to gainful employment can ease financial burdens associated with treatment.

In this new era of cancer care, advanced lung cancer is becoming more of a chronic illness. As patients with lung cancer live longer, it is critical that clinicians and health systems take an active approach to addressing long-term cancer treatment adverse events and their impact on survivorship. The challenge for clinicians is to optimize patient quality of life by minimizing both the burden of a chronic cancer diagnosis and the sequelae of treatment, including physical limitations from the disease itself, treatment adverse events, and the emotional and financial burdens of the uncertainties of cancer survivorship.

What quality-of-life issues are your patients with advanced lung cancer talking about? How are you helping them? Please join the conversation below!

Continue

Poll

1.
What resources does your practice have for patients living with advanced lung cancer?
Submit