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Current Treatment Options in Oncology
Published in: Current Treatment Options in Oncology 5/2016

Open Access 01-05-2016 | Lung Cancer (HA Wakelee, Section Editor)

Integrated Palliative Care and Oncologic Care in Non-Small-Cell Lung Cancer

Authors: Divya Chandrasekar, MD, Erika Tribett, MPH, Kavitha Ramchandran, MD

Published in: Current Treatment Options in Oncology | Issue 5/2016

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Opinion statement

Palliative care integrated into standard medical oncologic care will transform the way we approach and practice oncologic care. Integration of appropriate components of palliative care into oncologic treatment using a pathway-based approach will be described in this review. Care pathways build on disease status (early, locally advanced, advanced) as well as patient and family needs. This allows for an individualized approach to care and is the best means for proactive screening, assessment, and intervention, to ensure that all palliative care needs are met throughout the continuum of care. Components of palliative care that will be discussed include assessment of physical symptoms, psychosocial distress, and spiritual distress. Specific components of these should be integrated based on disease trajectory, as well as clinical assessment. Palliative care should also include family and caregiver education, training, and support, from diagnosis through survivorship and end of life. Effective integration of palliative care interventions have the potential to impact quality of life and longevity for patients, as well as improve caregiver outcomes.
Literature
1.
2.
3.
Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the project ENABLE II randomized controlled trial. JAMA. 2009;302(7):741–9.PubMedPubMedCentralCrossRef
4.••
Temel JS, Greer JH, Muzikansky A, Gallagher EA, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733–42. The authors randomly assign patients with newly diagnosed metastatic NSCLC to either receive early palliative care integrated with standard oncologic care or standard oncologic care. The hypothesis tested was that early palliative care would be beneficial concerning patient-reported outcomes and end of life care. They found that their hypothesis is strongly supported as patients who received early palliative care integrated with standard oncologic care showed higher scores on the FACT-L quality of life assessment instrument and fewer depressive symptoms. Interestingly, the early palliative care group patients also had less aggressive end of life care but longer survival.PubMedCrossRef
5.
6.
Ostgathe C, Walshe R, Wolf J, Hallek M, Voltz R. A cost calculation model for specialist palliative care for patients with non-small cell lung cancer in a tertiary centre. Support Care Cancer. 2007;16(5):501–6.PubMedCrossRef
7.
Coy P, Schaafsma J, Schofield JA. The cost-effectiveness and cost-utility of high-dose palliative radiotherapy for advanced non–small-cell lung cancer. Int J Radiat Oncol Biol Phys. 2000;48(4):1025–33.PubMedCrossRef
8.
Billingham L, Bathers S, Burton A, Bryan S, Cullen M. Patterns, costs and cost-effectiveness of care in a trial of chemotherapy for advanced non-small cell lung cancer. Lung Cancer. 2002;37(2):219–25.PubMedCrossRef
9.
Dooms C. Cost-utility analysis of chemotherapy in symptomatic advanced non-small cell lung cancer. Eur Respir J. 2006.
10.
Cooley ME. Symptoms in adults with lung cancer: a systematic research review. J Pain Symptom Manag. 2000;19(2):137–53.CrossRef
11.•
LeBlanc TW, Nickolich M, Rushing CN, Samsa GP, Locke SC, Abernethy Su AP. What bothers lung cancer patients the most? A prospective, longitudinal electronic patient-reported outcomes study in advanced non-small cell lung cancer. Support Care Cancer. 2015;23:3455–63. The authors and researchers at Duke University in North Carolina assessed patients with advanced NSCLC longitudinally over time using an electronic assessment instrument measuring patient-reported symptoms in order to gain more information regarding which symptoms occurred with what frequency and severity. The results showed that functional concerns predominated over non-functional concerns. Severe dyspnea and fatigue were the most prevalent nonfunctional symptoms. Depression was reported but infrequently. The number of moderate to severe symptoms increased with proximity to death. Overall, patients exhibited significant symptom burden which increased in frequency and severity closer to time of death.PubMedCrossRef
12.
Iyer S, Roughley A, Rider A, Taylor-Stokes G. The symptom burden of non-small cell lung cancer in the USA: a real-world cross-sectional study. Support Care Cancer. 2014;22:181–7.PubMedCrossRef
13.
Temel JS, Pirl WF, Lynch TJ. Comprehensive symptom management in patients with advanced-stage non-small-cell lung cancer. Clin Lung Cancer. 2006;7(4):241–9.PubMedCrossRef
14.
Granger CL, Denehy L, McDonald CF, Irving L, Clark RA. Physical activity measured using global positioning system tracking in non–small cell lung cancer: an observational study. Integr Cancer Ther 13(6):482–492.
15.
Arbane G, Tropmanb D, Jackson J, Garrod R. Evaluation of an early exercise intervention after thoracotomy for non-small cell lung cancer (NSCLC), effects on quality of life, muscle strength and exercise tolerance: randomised controlled trial. Lung Cancer. 2011;71:229–34.PubMedCrossRef
16.
Quist M, Rorth M, Langer S, Jones LW, et al. Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy: a pilot study. Lung Cancer. 2012;75:203–8.PubMedCrossRef
17.•
Payne C, Larkin PJ, McIlfatrick S, Dunwoody L, Gracey JH. Exercise and nutrition interventions in advanced lung cancer: a systematic review. Curr Oncol. 2013;20(4):321–37. In this systematic review, the authors evaluated the effects of physical activity and nutrition interventions (or both) on adults with NSCLC. The results of the study support that exercise and nutrition interventions are not harmful and may be beneficial on unintentional weight loss, physical strength, and functional performance in NSCLC patients.CrossRef
18.
Kuehr L, Wiskemann J, Abel U, Ulrich CM, Hummler S, Thomas M. Exercise in patients with non–small cell lung cancer. Med Sci Sports Exerc. 2014:656–663.
19.
Granger CL, McDonald CF, Berney S, Chao C, Denehy L. Exercise intervention to improve exercise capacity and health related quality of life for patients with non-small cell lung cancer: a systematic review. Lung Cancer. 2011;72:139–53.PubMedCrossRef
20.
Cavalheri V, Tahirah F, Nonoyama ML, Jenkins S, Hill K. Exercise training undertaken by people within 12 months of lung resection for non-small cell lung cancer (review). The Cochrane Collaboration 2013. Available at: http://​www.​thecochranelibra​ry.​com. Accessed 14 Dec 2015.
21.
Hoffman AJ, Brintnall RA, Eye AV, et al. Home-based exercise: promising rehabilitation for symptom relief, improved functional status and quality of life for post-surgical lung cancer patients. J Thorac Dis. 2014;6(6):632–40.PubMedPubMedCentral
22.
Jones LW, Eves ND, Peterson BL, et al. Safety and feasibility of aerobic training on cardiopulmonary function and quality of life in postsurgical nonsmall cell lung cancer patients. Available at: www.​interscience.​wiley.​com. Accessed 12 Dec 2015.
23.
Hoffman AJ, Brintnall RA, Brown JK, et al. Too sick not to exercise: using a 6-week, home-based exercise intervention for cancer-related fatigue self-management for postsurgical non small cell lung cancer patients. Cancer Nurs. 2013;36(3):175–88.PubMedCrossRef
24.
Sanchez-Lara K, Arrieta O, Pasaye E, et al. Brain activity correlated with food preferences: a functional study comparing advanced non-small cell lung cancer patients with and without anorexia. Nutrition. 2013;29:1013–9.PubMedCrossRef
25.
26.
Fearon K, Strasser F, Anker SD, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol. 2011;2:489–95.CrossRef
27.
Fearon KC, Voss AC, Hustead DS, Cancer Cachexia Study G. Definition of cancer cachexia: effect of weight loss, reduced food intake, and systemic inflammation on functional status and prognosis. Am J Clin Nutr. 2006;83(6):1345–50.PubMed
28.
Petrella F, Radice D, Borri A, et al. The impact of preoperative body mass index on respiratory complications after pneumonectomy for non-small-cell lung cancer. Results from a series of 154 consecutive standard pneumonectomies. Eur J Cardiothorac Surg. 2011;39:738–44.PubMedCrossRef
29.
Tewari NI, Martin-Ucar AE, Black E, et al. Nutritional status affects long term survival after lobectomy for lung cancer. Lung Cancer. 2007;57:389–94.PubMedCrossRef
30.
Jagoe RT, Goodship TH, Gibson GJ. The influence of nutritional status on complications after operations for lung cancer. Ann Thorac Surg. 2001;71:936–43.PubMedCrossRef
31.
Ross PJ, Ashley S, Norton A, Priest K, Waters JS, Eisen T, et al. Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers? Br J Cancer. 2004;90:1905–11.PubMedPubMedCentralCrossRef
32.
Arrieta O, Michel Ortega RM, Villanueva-Rodríguez G, Serna- Thoméh MG, Flores-Estrada D, Diaz-Romero C, et al. Association of nutritional status and serum albumin levels with development of toxicity in patients with advanced non-small cell lung cancer treated with paclitaxel–cisplatin chemotherapy: a prospective study. BMC Cancer. 2010;10:50.PubMedPubMedCentralCrossRef
33.
Op Den Kamp CMH, De Ruysscher DKM, Heuvel MVD, et al. Early body weight loss during concurrent chemo-radiotherapy for non-small cell lung cancer. J Cachex Sacropenia Muscle. 2014;5:127–37.CrossRef
34.
Kimura M, Naito T, Kenmotsu H, Taira T, Wakuda K, et al. Prognostic impact of cancer cachexia in patients with advanced non-small cell lung cancer. Support Care Cancer. 2015;23:1699–708.PubMedCrossRef
35.
Murphy RA, Mourtzakis M, Chu QS, Reiman T, Mazurak VC. Skeletal muscle depletion is associated with reduced plasma (n-3) fatty acids in non-small cell lung cancer patients. J Nutr. 2010;140:1602–6.PubMedCrossRef
36.
van der Meij BS, Languis JAE, Spreeuwenberg MD, et al. Oral nutritional supplements containing n-3 polyunsaturated fatty acids affect quality of life and functional status in lung cancer patients during multimodality treatment: an RCT. Eur J Clin Nutr. 2012;66:399–404.PubMedPubMedCentralCrossRef
37.
van der Meij BS, Languis JAE, Smit EF, et al. Oral nutritional supplements containing (n-3) polyunsaturated fatty acids affect the nutritional status of patients with stage III non-small cell lung cancer during multimodality treatment. Available at: jn.​nutrition.​org.
38.
Del Ferraro C, Grant M, Koczywas M, Dorr-Uyemura LA. Management of anorexia-cachexia in late-stage lung cancer patients. J Hosp Palliat Nurs. 2012;14:397–402.CrossRef
39.
Granda-Cameron C, Demille D, Lynch MP, et al. An interdisciplinary approach to manage cancer cachexia. Clin J Oncol Nurs. 2010;14(1):72–80.PubMedCrossRef
40.
Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, et al. The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol. 1993;11:570–9.PubMed
41.
LeBlanc TW, Samsa GP, Wolf SP, Locke SC, Cella DF, Abernethy AP. Validation and real-world assessment of the functional assessment of anorexia–cachexia therapy (FAACT) scale in patients with advanced non-small cell lung cancer and the cancer anorexia–cachexia syndrome (CACS). Support Care Cancer. 2015;23:2341–7.PubMedCrossRef
42.
Salsman JM, Beaumont JL, Wortman K, Yan Y, Friend J, Cella D. Brief versions of the FACIT-fatigue and FAACT subscales for patients with non-small cell lung cancer cachexia. Support Care Cancer. 2015;23:1355–64.PubMedPubMedCentralCrossRef
43.
Potter J, Higginson IJ. Pain experienced by lung cancer patients: a review of prevalence, causes and pathophysiology. Lung Cancer. 2004;43:247–57.PubMedCrossRef
44.
Caraceni A, Portenoy RK. An international survey of cancer pain characteristics and syndromes. IASP Task Force on Cancer Pain. Pain. 1999;82(32):263–74.PubMedCrossRef
45.
46.
Chute CG, Greenberg ER, Baron J, Korson R, Baker J, Yates J. Presenting conditions of 1539 population-based lung cancer patients by cell type and stage in New Hampshire and Vermont. Cancer. 1985;56(8):2107–11.PubMedCrossRef
47.
48.
Mercandante S, Vitrano V. Pain in patients with lung cancer: pathophysiology and treatment. Lung Cancer. 2010;68:10–5.CrossRef
49.
Geneva W. Cancer pain relief. World Health Organisation; 1996.
50.
Ferrel B, Levy MH, Paice J. Managing pain from advanced cancer in the palliative care setting. Clin J Oncol Nurs. 2008;12:575–81.CrossRef
51.
Yuan CS. Methylnaltrexone mechanisms of action and effects on opioid bowel dysfunction and other opioid adverse effects. Ann Pharmacother. 2007;41(6):984–93.PubMedCrossRef
52.
Hu M, Zhi X, Zhang J. Radiofrequency ablation (RFA) for palliative treatment of painful non-small cell lung cancer (NSCLC) rib metastasis: experience in 12 patients. Thorac Cancer. 2015;6:761–4.PubMedPubMedCentralCrossRef
53.
Barbera L, Zhang-Salomons J, Huang J, Tyldesley S, Mackillop W. Defining the need for radiotherapy for lung cancer in the general population: a criterion-based, benchmarking approach. Med Care. 2003;41(9):1074–85.PubMedCrossRef
54.
Toy E, Macbeth F, Coles B, Melville A, Eastwood A. Palliative thoracic radiotherapy for non-small-cell lung cancer: a systematic review. Am J Clin Oncol. 2003;26(2):112–20.PubMedCrossRef
55.
Cassileth BR, Deng GE, Gomez JE, Johnstone PA, Kumar N, Vickers AJ. Complementary therapies and integrative oncology in lung cancer: ACCP evidence-based clinical practice guidelines (2nd edition). Chest. 2007;132 Suppl 3:340S–54.PubMedCrossRef
56.
Molassiotis A, Lowe M, Blackhall F, Lorigan P. A qualitative exploration of a respiratory distress symptom cluster in lung cancer: cough, breathlessness and fatigue. Lung Cancer. 2011;71:94–71:9.
57.
Cheville AL, Novotny PJ, Sloan JA, et al. The value of a symptom cluster of fatigue, dyspnea, and cough in predicting clinical outcomes in lung cancer survivors. J Pain Symptom Manag. 2011;42(2):213.CrossRef
58.
Tiep et al. Pulmonary rehabilitation and palliative care for the lung cancer patient. J Hosp Palliat Nurs. 2015;17(5):462–8.PubMedCrossRef
59.
Cheville AL, Novotny PJ, Sloan JA, et al. Fatigue, dyspnea, and cough comprise a persistent symptom cluster up to five years after diagnosis with lung cancer. J Pain Symptom Manage. 2011;42:202–12.PubMedPubMedCentralCrossRef
60.
Henoch I, Bergman B, Gustaffson M, Gaston-Johansson F, Danielson E. Dyspnea experience in patients with lung cancer in palliative care. Eur J Oncol Nurs. 2008;12:86–12.PubMedCrossRef
61.
Koczywas et al. Interdisciplinary palliative care intervention in metastatic non-small-cell lung cancer. Clin Lung Cancer. 2013;14(6):736–44.PubMedCrossRef
62.
Henoch I, Bergman B, Danielson E. Dyspnea experience and management strategies in patients with lung cancer. Psychooncology. 2008;17(7):709–15.PubMedCrossRef
63.
Ries AL, Bauldoff GS, Carlin BW, et al. Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest. 2007;131 suppl 5:4S–2.PubMedCrossRef
64.
Abernethy AP, McDonald CF, Frith PA, et al. Effect of palliative oxygen versus room air in relief of breathlessness in patients with refractory dyspnoea: a double-blind, randomised controlled trial. Lancet. 2010;376(9743):784–93.PubMedPubMedCentralCrossRef
65.
Tiep B, Carter R, Zachariah F, et al. Oxygen for end-of-life lung cancer care: managing dyspnea and hypoxemia. Expert Rev Respir Med. 2013;7(5):479–90.PubMedCrossRef
66.
Currow DC, Ekstrom M, Abernethy AP. Opioids for chronic refractory breathlessness: right patient, right route? Drugs. 2014;74(1):1–6.PubMedCrossRef
67.••
Yates et al. Supportive and palliative care for lung cancer patients. J Thorac Dis. 2013;5(5):S623–8. This review study evaluated evidence-based interventions that support best practice supportive and palliative care for patients with lung cancer, specifically interventions to manage dyspnea and psychosocial interventions to reduce anxiety and distress.PubMedPubMedCentral
68.
Rueda JR, Solà I, Pascual A, Subirana Casacuberta M. Non-invasive interventions for improving well-being and quality of life in patients with lung cancer. Cochrane Database Syst Rev. 2011;9, CD004282.PubMed
69.
Henoch I, Bergman B, Gustafsson M, Gaston-Johansson F, Danielson E. The impact of symptoms, coping capacity, and social support on quality of life experience over time in patients with lung cancer. J Pain Symptom Manag. 2007;34(4):370–9.CrossRef
70.
Akechi T, Okuyama T, Akizuki N, et al. Course of psychological distress and its predictors in advanced non-small cell lung cancer patients. Available at: www.​interscience.​wiley.​com. Accessed 12 Jan 2016.
71.
Murray SA, Kendall M, Grant E, Boyd K, Barclay S, Sheikh A. Patterns of social, psychological, and spiritual decline toward the end of life in lung cancer and heart failure. J Pain Symptom Manag. 2007;34(4):393–402.CrossRef
72.
Hopwood P, Stephens RJ. Depression in patients with lung cancer: prevalence and risk factors derived from quality of life data. J Clin Oncol. 2000;18(4):893–903.PubMed
73.
Carlsen K, Jensen AB, Jacobsen E, Krasnik M, Johansen C. Psychosocial aspects of lung cancer. Lung Cancer. 2005;47:293–300.PubMedCrossRef
74.
Kurtz ME, Kurtz JC, Stommel M, Given CW, Given B. Predictors of depressive symptomatology of geriatric patients with lung cancer—–a longitudinal analysis. Psychooncology. 2002;11:12–22.PubMedCrossRef
75.
Pirl WF, Greer JA, Traeger L, et al. Depression and survival in metastatic non-small-cell lung cancer: effects of early palliative care. J Clin Oncol. 2012;30(12):1310–5.
76.
77.
Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer. 2009;115:5349–61.PubMedCrossRef
78.
Fujisawa D, Temel JS, Traeger L, et al. Psychological factors at early stage of treatment as predictors of receiving chemotherapy at the end of life. Available at: wileyonlinelibra​ry.​com. Accessed 10 Dec 2015.
79.
Akechi T, Kugaya A, Okamura H, Nishiwaki Y, Yamawaki S, Uchitomi Y. Predictive factors for psychological distress in ambulatory lung cancer patients. Support Care Cancer. 1998;6:281–6.PubMedCrossRef
80.
Prasertsri N, Holden J, Keefe FJ, Wilkie DJ. Repressive coping style: relationships with depression, pain, and pain coping strategies in lung cancer out patients repressive coping style: relationships with depression, pain, and pain coping strategies in lung cancer out patients. Lung Cancer. 2011;71:235–40.PubMedPubMedCentralCrossRef
81.
Graves KD, Arnold SM, Love CL, Kirsh KL, Moore PG, Passik SD. Distress screening in a multidisciplinary lung cancer clinic: prevalence and predictors of clinically significant distress. Lung Cancer. 2007;55:215–24.PubMedPubMedCentralCrossRef
82.
Jamal A, Homa DM, O’Connor E, et al. Current cigarette smoking among adults — United States, 2005–2014. MMWR Morb Mortal Wkly Rep. 2015;64(44):1233–40.PubMedCrossRef
83.
Nia PS, Weyler J, Colpaert C, Vermeulen P, Marck EV, Schil PV. Prognostic value of smoking status in operated non-small cell lung cancer. Lung Cancer. 2005;47:351–9.CrossRef
84.
Liu X, Lin XJ, Wang CP, et al. Association between smoking and p53 mutation in lung cancer: a meta-analysis. Clin Oncol. 2014;26:18–24.CrossRef
85.
Tam IY, Chung LP, Suen WS, Wang E, Wong MC, Ho KK, et al. Distinct epidermal growth factor receptor and KRAS mutation patterns in non-small cell lung cancer patients with different tobacco exposure and clinicopathologic features. Clin Cancer Res. 2006;12:1647–53.PubMedCrossRef
86.
Togashi Y, Hayashi H, Okamoto K, Fumita S, Terashima M, et al. Chronic nicotine exposure mediates resistance to EGFR-TKI inEGFR-mutated lung cancer via an EGFR signal. Lung Cancer. 2015;88:16–23.PubMedCrossRef
87.
Zhai R, Yu X, Su L, Christiani DC. Smoking and smoking cessation in relation to the development of co-existing non-small cell lung cancer with chronicobstructive pulmonary disease. Int J Cancer. 2014;134:961–70.PubMedPubMedCentralCrossRef
88.
Boyle JM, Tandberg DJ, Chino JP, D’Amico TA, Ready NE, Kelsey CR. Smoking history predicts for increased risk of second primary lung cancer: a comprehensive analysis. Available at: wileyonlinelibra​ry.​com. Accessed 12 Jan 2016.
89.
Zhou W, Heist RS, Liu G, Zhai R, Yu X, Su L, et al. Smoking and smoking cessation in relation to the development of co-existing non-small cell lung cancer with chronicobstructive pulmonary disease. Int J Cancer. 2014;134:961–70. Lung Cancer 2006;53:375–380.CrossRef
90.
Baser S, Shannon VR, Eapen GA, et al. Smoking cessation after diagnosis of lung cancer is associated with a beneficial effect on performance status. Chest. 2006;130(6):1784–90.PubMedCrossRef
91.
92.
93.
94.
Sun V, Kim JY, Irish TL, et al. Palliative care and spiritual well-being in lung cancer patients and family caregivers. Available at: wileyonlinelibra​ry.​com. Accessed 2015.
95.
Lovgren M, Tishelman C, Sprangers M, Koyi H, Hamberg K. Symptoms and problems with functioning among women and men with inoperable lung cancer—–a longitudinal study. Lung Cancer. 2008;60:113–24.PubMedCrossRef
96.
Jacobs-Lawson JM, Schumacher MM, Hughes T, Arnold S. Gender differences in psychosocial responses to lung cancer. Gend Med. 2010;7(2):137–48.PubMedCrossRef
97.
98.
99.
Hung R, Krebs P, Coups EJ, et al. Fatigue and functional impairment in early-stage non-small cell lung cancer survivors. C22. Behavioral And Psychosocial Factors In Asthma, Chronic Obstructive Pulmonary Disease And Other Lung Diseases 2010.
100.
101.
Fouladbakhsh JM, Davis JE, Yarandi HN. A pilot study of the feasibility and outcomes of yoga for lung cancer survivors. Oncol Nurs Forum. 2014;41(2):162–74.PubMedCrossRef
102.
Peddle-Mcintyre CJ, Bell G, Fenton D, Mccargar L, Courneya KS. Feasibility and preliminary efficacy of progressive resistance exercise training in lung cancer survivors. Lung Cancer. 2012;75(1):126–32.PubMedCrossRef
103.
Ostroff JS, Krebs P, Coups EJ, et al. Health-related quality of life among early-stage, non-small cell, lung cancer survivors. Lung Cancer. 2011;71(1):103–8.PubMedPubMedCentralCrossRef
104.••
Vijayvergia N, Shah PC, Denlinger CS. Survivorship in non-small cell lung cancer: challenges faced and steps forward. J Natl Compr Cancer Netw. 2015;13(9):1151–61. In this study, the authors summarize the major issues faced by NSCLC survivors and suggest appropriate management. Most NSCLC carry a higher comorbidity burden than survivors of other cancers and overall quality of life and health-related quality of life decrease. Symptoms including respiratory issues, fatigue, hearing loss, neuropathy, post-surgical pain, psychological distress, depression, financial issues, poor compliance with recommended guidelines, and fear of recurrence or secondary malignancies are common and burdensome among survivors.
105.
Colt HG, Murgu SD, Korst RJ, Slatore CG, Unger M, Quadrelli S. Follow-up and surveillance of the patient with lung cancer after curative-intent therapy. Chest. 2013;143(5).
106.
Lou F, Huang J, Sima CS, Dycoco J, Rusch V, Bach PB. Patterns of recurrence and second primary lung cancer in early-stage lung cancer survivors followed with routine computed tomography surveillance. J Thorac Cardiovasc Surg. 2013;145(1):75–82.PubMedCrossRef
107.
Mollberg NM, Ferguson MK. Postoperative surveillance for non-small cell lung cancer resected with curative intent: developing a patient-centered approach. Ann Thorac Surg. 2013;95(3):1112–21.PubMedCrossRef
108.
Jaklitsch MT, Jacobson FL, Austin JH, et al. The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg. 2012;144(1):33–8.PubMedCrossRef
109.
Ocana CV, Lopez PG, Trueba IM. Multidisciplinary approach in stage III non-small-cell lung cancer: standard of care and open questions. Clin Transl Oncol. 2011;13:629–35.CrossRef
110.
Boxer MM, Vinod SK, Shafiq J, Duggan KJ. Do multidisciplinary team meetings make a difference in the management of lung cancer? Cancer 2011:5112–5120.
111.
Howe M, Burkes RL. Collaborative care in NSCLC; the role of early palliative care. Front Oncol. 2014;4:1–3.CrossRef
112.
Temel JS, Jackson VA, Billings JA, et al. Phase II study: integrated palliative care in newly diagnosed advanced non-small-cell lung cancer patients. J Clin Oncol. 2007;25(17):2377–82.PubMedCrossRef
113.••
Ferrel B, Sun V, Hurria A, et al. Interdisciplinary palliative care for patients with lung cancer. J Pain Symptom Manage. 2015:1–10. In this study, patients with stage IV NSCLC were enrolled in a prospective quasi-experimental study where the intervention group was presented at interdisciplinary care meetings where appropriate supportive care referrals were made. The authors hypothesized that interdisciplinary care would be beneficial which the results strongly supported, showing significant improvement in quality of life, symptoms and distress.
114.
Ramella S, D’Angelillo RM. Radiotherapy in palliative treatment of metastatic NSCLC: not all one and the same. Ann Palliat Med. 2013;2(2):92–4.PubMed
115.
Langendijk JA, Aaronson NK, ten Velde GPM, Jong JMA, Muller MJ, Wouters EFM. Pretreatment quality of life of inoperable non-small cell lung cancer patients referred for primary radiotherapy. Acta Oncol. 2000;39(8):949–58.PubMedCrossRef
116.
Langendijk JA, ten Velde GPM, Aaronson NK, de Jong JM, Muller MJ, Wouters EFM. Quality of life after palliative radiotherapy in non-small cell lung cancer: a prospective study. Int J Radiat Oncol. 2000;47(1):149–55.CrossRef
117.
Langendijk JS, Aaronson NK, de Jong JM, et al. Prospective study on quality of life before and after radical radiotherapy in non-small-cell lung cancer. J Clin Oncol. 2001;19(8):2123–33.PubMed
118.
Schaafsma J, Coy P. Response of global quality of life to high-dose palliative radiotherapy for non-small-cell lung cancer. Int J Radiat Oncol. 2000;47(3):691–701.CrossRef
119.
Klastersky J, Paesmans M. Response to chemotherapy, quality of life benefits and survival in advanced non-small cell lung cancer: review of literature results. Lung Cancer. 2001;34:S95–101.PubMedCrossRef
120.
121.
Belani CP, Pereira JR, Jvon, et al. Effect of chemotherapy for advanced non-small cell lung cancer on patients’ quality of life. A randomized controlled trial. Lung Cancer. 2006;53:231–9.PubMedCrossRef
122.
Mannion E, Gilmartin JJ, Donnellan P, Keane M, Waldron D. Effect of chemotherapy on quality of life in patients with non-small cell lung cancer. Support Care Cancer. 2014;22:1417–28.PubMedCrossRef
123.
Matsudo A, Yamaoka K, Tango T. Quality of life in advanced non-small cell lung cancer patients receiving palliative chemotherapy: a meta-analysis of randomized controlled trials. Exp Therapeut Med. 2012;3:134–40.
124.
Saito AM, Landrum MB, Neville BA, Ayanjan JZ, Earle CC. The effect on survival of continuing chemotherapy to near death. BMC Palliat Care. 2011;10(14):1–11.
125.
Plessen C, Bergman B, Andersen O, et al. Palliative chemotherapy beyond three courses conveys no survival or consistent quality-of-life benefits in advanced non-small-cell lung cancer. Br J Cancer. 2006;95:966–73.CrossRef
126.
Greer JA, Pirl WF, Jackson VA, et al. Effect of early palliative care on chemotherapy use and end-of-life care in patients with metastatic non-small-cell lung cancer. J Clin Oncol. 2011;30:394–400.PubMedCrossRef
127.
Ng R, de Boer R, Green MD. Undertreatment of elderly patients with non-small-cell lung cancer. Clin Lung Cancer. 2005;7(3):168–74.PubMedCrossRef
128.
Berghmans T, Tragas G, Sculier JP. Age and treatment of non-small-cell lung cancer: a database analysis in elderly patients. Support Care Cancer. 2002;10:619–23.PubMedCrossRef
129.
Weiss J, Langer C. NSCLC in the elderly—the legacy of therapeutic neglect. Curr Treat Options in Oncol. 2009;10:180–94.CrossRef
130.
Aggarwal C, Langer CJ. Older age, poor performance status and major comorbidities: how to treat high-risk patients with advanced nonsmall cell lung cancer. Curr Opin Oncol. 2012;24(2):130–6.PubMedCrossRef
131.
Domingues PM, Zylberberg R, da Matta de Castro T, Baldotto CS, de Lima Araujo LH. Survival data in elderly patients with locally advanced non-small cell lung cancer. Med Oncol. 2013;30:1–6.CrossRef
132.
Turner NJ, Muers MF, Haward RA, Mulley GP. Do elderly people with lung cancer benefit from palliative radiotherapy? Lung Cancer. 2005;49:193–202.PubMedCrossRef
133.
Lonardi F, Coeli M, Pavanato G, Adami F, Gioga G, Campostrini F. Radiotherapy for non-small cell lung cancer in patients aged 75 and over: safety, effectiveness and possible impact on survival. Lung Cancer. 2000;28:43–50.PubMedCrossRef
134.
Costa GJ, Fernandes ALG, Pereira JR, Curtis JR, Santoro IL. Survival rates and tolerability of platinum-based chemotherapy regimens for elderly patients with non-small-cell lung cancer (NSCLC). Lung Cancer. 2006;53(2):171–6.PubMedCrossRef
135.
Santos FN, Castria TBD, Cruz MR, Riera R. Chemotherapy for advanced non-small cell lung cancer in the elderly population. Cochrane Database Syst Rev. 2015.
136.
Hickish T, Smith I, O’brien M, Ashley S, Middleton G. Clinical benefit from palliative chemotherapy in non-small-cell lung cancer extends to the elderly and those with poor prognostic factors. Br J Cancer. 1998;78(1):28–33.PubMedPubMedCentralCrossRef
137.
Earle CC, Tsai JS, Gelber RD, Weinstein MC, Neumann PJ, Weeks JC. Effectiveness of chemotherapy for advanced lung cancer in the elderly: instrumental variable and propensity analysis. J Clin Oncol. 2001;19(4):1064–70.PubMed
138.
Ferguson MK, Parma CM, Celauro AD, Vigneswaran WT. Quality of life and mood in older patients after major lung resection. Ann Thorac Surg. 2009;87:1007–13.PubMedCrossRef
139.
Burfeind WR, Tong BC, O’branski E, et al. Quality of life outcomes are equivalent after lobectomy in the elderly. J Thorac Cardiovasc Surg. 2008;136(3):597–604.PubMedCrossRef
140.
Grant M, Sun V, Fujinami R, et al. Family caregiver burden, skills preparedness, and quality of life in non-small cell lung cancer. Oncol Nurs Forum. 2013;40(4):337–46.PubMedPubMedCentralCrossRef
141.
Gridelli C, Ferrara C, Guerriero C, et al. Informal caregiving burden in advanced non-small cell lung cancer: the HABIT study. J Thorac Oncol. 2007;2(6):475–80.PubMedCrossRef
142.
Hendriksen E, Williams E, Sporn N, Greer J, Degrange A, Koopman C. Worried together: a qualitative study of shared anxiety in patients with metastatic non-small cell lung cancer and their family caregivers. Support Care Cancer. 2014;23(4):1035–41.PubMedCrossRef
143.
Broberger E, Tishelman C, Essen LV. Discrepancies and similarities in how patients with lung cancer and their professional and family caregivers assess symptom occurrence and symptom distress. J Pain Symptom Manag. 2005;29(6):572–83.CrossRef
144.
Mcpherson CJ, Wilson KG, Lobchuk MM, Brajtman S. Family caregivers’ assessment of symptoms in patients with advanced cancer: concordance with patients and factors affecting accuracy. J Pain Symptom Manag. 2008;35(1):70–82.CrossRef
145.
Porter LS, Keefe FJ, Garst J, Mcbride CM, Baucom D. Self-efficacy for managing pain, symptoms, and function in patients with lung cancer and their informal caregivers: associations with symptoms and distress. Pain. 2008;137(2):306–15.PubMedPubMedCentralCrossRef
146.
Keefe FJ, Ahles TA, Porter LS, et al. The self-efficacy of family caregivers for helping cancer patients manage pain at end-of-life. Pain. 2003;103(1):157–62.PubMedCrossRef
147.
Porter LS, Keefe FJ, Mcbride CM, Pollak K, Fish L, Garst J. Perceptions of patientsʼ self-efficacy for managing pain and lung cancer symptoms: correspondence between patients and family caregivers. Pain. 2002;98(1):169–78.PubMedCrossRef
148.
Porter LS, Keefe FJ, Garst J, et al. Caregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial. J Pain Symptom Manag. 2011;41(1):1–13.CrossRef
149.
Mccarthy EP. Hospice use among Medicare managed care and fee-for-service patients dying with cancer. JAMA. 2003;289(17):2238.PubMedCrossRef
150.
Obermeyer Z, Clarke AC, Makar M, Schuur JD, Cutler DM. Emergency care use and the Medicare hospice benefit for individuals with cancer with a poor prognosis. J Am Geriatr Soc. 2016.
151.
Obermeyer Z, Makar M, Abujaber S, Dominici F, Block S, Cutler DM. Association between the Medicare hospice benefit and health care utilization and costs for patients with poor-prognosis cancer. JAMA. 2014;312(18):1888.PubMedPubMedCentralCrossRef
152.
Zuckerman RB, Stearns SC, Sheingold SH. Hospice use, hospitalization, and medicare spending at the end of life. GERONB J Gerontol Ser B: Psychol Sci Soc Sci. 2015.
153.
Benson WF, Aldrich N. Advance care planning: ensuring your wishes are known and honored if you are unable to speak for yourself, critical issue brief, centers for disease control and prevention. 2012. www.​cdc.​gov/​aging.
Metadata
Title
Integrated Palliative Care and Oncologic Care in Non-Small-Cell Lung Cancer
Authors
Divya Chandrasekar, MD
Erika Tribett, MPH
Kavitha Ramchandran, MD
Publication date
01-05-2016
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 5/2016
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-016-0397-1

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