October 27, 2021 Just because there is no cure for certain types of cancer does not mean that those patients cease to receive medical care. The next obstacle becomes reframing what success looks like when life-saving care is no longer the main goal. A new study published in the Journal of Oncology Practice seeks to provide this added perspective, looking beyond the factor of prolonging life and focusing on the quality of life during the time patients have. This study looks at cases of advanced non-small cell lung cancer (NSCLC) because there is no known cure, and it may benefit the patient’s quality of life to consider other medical care goals.
Shared Decision-Making May Bridge Lung Cancer Patient Expectations and Treatment Reality
Chemotherapy is a common treatment for cancer since it may reduce tumor size and prolong a patient’s life, but it comes with unpleasant side effects that affect quality of life. In this study, researchers observed how chemotherapy participants felt before, during, and after treatment through a series of interviews to determine whether patients thought their treatment outcome was worth the treatment’s adverse effect. The first interview round revealed that 60% of patients defined their treatment success as dependent on more than just living longer and expressed the desire to improve their quality of life. By the final interview, 80% of patients who initially believed that prolonged survival equated to successful treatment converted to defining their treatment success as both survival and improved quality of life. The resulting trend emphasizes that more patients want a better quality of life, and they also are willing to endure the effects of chemotherapy so they can live longer.
Dr. Apar Kishor Ganti, who oversaw the study, deliberated on some of the reasons why patients might reconsider the importance of their quality of life. Determining these reasons will be vital to understanding what patients view as success for their treatment. Dr. Ganti considered income and how patients may decide they need more time to make plans to take care of their family or secure life insurance if those resources were not always available. This medical model puts the patient at the center of treatment planning because it is based on the patient’s own definition of treatment success. Since this definition of success for patients can change, it is important to re-evaluate how the patient defines their success as part of the process and modify treatment accordingly.
Coordinating the Lung Cancer Patient Journey
The lung cancer nurse specialist (LCNS) plays an indispensable role in understanding the patient’s idea of treatment success because they are typically the ones in communication with their patients the most throughout their care. It is the job of the LCNS to perform complex assessments offered both over the phone and in-person to determine factors that may affect patient treatment. Factors include the patient’s usual physical activity level, family or social support situations, medication use, whether they smoke, their job status, and even mental health history. All these features influence what kind of treatment and subsequent side effects the patient will be able to withstand.
The LCNS is responsible for communicating expectations and treatment realities based on their patients’ responses during the assessment. Still, Dr. Ganti’s data shows these kinds of evaluations need to be performed more than once to be useful since patients can change their reasoning during the course of treatment for a number of reasons.
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