Non-Small Cell Lung Cancer from the Patient’s Perspective

By John Henry Dreyfuss, MDalert.com staff.
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Non-small cell lung cancer is one of the more common cancers in the U.S. (See Figure 1.) When asked about their diagnosis and experience with lung cancer, patients focused on several key aspects. Many of them reported that the most common symptoms were pain, dyspnea, and fatigue.

Patients also reported difficulty differentiating the side effects of treatment from the symptoms of lung cancer. Patients said they felt encouraged by the availability of novel treatments for lung cancer and also voiced interest in unconventional therapies, such as yoga, acupuncture, support groups, nutritional interventions, and nutritional supplements.

Figure 1. Non-small cell lung cancer geographic distribution within the United States.
 

Many patients reported that maintaining an acceptable quality of life was just as important as prolonging life. Lung cancer (See Figure 2.) and its treatment were noted to have significant effects on daily life: a constant round of medical appointments, uncertainty regarding the future, the inability to work, and the stigma of being a sick person.

Figure 2. Stage 4 metastatic non-small cell lung cancer.

 

Patients whose lung cancer was treated with conventional chemotherapy (See Figure 3.) reported debilitating effects and noted issues with chronic pain after surgery. Targeted therapies were reported to have less severe side effects, but patients expressed concerns about the need for long-term treatment and fears of developing resistance to treatment.

Figure 3. Treatment targets in advanced non-small cell lung cancer.
Patients with lung cancer emphasized the importance of physicians’ clarifying the long- and short-term goals of treatment and the expectations for cure, and of physicians’ taking the time to understand individual patients’ definitions of an acceptable quality of life. They stressed the importance of transparency in clinical trials and of understanding the financial consequences of the various treatment options. They also expressed interest in clinical trial participation. Finally, patients underscored the need for coordination of care in symptom management.

NSCLC is a complex disease that affects multiple aspects of a patient’s life. However, targeted therapies, multidisciplinary treatment, aggressive symptom management, and a focus on individual patients’ desires and goals of care can improve the experience of both patients and physicians.

Further Reading

  • Aspirin and nonsteroidal anti-inflammatory drugs can prevent cutaneous squamous cell carcinoma: a systematic review and meta-analysis. Muranushi C, Olsen CM, Pandeya N, Green AC. J Invest Dermatol. 2015;135(4):975-83
  • Prophylactic use of aspirin: systematic review of harms and approaches to mitigation in the general population. Thorat MA, Cuzick J. Eur J Epidemiol. 2015;30(1):5-18.
  • [Opioids in chronic noncancer pain-are opioids superior to nonopioid analgesics? A systematic review and meta-analysis of efficacy, tolerability and safety in randomized head-to-head comparisons of opioids versus nonopioid analgesics of at least four week's duration]. Welsch P, Sommer C, Schiltenwolf M, Häuser W. Schmerz. 2015;29(1):85-95
  • American Cancer Society. Side effects of targeted cancer therapy drugs. Revised December 11, 2014. Accessed September 20, 2015.