PURPOSE: This National Cancer Institute funded Program Project (P01) is an interdisciplinary research project focused on palliative care, quality of life (QOL), and symptom control in lung cancer which is diagnosed in 213,000 Americans each year. The purpose of this study is to test usual care versus integration of palliative care encompassing four dimensions of QOL.
METHODS: Our two previous pilot projects in a NCI Comprehensive Cancer Center demonstrated the unmet needs in lung cancer and the limited use of supportive care services by those with lung cancer. Project 2 of this Program focuses on late stage lung cancer, and uses a two group, prospective, tandem enrollment comparing usual care to a structured palliative care intervention. Patients are followed for 6 months and measures include the FACT-L, FACIT- Spiritual, MSAS, Social Support tool and a Chart Audit capturing care and resources used.
RESULTS: This usual care phase sample of Stage IV lung cancer (N=116) included 70% female, 43% minority patients. Seventy one percent had at least 1 other chronic illness and 20% had a prior cancer diagnosis. MSAS scores revealed key symptoms to include lack of energy, difficulty sleeping, worrying, dyspnea and pain and MSAS distress of x=3.3 on scale of 0-4. FACT-L data indicated key QOL concerns related to sexuality (x=2.83), fear of worsening disease (x=3.18), sleep disruption (x=3.2), overall poor QOL (x=3.24) and lack of energy (x=3.3). Greatest spiritual concerns from the FACIT-Spiritual tool included lack of meaning, lack of purpose and trouble feeling at peace. Chart audit data documented limited use of advanced directives or palliative care consultation.
CONCLUSIONS: Findings identify significant gaps in supportive care in lung cancer and provide direction for the intervention phase of a comprehensive educational intervention and enhanced resources for lung cancer patients.
CLINICAL IMPLICATIONS: These findings lead to creation of a four part, QOL education program specific to lung cancer and a interdisciplinary care planning process involving multiple disciplines.
DISCLOSURE: The following authors have nothing to disclose: Betty Ferrell, Marianna Koczywas, Karen Reckamp, Mihaela Cristea, Brian Tiep, Dana Tarcatu, Jay Thomas, Fredrick Grannis, Gwen Uman
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