Supportive Care and Palliative Treatment
Palliative care is a specialized field that aims to alleviate symptoms and maximize the patient’s quality of life. Palliative care does not focus on curing the disease or prolonging life, which is the goal of other cancer treatments.
However, palliative care is an important part of the patient’s treatment plan and encompasses physical symptoms, psychosocial distress, spiritual distress, and caregiver distress.1 Palliative care is often provided by a number of healthcare professionals, often working as part of a multidisciplinary team. The team may include doctors, nurses, dietitians, pharmacists, psychologists, and social workers.2
Palliative care for physical symptoms
Patients with advanced lung cancer experience the most troubling symptoms as well as dealing with potential side effects from treatment. Symptom management is one of the critical parts of care for patients with advanced disease.
The most common symptoms of patients with late stage lung cancer include difficulty breathing (dyspnea), cough, fatigue, loss of appetite, weakness due to ill health and malnutrition associated weight loss, and pain. Palliative care therapies that may be used to address physical symptoms include the following approaches:1
Exercise has been shown to reduce the severity of fatigue, improve emotional well-being, and improve the ability to perform daily activities in patients with lung cancer. Studies have suggested that patients who receive physical therapy interventions earlier in their treatment are more likely to adhere to and tolerate physical activity, which has demonstrated numerous positive effects on endurance and overall quality of life.1
Weight loss and malnutrition are associated with an increased risk of complications following surgery and can impact the ability to receive treatments like chemotherapy. Research suggests that patients’ nutritional intake, imbalances, and supplementation should be assessed early in treatment and throughout the treatment timeframe.1
It is estimated that approximately 75 percent of all cancer patients experience chronic pain, and pain is the most common symptom reported by patients with non-small cell lung cancer (NSCLC). Pain management often requires a multidisciplinary approach, including the use of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), weak opioid analgesics (pain medication), and strong opioid analgesics. It is important that patients tell their doctor about any over-the-counter pain medications they are considering taking (before taking them) to ensure that nothing interferes negatively with their treatment, or causes unwanted side effects.
Radiofrequency ablation and radiation therapy can help reduce pain of metastases (areas in the body where the cancer has spread), and complementary therapies such as massage and acupuncture can also provide pain relief for some patients.1
To support a patient’s respiratory symptoms, such as difficulty breathing and cough, several approaches are used including medication, oxygen therapy, breathing exercises, and smoking cessation (stopping smoking).1
Palliative care for psychosocial distress
In addition to physical symptoms experienced by patients with lung cancer, palliative care also addresses the psychological, social, spiritual, and financial well-being of patients. Psychosocial distress has been shown to correlate to key points in a patient’s disease course, including at the time of diagnosis, at discharge after treatment, as the disease progresses, and at end of life.
Patients with NSCLC, especially among those with more severe symptoms and functional limitations, commonly experience depression and anxiety. Some research has suggested that the presence of depression is an indicator of worse survival in cancer.
In addition to depression and anxiety, patients dealing with lung cancer may also experience challenges with family relationships, financial issues, or child care. Patients should receive referrals to social workers, care coordinators, financial specialists, mental health professionals, or spiritual counselors, based on their needs.1