Early Palliative Care in Advanced Lung Cancer

Abstract

Background: Early ambulatory palliative care (PC) is an emerging practice, and its key elements have not been defined. We conducted a qualitative analysis of data from a randomized controlled trial that demonstrated improved quality of life, mood, and survival in patients with newly diagnosed metastatic non-small cell lung cancer who received early PC integrated with standard oncologic care vs standard oncologic care alone. Our objectives were to (1) identify key elements of early PC clinic visits, (2) explore the timing of key elements, and (3) compare the content of PC and oncologic visit notes at the critical time points of clinical deterioration and radiographic disease progression. Methods: We randomly selected 20 patients who received early PC and survived within 4 periods: less than 3 months (n=5), 3 to 6 months (n = 5), 6 to 12 months (n=5), and 12 to 24 months (n = 5). We performed content analysis on PC and oncologic visit notes from the electronic health records of these patients. Results: Addressing symptoms and coping were the most prevalent components of the PC clinic visits. Initial vis-Conclusions: Early PC clinic visits emphasize managing symptoms, strengthening coping, and cultivating illness understanding and prognostic awareness in a responsive and time-sensitive model. During critical clinical time points, PC and oncologic care visits have distinct features that suggest a key role for PC involvement and enable oncologists to focus on cancer treatment and managing medical complications.

CARE Track for Advanced Cancer: Impact and Timing of an Outpatient Palliative Care Clinic

“…While improved quality of EOL care and decreased hospital costs are an important contribution of palliative care programs, avoiding terminal hospitalization is arguably more important for those with incurable malignancies, and meeting this goal may require relationship building and coordination of care that can only occur when concurrent outpatient care is available in addition to inpatient palliative services. 33 Much of the differences between the control and CARE Track care patients in terms of hospitalizations were due to earlier and more frequent referral to hospice services by those in the CARE Track group. At the very end of life, virtually all patients with cancer will be increasingly bedbound, have worsening symptoms, and increasing care requirements.…”

The lung cancer patient, the pneumologist and palliative care: a developing alliance

“…It has spread outside the hospice setting, meaning that it is no longer restricted to the terminal phase of cancerous disease but is also beneficially applied in chronic, nonmalignant illnesses at earlier stages. YOONG et al [6] summarised recently that palliative care seeks to achieve a better quality of life and mood, an improved symptom control and patient satisfaction, and possibly even a better survival. Furthermore, palliative care is able to improve caregivers' satisfaction and can provide a better use of healthcare resources.…”

“…Lung cancer patients experience more psychological distress in addition to physical hardship than patients with other tumour sites [6,8,[15][16][17][18][19]. With a wide lack of specific information about lung cancer patients, data from cancer patients in general are helpful for an overview.…”

Palliative Care Nursing In Colorectal Cancer

“…Bununla birlikte, DSÖ tanımındaki yaklaşım ağrı, fiziksel, psikososyal ve manevi sorunların erken dönemde tanımlanması, kusursuz değerlendi-rilmesi ve tedavisi yoluyla acıların önlenmesi ve hafifletilmesini içerir (4) . Yapılan çalışmalarda, erken dönemde verilen palyatif bakımın yaşam kalitesini yükselttiği, semptom kontrolünde etkili olduğu, hasta ve bakım veren memnuniyetini arttırdığı bulunmuş-tur (5,6) . Meghani (7) palyatif bakımda yaşam ve ölü-mün normal süreçler olarak görüldüğünü, olabildiğince yaşamdan ölüme geçişin kolaylaştırıldığını ve bu süreçte hasta ve ailesini desteklendiğini vurgular.…”