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Advanced Lung Cancer- Palliative Care

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Palliative care works well for advanced lung cancer. By “works” I’m saying that, according to the study linked and excerpted below, managing your lung cancer may be better than undergoing “potentially curative” therapies.

And that is for two reasons-

  1. First, advanced lung cancer is incurable. Aggressive chemo and radiation have been shown not to give you more time than palliative therapy. 
  2. Second, aggressive therapies will reduce your quality of life meaning, what little time you have will be filled with short, long-term and late stage side effects. 

Let me be direct. Aggressive conventional lung cancer therapies have not proven to offer the patient much in terms of length of life. But chemotherapy may be able to stabilize (not cure) the patient.

When I was first diagnosed with my incurable blood cancer, multiple myeloma, I was told that my cancer was incurable with an average life expectancy of 3-5 years but I told myself I would be different. So I underwent aggressive chemotherapy and radiation. Big mistake.

The study below refers to “misconceptions” about palliative care. If you had mentioned the idea of palliative care to me when I was diagnosed, I would have thought that it was giving up or somehow shrinking from the challenge of cancer survival.

I was full of cancer aphorisms about fighting my cancer or being a myeloma warrior– philosophical  non-sense like that. After having lived with my short, long-term and late stage side effects caused by my aggressive toxic therapies, I’ve learned that fighting cancer is the wrong approach. If you want to adopt a philosophy, I recommend something about out-smarting cancer or some sort of chess analogy.

Please don’t misunderstand me. Chemotherapy, radiation and surgery all have their place in treating an aggressive cancer like lung cancer. But an approach like palliative care versus aggressive care can mean extra months if not years and many fewer side effects.

That last bullet point requires a little explanation. Conventional oncology is central to the newly diagnosed cancer patient’s cancer care. But conventional therapies are only one piece of lung cancer journey.

Read the posts linked below to learn more about palliative care-

Are you considering palliative care? Scroll down the page, post a question or comment and I will reply to you ASAP.

To Learn More about short, long-term and late stage side effects- click now

Hang in there,

David Emerson

  • Cancer Survivor
  • Cancer Coach
  • Director PeopleBeatingCancer

Palliative care use and utilization determinants among patients treated for advanced stage lung cancer care in the community and academic medical setting

“Purpose-Despite clinical guidelines, palliative care is underutilized during advanced stage lung cancer treatment…

Conclusion- Interventions should address knowledge and misconceptions, assess care needs, and facilitate communication between patients and oncologists about palliative care…

Introduction-Lung cancer is the leading cause of cancer mortality in the United States and the second most common cancer among men and women [1]. Psychosocial and physical concerns are prevalent among lung cancer patients[2, 3].

Rigorous randomized controlled trials have shown providing patients with outpatient specialty palliative care during lung cancer treatment addresses common psychosocial and physical concerns, improves quality of life and facilitates end-of-life care[4,5,6].

As such, practice guidelines recommend palliative care be delivered concurrently with cancer treatment for advanced stage lung cancer patients [7]…

Unfortunately, less than 30% of patients with advanced stage lung cancer receive palliative care within a year of diagnosis[8]. Patients who reside in rural areas or receive care in the community (vs. academic medical center) may be at increased risk for underutilization[9], presumably because of palliative care provider scarcity…

Palliative care knowledge, misconceptions, and functions

Only 18.2% (n = 14) reported they knew what palliative care was and could explain it (Table 2). Patients’ self-reported knowledge of palliative care was not significantly different by cancer treatment facility (community vs. academic medical center), residence (rural vs. urban), or availability of outpatient palliative care onsite (Table 2). 34.2% of women vs. 52.6% of men had never heard of palliative care (p = 0.052). Age was not significantly different across knowledge responses (M age for those who had never heard of palliative care = 66.7; SD = 10.0; M age for those who knew a little = 64.3, SD = 10.6; knew what it was and could explain it = 60.4; SD = 10.0, p = 0.158)…

Non-hospice palliative care (NHPC)


Patients reported positive attitudes towards NHPC (M = 24.83; SD = 7.98; range = 6–45). Attitudes towards NHPC were not significantly different by cancer treatment facility (M = 23.2; SD = 7.16 among academic medical center patients vs. M = 26.0; SD = 8.41 among community cancer patients; p = 0.14) or whether outpatient palliative care was available onsite (M = 23.88; SD = 8.25 among patients treated where outpatient palliative care was not available vs. M = 26.17; SD = 7.52 among those where outpatient palliative care was available, p = 0.233). Attitudes towards NHPC were also not significantly different by residence (M = 24.54, SD = 7.17 for rural patients; M = 25.35, SD = 9.38 for urban patients, p = 0.71), age (r = -0.01, p = 0.93), or sex (M men = 24.5; SD = 7.4; M female = 25.2; SD = 8.6, p = 0.73)…


Interventions to increase palliative care utilization among patients with advanced stage lung cancer need to address knowledge, misconceptions, and care delivery barriers, including lack of oncology provider discussions of palliative care during cancer treatment and cost and time concerns. Interventions should also assess patients’ care needs and inform patients of palliative care’s role in addressing those needs with their oncologist.

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