Quality-of-Life Assessment for Lung Cancer

A cure for lung cancer may be possible, but unlikely given that its biology is such that cure appears to be unlikely in any individual case.

Lung cancer is a disease that forms in the cells in the lungs, is characterized primarily by a growth of abnormal cells, and causes cells to grow and spread uncontrollably. In 2013 lung cancer resulted in about 467,000 deaths in the US. It is the number one cause of death from cancer among people aged 45 and over, and the 5th most common cause of cancer mortality overall. Smoking is an important risk factor in the development of lung cancer.

Symptoms of lung cancer include shortness of breath when lying flat, cough or weight loss. These may be not noticeable or only reported by the person in question if they have had lung cancer before. There may be an unexplained raised sedimentation rate. A cough lasting over a fortnight may in an elderly person indicate lung cancer. A small lump in the throat may prompt a further referral. It is also not uncommon for people with lung cancer to complain of chest pain. Some people with lung cancer may just have pleurisy or interstitial lung disease.

The average number of patients diagnosed with lung cancer is around 5,900 annually. In recent years, rates have been increasing in all states, but these increases appear to be due to increases in the average number of patients diagnosed because improvements in detection and/or treatments have been insufficient. It is unclear at what level these increases are due the most—either population level increases or changes in the stage at which lung cancer is diagnosed.

The causes of [lung cancer](https://www.withpower.com/clinical-trials/lung-cancer)s may include cigarette smoking and radon exposure. Smoking is strongly linked to the risk for both lung cancer and cancers of the lungs that respond better to tobacco treatments. In areas with widespread radon exposure, the risk increases substantially with increasing level of exposure, and in areas where radon exposure occurs by breathing the air in areas of high concentrations, the risk increases with time of exposure. People with lung cancer who are heavy smokers have a higher risk of lung cancer, and lung cancer is more common among men than among women. Both viral infection and genetic changes in the immune system have been proposed as explanations for cancer development. The role of inhaled toxins and the role of viruses in cancer have not been clearly established.

Most physicians are familiar with many of the treatments for localized and advanced lung cancer, but there remains room for more effective treatment and improved knowledge in managing lung cancer.

There are many types of treatment available that have shown efficacy for delaying or halting the spread of lung cancer. They include systemic chemotherapy, radiation, biologic therapies (i.e. drugs), surgical resection and targeted therapy. Recently, the use of targeted therapies has been very successful in slowing down the disease. For small cell lung cancer, targeted treatment with a small molecule inhibitor of epidermal growth factor receptor has been shown to enhance the efficacy of chemotherapy. In addition to the advances in pharmaceutical treatment for lung cancer, there are also many advances in surgical treatment of lung cancer. One of the most important advances has been the introduction of lobectomy in lieu of complete pneumonectomy if the condition is optimally controlled by chemotherapy.

Quality of life improvement may be the most important benefit of treatment. Physicians caring for patients with lung cancer have a responsibility not only to optimize treatment but also to reduce side effects.

QOL assessments are more effective than a placebo among both patients with advanced or recurrent lung cancer and their caregivers, and appear to improve both patient and caregiver QOL. QOL assessments will continue to occupy the primary role in lung cancer clinical trials.

There is high-quality evidence that the EQ-5D-5L questionnaire is valid to be used as a proxy HRQoL assessment in people with lung cancer and that it is a useful tool for assessing HRQoL in people. The data from this meta-analyses should help health professionals to decide the questionnaires that will best support patient decisions about treatment options.

In our study, most respondents found quality of life assessments to be helpful in decision making on treatment. Although side effects are common, they do not hinder the decision making process. The most troublesome side effects are dysphagia, hypoalbuminemia, weight loss, and low self-esteem. For healthcare providers and their patients, QoL assessments are helpful in deciding treatment and in evaluating the treatment's outcomes, and it is also an important strategy to help patients with lung cancer live as much as possible, in spite of side effects.