Patients With Lung Cancer May Need More Support, Education When Making Treatment Decisions

In a survey conducted by the Cancer Support Community, 33% of patients with lung cancer reported they were somewhat or not at all involved in the decision-making process, and 66% were not as knowledgeable about their treatment options as needed to make this decision.

Nearly half of patients with and survivors of lung cancer reported that they were not knowledgeable enough about their treatment options before making a decision with their doctor, which may highlight the need for more educational materials and in-person counseling during the decision-making process, according to results from a study presented at the 2020 World Conference on Lung Cancer.

Results from the survey also demonstrated that there may be a relationship between discussing treatment options with a doctor and a patient’s involvement in the decision-making process.

“With recent advances in early detection of lung cancer, biomarker testing and personalized treatment planning, effective patient-provider communication is more important than ever for short- and long-term survivorship,” said Kelly Clark, research manager at the Research and Training Institute at Cancer Support Community in Philadelphia, during the virtual presentation. “Open communication between patients and clinicians about treatment options and cancer experience is a critical step toward collaborative treatment decision making.”

Researchers assessed responses from 276 patients (mean age, 61.8 years; 67% women; 86% White) with lung cancer in the Cancer Support Community’s Cancer Experience Registry, “an online survey open to any adult ever diagnosed with cancer,” said Clark during the presentation. Patients in this study answered additional questions about their lung cancer diagnosis and treatment decision making.

Of the patients in this study, 82% had non-small cell lung cancer. The mean time since diagnosis for all patients was three years. In addition, 23% had cancer recurrence and 39% had metastatic cancer. With regards to treatment, 76% underwent chemotherapy and 28% received immunotherapy. More than half of the patients in this study — 58% — were currently undergoing treatment.

With regards to treatment decision making, 67% of patients reported that they were quite a bit or very much involved in the process compared with 33% who reported they were somewhat or not at all involved. In addition, 34% reported being quite a bit or very knowledgeable about their treatment options before going through the treatment decision-making process versus 66% who were somewhat or not at all knowledgeable about their options.

Findings also determined that 38% of patients would have liked more support before treatment decision making compared with 42% who did not feel that they needed more support. Sixty percent of patients were somewhat or not at all prepared to discuss treatment options with their doctor compared with 40% who reported they were quite a bit or very much prepared to do so.

Preparation to discuss treatment options with the doctor was positively correlated with involvement in the treatment decision-making process and knowledge about treatment options. Patients with income greater than $40,000 were more likely to be more prepared, have more knowledge about treatment options and were more involved in the treatment decision-making process compared with those with income less than $40,000.

“(This is) suggesting that those with lower income may have less access to treatment decision-making resources compared to their economically advantaged counterparts,” said Clark during the presentation.

There was a small yet statistically significant difference regarding sex and preparation for treatment option discussions with their doctor. Women were more likely than men to report feeling prepared for these discussions. In contrast, treatment decision-making factors did not differ by race, age and lung cancer subtype.

“Results suggest involvement alone is insufficient for an informed treatment decision-making experience, and highlight a need for additional resources such as treatment decision-making guides or in-person counseling to enhance health care team communication surrounding treatment decision making for individuals with lung cancer, particularly for economically disadvantaged individuals. Such efforts may provide patients better knowledge about treatment options, thus enhancing their preparation to discuss and select the appropriate treatment pathway.”

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