The most common symptoms reported by newly diagnosed lung cancer patients are fatigue, pain, insomnia, and depression. Many patients also experience breathing difficulty and coughing that affects their physical functioning. Frequent communication is critical among the patient, family, and healthcare team to ensure better understanding of the side effects/symptoms of the disease and its treatment, and to decrease psychological distress.
The course of the patient's disease depends on the type of cancer and its biology. Some patients benefit from multiple chemotherapy regimens and experience long disease-free intervals before succumbing to the disease. The experience of living with chronic disease and ongoing treatment can have physical, social, and emotional consequences that ultimately affect the patient's quality of life.
Characteristics of advanced cancer that require coordinated supportive care include multiple physical needs, intense psychological distress manifested by anxiety and depression, and complex patient and caregiver needs.
The goals of palliative care, a philosophy and approach to managing serious illness that focuses on optimizing quality of life and minimizing distress across the illness trajectory, are best achieved if palliative care is integrated with life-prolonging therapies from the point of diagnosis. One of the most efficient ways of monitoring patients' needs is to coordinate the overall plan of management with the oncology team during times of crisis; this approach decreases fragmentation of care and promotes continuity.
Many review articles have documented the needs of oncology patients across the disease and treatment courses. Although there can be important cultural differences in regard to the degree of desired information disclosure, patients and their families generally desire information about specific treatments, the expected course of care, traditional as well as alternative approaches to treatment, ways to manage symptoms, and which community resources are available.
Patients also need information about the emotional aspects of their illness, and their expected course of emotional recovery. Patient and family needs for information can change over the course of illness. Evidence suggests that patients and families benefit from supportive services directed at their individual needs, including both physical and psychological needs.
Distress Definition and Assessment With Nursing Management
With the publication in 2008 of the Institute of Medicine (IOM) report, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, there is a growing national recognition that many patients and their families report unmet psychosocial needs, and that psychosocial assessment and treatment should be a standard of quality cancer care.
The National Comprehensive Cancer Network (NCCN) has published clinical practice guidelines for distress management (V.1.2010). The term ‘distress' was selected because it was considered more acceptable and less stigmatizing than other terms such as ‘psychiatric,' ‘psychological,' or ‘emotional,' and it can be defined and measured by self-report.