Abstract
BackgroundIn the U.S., lung cancer accounts for 14% of cancer diagnoses and 28% of cancer deaths annually. Since no cure exists for advanced lung cancer, the main treatment goal is to prolong survival. Chemotherapy regimens produce side effects with different profiles. Coupling this with individual patient’s preferred side effects could result in patient-centered choices leading to better treatment outcomes. There are apparently no previous studies of or tools for assessing and utilizing patient chemotherapy preferences in clinical settings.The long-term goal of the study was to facilitate patients’ treatment choices for advanced-stage lung cancer. A primary aim was to determine how preferences for chemotherapy side effects relate to chemotherapy choices.MethodsAn observational, longitudinal, open cohort study of patients with advanced-stage non-small cell lung cancer (NSCLC) was conducted. Data sources included patient medical records and from one to three interviews per subject. Data were analyzed using Chi-square, Fisher’s Exact and McNamara’s test, and logistic regression.ResultsPatients identified the top three chemotherapy side effects that they would most like to avoid: shortness of breath, bleeding, and fatigue. These side effects were similar between first and last interviews, although the rank order changed after patients experienced chemotherapy.ConclusionsPatients ranked drug side effects that they would most like to avoid. Patient-centered clinical care and patient-centered outcomes research are feasible and may be enhanced by stakeholder commitment. The study results are limited to patients with advanced NSCLC. Most of the subjects were White, since patients were drawn from the U.S. Midwest, a predominantly White population.
Highlights
In the U.S, lung cancer accounts for 14% of cancer diagnoses and 28% of cancer deaths annually
None of the patient characteristics we tested showed statistical significance associated with the period that patients were willing to tolerate drug side effects
Interviews that occurred at enrollment were termed ‘before’ or ‘first interviews’ and those that occurred after patients had more chemotherapy, were called, ‘after’ or ‘last’ interviews
Summary
In the U.S, lung cancer accounts for 14% of cancer diagnoses and 28% of cancer deaths annually. Chemotherapy regimens produce side effects with different profiles. Coupling this with individual patient’s preferred side effects could result in patient-centered choices leading to better treatment outcomes. The long-term goal of the study was to facilitate patients’ treatment choices for advanced-stage lung cancer. The treatment options for non-small cell lung cancer (NSCLC) are based mainly on the stage of the cancer. Other factors, such as a person’s health status, lung function, and characteristics of the cancer, are considered. Islam et al BMC Cancer (2019) 19:835 toxicity profiles are involved in determining treatment choices, patient tolerability of chemotherapy, and treatment success [9]
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