Symptom burden and willingness to participate: implications for herbal clinical trials in lung cancer

Background: People with lung cancer are interested in using herbs for symptom management. However, well-designed clinical trials are lacking. We aimed to quantify symptom burden and willingness to participate in herbal clinical trials among this population. Methods: We conducted a cross-sectional analysis using data collected from people with lung cancer at an oncology clinic at an academic cancer center. The primary outcome was self-reported willingness to participate in herbal research. We measured symptoms using the MD Anderson Symptom Inventory (MDASI). Multivariate logistic regression was performed to explore the relationship between demographic/clinical factors, symptom burden, and willingness to participate in herbal studies. Results: Among 288 participants, 55% were female, 42% were >65 years, 54% had stage IV cancer, and 86% had non-small cell lung cancer (NSCLC). Nearly half (46%) indicated willingness to participate in an herbal clinical trial. The most commonly reported moderate to severe symptoms (>= 4 on the MDASI scale) were fatigue (57%), drowsiness (44%), disturbed sleep (43%), distress (42%), and dyspnea (36%). In multivariate analyses, higher education was significantly associated with willingness to participate in herbal studies (adjusted odds ratio 1.87, 95% confidence interval, 1.12-3.10, P=0.016), while symptom burden was not. Conclusions: People with lung cancer experience high rates of symptom burden. Nearly half of our participants expressed willingness to participate in an herbal clinical trial, particularly those with higher education. These findings can inform the design of future herbal clinical trials targeting common symptoms in lung cancer populations.