Early palliative care. Fourth modality in metastasic lung cancer

Background. Many patients with metastatic lung cancer suffer from physical and psychological symptoms as well as of social and spiritual concerns. The goals of therapy are usually palliative. Factors like symptom control and quality of life are important in addition to prolonged survival in these circumstances. The randomised trial by Temel et al. presented here shows that early palliative care can reduce symptoms, improve quality of life and prolong survival. Objectives. The effect of early palliative care on quality of life and end-of-life care among ambulatory patients with newly diagnosed metastatic lung cancer was evaluated. Materials and methods. Patients with newly diagnosed metastatic lung cancer were randomised to treatment with standard therapy or standard therapy plus early palliative care. Quality of life and mood were assessed at baseline and at 12 weeks with the Functional Assessment of Cancer Therapy-Lung (FACTL) scale and the Hospital Anxiety and Depression Scale (HADS). The primary outcome was the change in quality of life at 12 weeks. The data of end-of-life care were collected from electronic medical records. Results. The palliative care group had significantly better quality of life and less depression. The end-of-life care was less aggressive and hospice care was integrated earlier and more often. The survival time was significantly prolonged. Conclusion. These data support the approach to integrate palliative care by a multiprofessional team early in the therapeutic concept for patients with newly diagnosed metastatic lung cancer.