Management

People living with lung cancer have care needs across the physical, psychological, social, information, spiritual and practical domains[1]. These needs are referred to as supportive care needs, and it is important that they are screened for and addressed appropriately. When identified needs are addressed appropriately patients experience decreased distress, enhanced satisfaction with care, and are more likely to adhere with treatments and other clinician recommendations[2].

Primary care physicians and nurses are ideally placed to identify and respond to supportive care needs due to practice accessibility, clinician’s familiarity with patients and their families, and broad scope of practice. Patients in regional, rural and remote areas will rely most heavily on primary care clinicians to provide supportive care. It is important that the needs of caregivers and families are also considered and addressed appropriately.

Patients with lung cancer and their caregivers should be assessed for supportive care needs at key points of the care pathway3, including:

• Initial presentation, or at diagnosis
• At the commencement of treatment, or when treatment changes
• When a patient’s prognosis changes
• When treatment has ended
• During survivorship
• If disease recurs
• At a change in or development of new symptoms
• When patients experience any significant change in their personal circumstances, for example illness of caregivers or a change in household finances.

Optimal cancer care pathways (OCPs) describe optimal cancer care across the patient journey, aiming to foster an understanding of the whole pathway and its distinct components to promote quality cancer care and optimal patient experiences. OCPs are implemented nationally and available for many different cancers, including lung cancer.

OCPs are based on several key principles of care, including the following:

• Patient-centred care – referring to care that respects and responds to the needs, wishes and values of patients.
• Safe and quality care – achieved through appropriately trained and credentialled clinicians, and hospitals and clinics that are effectively resourced and evaluated.
• Multidisciplinary care – which provides an integrated team approach to healthcare in which medical and allied health professionals consider all relevant treatment options and collaboratively develop an individual treatment and care plan for each patient.
• Care coordination – to achieve continuity of care for patients, thereby ensuring that care is delivered in a logical, connected and timely manner so the medical and personal needs of the patient are met.
• Communication – to ensure that patients, their families and carers can communicate effectively with clinicians and care providers throughout their lung cancer treatment and survivorship.
• Research and clinical trials – participation should be offered to patients at any stage of the care pathway, as they play an important role in establishing efficacy and safety for a range of treatments, and identify benefits around psychological, supportive and palliative care interventions.
• Supportive care, which refers to services that lung cancer patients may require during their treatment and survivorship to address varied and changing needs.

The OCP also clearly outlines the ways that your patient’s leading lung cancer management clinician can be expected to communicate with your patient and with primary care professionals to work as a team in the treatment and management of their lung cancer.