Palliative care is a specific treatment modality that improves the quality of life of patients and families facing death from disease by controlling pain, relieving symptoms, and providing spiritual and social support. In China, the number of people requiring palliative care has increased significantly with the progress of the aging population and the expected increase in cancer incidence and mortality, and therefore it has become increasingly important to provide palliative care that meets WHO and NCCN standards.
Palliative care includes the management of the physical, spiritual, psychological and social needs of cancer patients. Palliative care can be initiated at the time of diagnosis and early stages of cancer, and can be adapted as the patient’s needs evolve. Studies have shown that the early introduction of palliative care not only improves the quality of life of patients with advanced cancer, but also increases survival rates and reduces caregiver depression and stress scores. There is strong evidence that combining palliative care with standard anticancer therapy or as a focus of treatment leads to better outcomes for patients and caregivers, so combining standard anticancer therapy with palliative care should be considered early in treatment for any patient with metastatic cancer and/or a high symptom burden. For patients with lung cancer, palliative care includes the use of palliative surgery, chemotherapy, radiation therapy, endocrine therapy, targeted therapy, immunotherapy, and/or other means of relieving the patient’s symptoms, such as pain and dyspnea. Patient comfort is a priority at all stages of treatment. Hospice care may be considered if the physician and patient agree that treatment has failed to slow or stop the progression of the cancer.
The goal of palliative care is to relieve symptoms, relieve pain, and improve quality of life. All lung cancer patients should be screened, evaluated and treated for symptoms throughout the course of palliative medicine. The symptoms to be screened include both common physical symptoms such as pain, dyspnea, fatigue, anorexia and cachexia, nausea and vomiting, constipation and diarrhea, and psychological problems such as sleep disturbance, anxiety and depression, and delirium.
Quality of life evaluation should be included in the overall evaluation system of lung cancer patients and in the evaluation of the efficacy of palliative care. The Chinese version of the European Organization for Research and Treatment of Cancer quality of life-C30 (EORTC QLQ-C30) (V3.0) is recommended for overall assessment, and the quality of life scale EORTC QLQ-C30 can also be used. The Chinese version of the European Organization for Research and Treatment of Cancer quality of life-C30 (EORTC QLQ-C30) (V3.0) is used for overall assessment, and the EORTC QLQ-LC13 is also used to screen and assess common symptoms in lung cancer patients.