Advances have been made in the treatment of lung cancer, but the disease continues to be a challenge to treat, primarily because of a high number of people who have late-stage cancer at the time of diagnosis, the likelihood of poor outcomes, and a greater symptom burden.
To explore how patients with lung cancer are perceived, researchers led by a team at the University of Texas Southwestern Medical Center reviewed data from clinician reports for more than 3,000 patients with solid tumors to see whether the perceptions about patients with lung cancer differed from those about patients with other types of cancer. Data had been gathered as part of the Eastern Cooperative Oncology Group Symptoms Outcomes and Practice Patterns study. Their findings are published in the December issue of the International Association for the Study of Lung Cancer's journal, the Journal of Thoracic Oncology (JTO).
The researchers found that, overall, clinicians were more pessimistic about patients with lung cancer compared with patients with breast, colon, or prostate cancer. Clinicians rated patients with lung cancer as more difficult to treat and as having a poorer quality of life and more difficulties related to cancer, comorbidities, treatment, and weight change. When other explanatory factors were considered for these differences (such as stage of disease and overall health of the patient), however, differences remained only for perceptions of quality of life and weight difficulties. In fact, even after accounting for these other explanatory factors, there was nearly four times the odds of clinicians perceiving patients with lung cancer to have a poor overall quality of life.
"The findings of this study suggest that certain clinician judgments, such as quality of life and weight problems, may have been influenced by preexisting ideas about patients with lung cancer and their treatment options," says lead author Heidi A. Hamann, PhD, of the University of Texas Southwestern Medical Center and Harold C. Simmons Cancer Center, Dallas. Although the results seem to indicate a subtle underlying bias, further investigation is needed to determine if this bias is real or if, instead, clinicians based their perceptions in part on other unmeasured factors.
Coauthors of the study include IASLC members Joan Schiller, MD, also of the University of Texas Southwestern Medical Center, and Leora Horn, MD, of Vanderbilt University, Nashville, Tennessee.