Educated Patient® Lung Cancer Summit Early Introduction to Palliative Care Presentation: October 1, 2022

Integrating palliative care, or supportive care, may be just as important as the anti-cancer therapies a patient receives when their cancer team aims to improve their quality and quantity of life, according to an expert.

In particular, palliative care can include mind-body modalities like yoga, exercise, acupuncture and nutritional interventions, among other approaches, Dr. Jessica R. Bauman presented at the CURE®’s Educated Patient® Lung Cancer Summit. These approaches can potentially reduce depression anxiety and increase survival, quality and quantity of life, and communication about care.

“Our goal is to help patients live as long and as well as they can,” said Bauman, program director of the hematology-oncology fellowship and thoracic head/neck medical oncologist at the Fox Chase Cancer Center in Philadelphia. “It's not just about the cancer treatment that they're receiving, but it is also about the supportive care and how they are approaching those aspects of their cancer diagnosis; how it impacts their family, how it impacts their whole livelihoods. Having a care team that is paying attention to those aspects as well is really helpful for them to be able to cope and live with what can be a devastating diagnosis.”

Unmet Need in Supportive Care

Most patients (76%) previously reported unmet needs during their cancer care including physical and psychological symptom support, having someone to talk to about their disease and informational needs, according to the presentation. In addition, at least a third of patients reported having an inaccurate understanding of their diagnosis and/or prognosis.

Bauman discussed how an integrative approach can enhance the supportive care patients receive. This combination of a traditional cancer team with an added palliative care approach addresses the immediate health and disease concerns while also addressing exercise, dietary and spiritual needs.

The benefits of proper diet and exercise have long been emphasized to all patients with cancer, but patients diagnosed with lung cancer may be most likely to experience severe malnutrition (up to 69% of patients) compared with all cancer types. Regardless of a patient’s weight status before a cancer diagnosis, their care may be negatively affected.

Malnutrition may lead to an increased risk for mortality, risk of recurrence, side effects and hospital readmission rates, along with decreased chemo/radiation tolerance and quality of life. Some beneficial interventions may include fish oil, protein supplements, dietary counselling and medically tailored meals.

“There certainly have been some decently sized studies from a nutritional aspect that do show improvements in nutrition,” Bauman told CURE®. “We know that malnutrition can really lead to detrimental outcomes for patients with lung cancer, so more attention to nutrition and nutritional interventions … is actually very critical to us as oncologists taking care of patients with lung cancer.”

Mind-Body Modalities

An integrative approach to supportive care is also unique for focusing on mind-body modalities, which are behaviors and practices such as yoga and tai chi.

Addressing the spiritual needs of patients with lung cancer has been shown to improve depressive symptoms and quality of life.

“There's many decades or hundreds of years of Chinese traditions from an acupuncture perspective, but also some of the mind-body in terms of yoga and tai chi,” Bauman said. “In some ways these traditions are very, very old, but the understanding how they're affecting the body and the biology of cancer, as well as the biology of the immune system, is really important so we can understand what are the improvements that we can see for our patients (and) can we, in fact, recommend these things.”

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