Assessment and Management of Symptoms for Outpatients Newly Diagnosed With Lung Cancer.
BACKGROUND
Little is known about symptom assessment around the time of lung cancer diagnosis. The purpose of this pilot study was to assess symptoms within 2 months of diagnosis and the frequency with which clinicians addressed symptoms among a cohort of veterans (n = 20) newly diagnosed with lung cancer. We administered questionnaires and then reviewed medical records to identify symptom assessment and management provided by subspecialty clinics for 6 months following diagnosis.


RESULTS
Half (50%) of the patients were diagnosed with early-stage non-small-cell lung cancer (NSCLC), stage I or II. At baseline, 45% patients rated their overall symptoms as severe. There were no significant differences in symptoms among patients with early- or late-stage NSCLC or small-cell lung cancer. Of the 212 clinic visits over 6 months, 70.2% occurred in oncology. Clinicians most frequently addressed pain although assessment differed by clinic.


CONCLUSIONS
Veterans with newly diagnosed lung cancer report significant symptom burden. Despite ample opportunities to address patients' symptoms, variations in assessment exist among subspecialty services. Coordinated approaches to symptom assessment are likely needed among patients newly diagnosed with lung cancer.
Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA Department of Biobehavioral Nursing and Health Systems, University of Washington, School of Nursing, Seattle, WA, USA reinkl@uw.edu.
Lynn F
LF
Reinke
Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA Pulmonary and Critical Care Medicine Division, University of Washington, School of Medicine, Seattle, WA, USA.
Laura C
LC
Feemster
Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA University of Washington, School of Surgery, Cardiothoracic Surgery Division, Seattle, WA, USA.
Leah M
LM
Backhus
Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA.
Ina
I
Gylys-Colwell
Department of Veterans Affairs, Puget Sound Health Care System, Health Services R&D, Seattle, WA, USA Pulmonary and Critical Care Medicine Division, University of Washington, School of Medicine, Seattle, WA, USA.
David H
DH
Au
D000368:Aged; D000072716:Cancer Pain / Q000503:physiopathology / Q000628:therapy; D019468:Disease Management; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010045:Outpatients; D010865:Pilot Projects; D011788:Quality of Life; D012720:Severity of Illness Index; D013727:Terminal Care / Q000458:organization & administration*; D014186:Transportation; D014481:United States; D014728:Veterans
lung cancer; management; newly diagnosed; symptom assessment