Dyspnea Management in Early-Stage Lung Cancer: A Palliative Perspective

Williams, Anna Cathy BSN, PHN, RN; Grant, Marcia DNSc, FAAN, RN; Tiep, Brian MD; Kim, Jae Y. MD; Hayter, Jennifer MA, OTR/L, SWC, CLT-LANA

Journal of Hospice & Palliative Nursing: July 2012 - Volume 14 - Issue 5 - p 332–340
doi: 10.1097/NJH.0b013e318258043a
Symptom Management Series

A new cohort of lung cancer patient is on the horizon. With rapidly evolving diagnostics and treatment methodology, early-stage non–small cell lung cancer patients are increasing in numbers. Although stage I-II patients are deemed “curable,” there linger threats of recurrence, new primaries, and existing or imposed comorbidities due to the treatment itself. Consequently, the outlook remains tenuous for this population. With improving survival rates, it is imperative that patients with early-stage non–small cell lung cancer be fully assessed, aggressively managed, and followed up long term, according to the National Comprehensive Cancer Network guidelines. Dyspnea is one of the most frightening of all symptoms, regardless of diagnosis and stage of any disease. It accompanies feelings of suffocating and even impending death. Given the subjectivity of dyspnea, it is critical to assess the impact it imposes on quality of life for each patient and their loved ones. Cognizant of the abundance of care involved in such cases, it is the palliative care nurse who is the core advocate and coordinator of services. Through a comprehensive care plan and interdisciplinary effort, healthcare professionals may be able to offer early-stage non–small cell lung cancer patients with dyspnea stellar evidence-based intervention and hopefully a greater chance of possessing a sense of normalcy in their lifestyles.

Anna Cathy Williams, BSN, PHN, RN, is Senior Research Specialist, Division of Nursing Research & Education, Department of Cancer Control & Population Sciences, City of Hope, Duarte, California.

Marcia Grant, DNSc, FAAN, RN, is Director and Professor, Division of Nursing Research & Education, Department of Cancer Control & Population Sciences, City of Hope, Duarte, California.

Brian Tiep, MD, is Staff Physician, Critical Care Medicine, Department of Medical Specialists, City of Hope, Duarte, California.

Jae Y. Kim, MD, is Staff Surgeon, Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, California.

Jennifer Hayter, MA, OTR/L, SWC, CLT-LANA, is Director, Expense Rehabilitation Services, City of Hope, Duarte, California.

Address correspondence to Anna Cathy Williams, BSN, PHN, RN, Division of Nursing Research & Education, Department of Cancer Control & Population Sciences, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010 (acwilliams@coh.org).

The authors have no conflict of interest to disclose.

This work is supported by a grant from the National Cancer Institute (PO1 CA–136396–Palliative Care for Quality of Life and Symptom Concerns in Lung Cancer; B. Ferrell, PI).

© 2012 The Hospice and Palliative Nurses Association