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J Pain Symptom Manage. 2015 Dec;50(6):758-67. doi: 10.1016/j.jpainsymman.2015.07.005. Epub 2015 Aug 19.

Interdisciplinary Palliative Care for Patients With Lung Cancer.

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Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA. Electronic address:
Division of Nursing Research and Education, Department of Population Sciences, City of Hope, Duarte, California, USA.
Department of Medical Oncology and Therapeutics Research, City of Hope, Duarte, California, USA.
Division of Thoracic Surgery, Department of Surgery, City of Hope, Duarte, California, USA.
Vital Research, LLC, Los Angeles, California, USA.



Palliative care, including symptom management and attention to quality of life (QOL) concerns, should be addressed throughout the trajectory of a serious illness such as lung cancer.


This study tested the effectiveness of an interdisciplinary palliative care intervention for patients with Stage I-IV non-small cell lung cancer (NSCLC).


Patients undergoing treatments for NSCLC were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. Patients in the intervention group were presented at interdisciplinary care meetings, and appropriate supportive care referrals were made. They also received four educational sessions. In both groups, QOL, symptoms, and psychological distress were assessed at baseline and 12 weeks using surveys which included the Functional Assessment of Cancer Therapy-Lung and the Lung Cancer Subscale, the 12-item Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being, and the Distress Thermometer.


A total of 491 patients were included in the primary analysis. Patients who received the intervention had significantly better scores for QOL (109.1 vs. 101.4; P < 0.001), symptoms (25.8 vs. 23.9; P < 0.001) spiritual well-being (38.1 vs. 36.2; P = 0.001), and lower psychological distress (2.2 vs. 3.3; P < 0.001) at 12 weeks, after controlling for baseline scores, compared to patients in the usual care group. Patients in the intervention group also had significantly higher numbers of completed advance care directives (44% vs. 9%; P < 0.001), and overall supportive care referrals (61% vs. 28%; P < 0.001). The benefits were seen primarily in the earlier stage patients vs. those with Stage IV disease.


Interdisciplinary palliative care in the ambulatory care setting resulted in significant improvements in QOL, symptoms, and distress for NSCLC patients.


Lung cancer; distress; interdisciplinary care; palliative care; quality of life; symptoms

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