Project 1: Early Stage Lung Cancer focuses on Stages l-llla resectable lung cancer within a program project with central themes related to palliative care, quality of life (QOL), and symptom management. Project 1, Early Stage Lung Cancer, provides a model of integrating palliative care throughout the trajectory of disease. The project aims are:
Aim1 : Test the effects of the Palliative Care Intervention (PCI) on overall QOL and psychological distress for patients with Early (Stage l-llla) resectable NSCLC compared to a group receiving usual care.
Aim 2 : Compare symptom control in the PCI group versus the usual care group in Early Stage NSCLC.
Aim 3 : Compare geriatric assessment outcomes (OARS Instrumental Activities of Daily Living, MOS Activities of Daily Living, MOS Social Activities Limitation Scale, Hospital Anxiety and Depression Scale scores, and the Karnofsky Performance Scale) in the PCI group versus the usual care group.
Aim 4 : Test the effects of the PCI on resource use as compared to the usual care group.
Aim 5 : Identify subgroups of patients who benefit most from the PCI in relation to sociodemographic characteristics, treatment factors, and geriatric assessment predictors at the 12-week primary end-point. A two group, prospective sequential, quasi-experimental, tandem enrollment design (N=207) will be used for this study, in which the usual care group is accrued and followed during Phase 1 and the Palliative Care Intervention group is accrued and followed during Phase 2. The proposed PCI intervention combines preoperative assessment and goal setting related to QOL and symptom concerns through the collaboration of an interdisciplinary team. The Palliative Care Intervention is based on pilot work completed from 2005-2007 by the investigators documenting needs of lung cancer patients and testing the intervention. This project has great significance to public health given the significant numbers of people diagnosed with lung cancer and the associated individual and societal costs.
Lung cancer impacts elderly patients, creates extensive family and social burden and both psychosocial and financial consequences are substantial. Integration of palliative care into early stage lung cancer care can serve as a public health model to maximize both quality of life and health care resources.
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