Educational needs of lung cancer patients unique

Quality of life key in common late-stage diagnosis

Each type of cancer needs a different education perspective, says Mary Szczepanik, MS, BSN, RN, manager of cancer education, support, and outreach at OhioHealth Cancer Services in Columbus.

While health care professionals tailor education to a person's learning style or their ability to read, education for cancer is different for one patient vs. another based on the disease itself and the stage in which it is detected, she explains.

For example, lung cancer is very different from many other cancers because it is more difficult to diagnose at an early stage and more difficult to cure. The average survival rate for people with lung cancer is 13 to 14 months, says Szczepanik.

According to the Atlanta-based American Cancer Society it is the leading cause of cancer death for both men and women. More people die of lung cancer than colon, breast, and prostate cancers combined.

A person with late-stage cancer has different educational needs than an early stage patient, says Szczepanik.

Patients diagnosed with stage one or two lung cancer will need information on the disease, its stage, and treatment options, along with their long- and short-term side effects. Also they need to learn about lifestyle changes they should make in order to help prevent a recurrence, explains Szczepanik.

In the early stages, surgery is usually an option; however the diagnostic workup is a lot different than other cancers. "It is a lot more in-depth," says Kelly Damman, RN, OCN, a lung health nurse at OhioHealth Cancer Care.

Pulmonary function tests help determine a person's breathing capacity if an entire lung or half a lung is removed. For example, if the left lung is removed it is important to determine how much lung capacity will remain from the right lung. If the test predicts the patient will only have 10% to 15% capacity it is too dangerous to do the surgery. "There is a lot of education just in the diagnostic process with lung cancer," says Damman.

Even when the cancer is removed through surgery patients must be taught that lung cancer should be viewed as a chronic disease. After surgery lung cancer patients need to be followed by an oncologist who will determine if they should have chemotherapy and watch them so that if their cancer does return it can be found early and treated.

It is important to help patients understand the severity of the disease without dashing all hope, says Damman.

Focus is quality of life

People diagnosed with stage three or four lung cancer are not going to get better, therefore education will focus more on symptom management, prognostic information, pain management, and emotional needs, says Szczepanik.

"Our No. 1 goal is quality of life," says Damman. For some lung cancer patients that means they will continue to smoke if they were a smoker when their disease was diagnosed. However, smoking cessation is an important part of education; patients will not only feel better but their risk for getting another lung cancer as well as infections of the respiratory system, including pneumonia, decrease, she explains.

In the higher stage lung cancer patient, radiation to decrease inflammation or the size of the tumor to manage symptoms is sometimes recommended to improve quality of life, says Szczepanik.

Late-stage patients also must be educated on the option of not having treatment as well as given information on hospice, says Damman.

Pain also is an issue. "It is important to educate patients that they don't need to be in pain and if they are with a physician who won't give them the pain medicine they need that means it is time to get another opinion, maybe switch to someone who will manage their pain," she says.

Patients should have the option of counseling as soon as possible so they can gain the tools they need to cope with the disease. It's important to help people learn how to deal with their feelings because the emotional state of cancer can be overwhelming, says Damman.

In addition, patients can be taught how to educate their family members and friends about lung cancer and what a devastating disease it is, says Damman. Lung cancer is considered the invisible cancer because few people talk about it. Although lung cancer was in the news when ABC news anchor Peter Jennings died of the disease in July 2005, it will not remain in the headlines, making word of mouth a good educational method, she says.

The list of educational needs for a lung cancer patient is long. "There are so many decisions for patients and families to make now, so many choices it is overwhelming for them. Part of education is helping them, not steering them in one direction or another, but making sure they truly understand the implications of one treatment vs. the implications of another," says Szczepanik.

Sources

For more information about educating lung cancer patients, contact:

  • Kelly Damman, RN, OCN, lung health nurse, OhioHealth Cancer Care, 3545 Olentangy River Road, Suite 511, Columbus, OH 43214. Phone: (614) 566-3899. E-mail: kdamman@OhioHealth.com.
  • Mary Szczepanik, MS, BSN, RN, manager, cancer education, support, and outreach, OhioHealth Cancer Services, 3535 Olentangy River Road, Columbus, OH 43214. Phone: (614) 566-3280. E-mail: szczepm@OhioHealth.com