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M. Jacobson



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    OA16 - Improving the Quality of Lung Cancer Care - Patients Perspective (ID 399)

    • Event: WCLC 2016
    • Type: Oral Session
    • Track: Patient Support and Advocacy Groups
    • Presentations: 1
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      OA16.06 - Willingness for Multiple Biopsies to Improve Quality of Lung Cancer Care: Understanding the Patient Perspective (ID 6052)

      16:00 - 17:30  |  Author(s): M. Jacobson

      • Abstract
      • Presentation
      • Slides

      Background:
      In this era of precision medicine, biomarker testing of cancer tissue is sometimes necessary to match the right patient to the right treatment. A patient might need multiple biopsies if there is recurrence of lung cancer, or to determine eligibility for a new drug or participation in a clinical trial. Anecdotal evidence suggests that physicians are unwilling to recommend additional biopsies because they assume that the patients are likely to refuse.

      Methods:
      To understand this patient-physician communications gap, we asked 340 lung cancer survivors through an online survey about their willingness to undergo additional biopsies. The survey was fielded through various social media platforms as well as through an independent research panel.

      Results:
      Three-quarters of the survivors surveyed indicated their willingness to have an additional biopsy, regardless of whether they reported any pain or complications from their initial biopsy. Specifically, among the survivors who were willing to undergo an additional biopsy: Almost all of the survivors (82%) would do so if it would help their health care team better match treatment to their specific cancer and personalize their care, versus just being told the test was to look for mutations. In other words, understanding the end benefit of having the test is an important piece of communication. Although almost 50% reported pain or complications from their initial biopsy, this group indicated equal willingness to have another biopsy as those without any issues. If the doctor were to recommend an additional biopsy or a biopsy after the start of treatment, nearly half would definitely undergo one. About two-thirds of the survivors felt that their doctor explained the reason for getting their initial biopsy really well.

      Conclusion:
      The study reinforces the importance of a patient-centric model in medicine–in which meaningful and timely information is provided to patients to enable them to be partners in their own care. The study has the following implications for different stakeholders: Patients: To ask their doctor about new treatments and discuss the need for additional biopsies if necessary. Understanding the end benefit of having the test is an important piece of communication. Patient Advocacy Organizations: To educate patients and physicians about having an open dialogue to help patients become equal partners in their treatment decision-making. Physicians: To discuss the benefits and the risks of an additional biopsy with their patients and how it may help decide course of treatment.

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    P2.08 - Poster Session with Presenters Present (ID 491)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Patient Support and Advocacy Groups
    • Presentations: 1
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      P2.08-005 - Treating Cachexia-Anorexia in Lung Cancer Patients: Understanding the Patient Perspective on Novel Treatment Approaches (ID 6284)

      14:30 - 15:45  |  Author(s): M. Jacobson

      • Abstract

      Background:
      Cachexia-anorexia (CA) is a weight loss/appetite loss syndrome commonly affecting cancer patients. It is characterized by progressive sarcopenia (loss of muscle mass) accompanied by weight and appetite loss. These physiological changes lead to a decreased ability to perform daily activities, a reduction in the quality of life of the patient, and a decrease in the efficacy of chemotherapy and other treatments. Typically, oncologists focus on palliation of the symptoms of CA, and the reduction of distress of patients and families instead of on a cure. Recently, drugs that offer the possibility of treatment have shown promise in clinical trials.

      Methods:
      We conducted an online survey of lung cancer patients to understand: Prevalence of CA among lung cancer patients Extent of impairment of quality of life of lung cancer patients How patients are managing the symptoms of CA The study was approved by Schulman IRB, Inc (IRB#201600600). Three hundred and thirty-five lung cancer patients were surveyed through different online platforms (social media and LUNGevity homepage).

      Results:
      Of the lung cancer patients surveyed, Six in ten report experiencing one or more of the physical changes asked about (unintended weight loss, loss of appetite, loss of muscle mass, and malnutrition) Patients currently undergoing treatment and Stage IV patients are more likely to experience these changes and be concerned than those who are not currently undergoing treatment or have less advanced lung cancer Unintended weight loss and other physical changes are most likely to lead to a decline in patients’ strength, energy level, and ability to engage in physical activities. Among patients who experienced a decrease in quality of life, the most important aspects they would like to improve or maintain are their energy level and their ability to remain independent. Patients were measured in their willingness to try new treatment approaches, especially when presented with a description of the adverse events associated with treatment.

      Conclusion:
      Cachexia-anorexia is common in lung cancer patients, including early-stage patients. Patient attitudes towards CA differ among those whose quality of life has been impaired due to weight loss and those who are able to continue living a normal life. Maintaining a sense of independence was of primary importance to all patients. Their willingness to try new treatment options, however, is based on understanding both the benefits and risks of these treatments, suggesting that a well-informed patient is more effectively engaged in their treatment decisions.