Navigating advanced lung cancer care, patient-physician alliance, cancer stigma, and psychosocial support in Asia-Pacific: perspectives from patients, caregivers, and physicians.

Abstract

Background: Factors influencing holistic lung cancer care among advanced/metastatic non-small cell lung cancer (NSCLC) patients in Asia-Pacific are understudied. We identified gaps in lung cancer care from patients, caregivers, and physicians in Australia, Japan, Mainland China, South Korea, and Taiwan.

Methods: Qualitative interviews and quantitative surveys were conducted among NSCLC patients with limited targeted treatment options, caregivers, and physicians. Patient-caregiver paired interviews (n = 15) were analyzed narratively and thematically; survey findings (70 patients, 106 physicians) were summarized descriptively. Descriptive analyses were performed with no formal hypothesis testing.

Findings: While patients (53-66%) felt able to care for their condition, 47% were unaware of genetic mutations and 46% perceived delays in diagnosis (41-44% were unaware of symptoms/severity). Most physicians (78-90%) prioritized treatment discussions, 51% decided for patients, and 69% encouraged patient-led decisions. Patients (61-77%) relied on physician decisions; 71-76% prioritizing reduced recurrence and minimal side effects over physician recommendations (53%). Although patients (66%) felt cared for by their doctors, 24-31% felt their mental/physical well-being was not proactively addressed.

Conclusion: This study identified significant gaps in lung cancer care, including patients' suboptimal disease and treatment knowledge, limited patient-physician shared decision-making, cancer stigma, and inadequate psychosocial support; underscoring the need for tailored interventions in Asia-Pacific.