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

Abstract

BackgroundFactors 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.MethodsQualitative 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.FindingsWhile 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.ConclusionThis 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.