Treatment decision-making in early stage lung cancer
Research type
Research Study
Full title
Understanding patients' experiences and their involvement in treatment decision-making for early stage non-small cell lung cancer.
IRAS ID
241030
Contact name
Hemangi Chavan
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Lung cancer is the leading cause of cancer death worldwide. The survival of patients with lung cancer in the UK remains low, amongst the lowest in Europe. Surgery remains the main treatment option for operable early stage non-small cell lung cancer (NSCLC). However, surgery is not without risk even in young and relatively fit patients. Several studies have reported immediate post-operative complications such as bleeding, prolonged air leak, infection, myocardial infarction and pulmonary emboli (Carver et al, 2007). Moreover, a number of patients are considered to be at high risk for major lung surgery because of co-existing health problems (Falcoz et al, 2007). Another treatment, stereotactic body radiation therapy (SBRT) has been introduced. This involves giving a high dose radiation to the well-defined area of the lung with cancer. Currently, SBRT is only considered in patients with early stage NSCLC with an unacceptable risk of surgical complications or who decline surgery (Lim et al, 2010).
Several studies have shown SBRT to be as effective as surgery in potentially operable patients (Crabtree et al, 2010; Chang et al, 2015; Treasure et al, 2015). However, there is a paucity of randomised trials to compare the results of surgery versus SBRT (Vallieres et al, 2012). Consequently, deciding the best treatment option in a given setting can be difficult. Patients are referred to a surgeon if surgery is an option or to oncologists if surgery is not an option. During their first consultation with the surgeon or oncologist patients receive information about the treatment for their lung cancer. This information may be given to patients in a variety of different ways with varying amounts of detail. It may also be presented by different medical teams in different ways by members of different teams caring for the patients. At present we do not know the best way to deliver this information to the patient, in what detail and what patients' preferences are in regards to involvement in making those treatment decisions.
In this research we would like to audio record the first clinic consultation between the patient and their surgeon or oncologist where the treatment for lung cancer will be discussed. The researcher will interview the patient and the doctor, and specialist nurse involved in these discussions for each patient participant. This will help in understanding patients' and health care professionals' perspectives and involvement in treatment decision-making. Patients will be asked to take part in follow up interviews at three months after their treatment. The aim of the interviews is to establish whether any changes have taken place in their knowledge, understanding and their experience of their diagnosis and treatment. Understanding patients' experiences, and their contribution to treatment decisions will help in identifying the strategies that patients and professionals can use, and already do use, to facilitate the treatment decisions in early stage lung cancer.
REC name
Wales REC 1
REC reference
18/WA/0328
Date of REC Opinion
9 Oct 2018
REC opinion
Further Information Favourable Opinion