A longitudinal perspective of the symptom experience of patients with lung cancer near the end of life

Lung cancer patients unrelieved symptoms are associated with poor quality of life. Understanding their symptoms can direct interventions to enhance quality of life. This longitudinal study explored the symptoms of patients with advanced lung cancer by examining changes in symptom frequency, severity, and distress and their relationship with quality of life and functional status. Eighty patients with advanced lung cancer were interviewed within 1 month of diagnosis and at 2- and 4-month follow-up periods. Fifty percent of patients died within 5 months of diagnosis. Patients reported less symptom frequency and severity over time but no significant changes in symptom distress. Lack of energy, pain, shortness of breath, cough, and difficulty sleeping were the most common symptoms. The patients reported increased pain frequency, decreased severity in sleeping difficulties, and decreased distress related to shortness of breath. The 11 most commonly occurring symptoms were inversely related to quality of life. Five of these symptoms were negatively associated with functional status. Although symptom prevalence and severity decreased over time, symptom distress did not. Frequent and ongoing symptom assessment that includes perceived distress is paramount to direct interventions to enhance quality of life and functional status of patients with advanced lung cancer.