ADVANCED NON-SMALL CELL LUNG CANCER (NSCLC): PATIENTS’ ILLNESS PERCEPTIONS AT DIAGNOSIS

Abstract

Lung cancer is the leading cause of cancer-related death worldwide with non-small cell lung cancer (NSCLC) being the most common type. Advanced NSCLC is not curable and carries a poor prognosis. It also is associated with the highest burden on mental and physical health-related quality of life (HRQoL) of all patients with cancer. Patients’ subjective experience with their illness and treatment (illness perceptions) may influence treatment decision making and health outcomes, including HRQoL. Illness perception studies with patients with lung cancer are reviewed. Using Leventhal and colleagues’ Self-Regulation Model to better understand patients’ experience and coping with their advanced-stage NSCLC (N=156) assessed illness perceptions (Illness Perception Questionnaire-Revised [BIPQ]) and HRQoL (EuroQol-visual analogue scale [EQ-VAS]). Patients reported high perceived consequences and stress (concern) at diagnosis along with moderate levels of symptoms (identity) and belief in their ability to manage their NSCLC (personal control). Patients reported low HRQoL compared to population norms. The illness perceptions of consequences, concern, and identity were negatively correlated with HRQoL, while personal control was positively correlated with HRQoL. Assessment of illness perceptions provides a nuanced understanding for patients as they cope with cancer diagnosis. To advance study, prospective longitudinal designs might study how illness perceptions might relate to HRQoL trajectories of patients with newly diagnosed advanced NSCLC as they receive first and later lines of cancer therapies.

Keywords

• non-small-cell lung cancer
• illness perceptions
• stress
• quality of life
• cancer diagnosis