Patients with lung cancer often feel anxious, depressed or distressed. Here’s how to help.
Research shows that 50% of Australians living with lung cancer experience distress, anxiety or depression, greatly affecting their quality of life. Compared with other cancers, the prevalence of poor mental health is almost 30% higher.
Multidisciplinary team (MDT) care, including a specialist lung cancer nurse, is considered best practice for the diagnosis, treatment planning and care provided for people with any type of cancer. Despite this, it is estimated that only half of the people living with lung cancer are managed through MDTs.
For patients unable to access an MDT, particularly those in regional and rural areas, Lung Foundation Australia’s Lung Cancer Support Nurse can help bridge this gap. Health professionals can refer patients to this free and confidential service, which aims to complement and promote effective communication between patients and their treating team. The service also helps patients to self-manage symptoms and treatment side effects.
In 2020, Lung Foundation Australia’s Lived Experience Survey found that one in five patients are not confident managing their condition and two-thirds feel isolated. A lung cancer diagnosis can be an overwhelming and frightening experience.
Nicole Parkinson, a lung cancer support nurse at LFA, says patients can feel their diagnosis is “all-consuming, debilitating or even embarrassing”.
“Common struggles for patients with lung cancer can be related to any aspect of a person’s life: physical, mental, social, practical or financial,” Mrs Parkinson said.
“The impact of symptoms such as breathlessness, coughing, fatigue and pain can cause people living with lung cancer to refrain from their normal daily activities – and can even make it hard to socialise with family and friends.
“This can in turn lead to depression, anxiety, low self-esteem and shame.”
The Lived Experience Survey found that seven out of 10 living with a lung disease feel the community shows more sympathy towards sufferers of other cancers, and two-thirds feel isolated.
Asked to identify “pressure points” of living with lung cancer, the research highlighted challenges such as adapting to a shortened life span, loss of job and change in relationships. Patients also spoke of sometimes overwhelming emotions of anger, shame, shock and helplessness.
Mrs Parkinson says primary care physicians and nurses are ideally placed to identify supportive care needs at all stages, including diagnosis, during and after treatment. When the unique supportive care needs of someone living with lung cancer are addressed, patients report decreased distress and are more likely to adhere to treatment and clinical recommendations.
It is important to also consider the needs of caregivers and families, as well as factors such as changes in personal circumstances (such as illness of a caregiver or a change in household finances) and whether a patient may need a mental health treatment plan.
In a presentation to the 2020 Australian Lung Cancer Conference, clinical psychologist Dr Maria Ftanou outlined stark statistics:
- Up to 35% of people with lung cancer experience anxiety
- When it comes to scans, up to 73% experience anxiety
- Up to 40% experience depression, which affects sleep, appetite, memory and concentration
- Almost all people with lung cancer (95%) experience stigma, leading to low self-worth and blame
- Those who have recovered fear a recurrence of their cancer.
Dr Ftanou said a lung cancer diagnosis could also be stressful for friends, family and carers, who may have to take on additional roles, and feel overwhelmed and unsure about how best to help. They may need their own emotional support to cope with the diagnosis.
How to refer your patients
Referring patients to the Lung Cancer Support Nurse can complement your own health care. Patients are supported to self-manage their lung cancer symptoms and treatment side effects more effectively, given supportive care (allied health), referral recommendations and peer support options.
The service is also available for carers and family members, and can help them to better understand their loved one’s diagnosis and treatment plan. The support nurse will not seek to clinically manage a patient and you will receive a summary of the support provided.
To refer your patients, complete the digital referral form here.
Services for your patients
Lung Foundation Australia provides supportive care to people living with a range of other conditions including chronic obstructive pulmonary disease, bronchiectasis, pulmonary fibrosis and pulmonary hypertension. This includes a range of free resources and services such as the Lung Cancer Support Nurse, Respiratory Care Nurse, peer support and pulmonary exercise maintenance programs.
 Making Lung Cancer a Fair Fight: A Blueprint for Reform. Lung Foundation Australia, 2018. Retrieved from https://lungfoundation.com.au/wp-content/uploads/2018/10/Information-Paper-Making-Lung-Cancer-A-Fair-Fight_A-Blueprint-for-Reform-Oct2018.pdf