CHEST Guidelines-Symptom-Management-in-Patients-With-Lung-Cancer

Symptom-Management-in-Patients-With-Lung-Cancer_ch

Pdf Summary

The American College of Chest Physicians (ACCP) has issued the 3rd edition of its guidelines on the diagnosis and management of lung cancer, focusing on symptom control to improve patient quality of life. The guidelines emphasize the importance of pain management, recommending a thorough assessment using patient-reported pain scales like VASs, NRSs, and verbal rating scales. For chronic pain, following the WHO analgesic ladder is advised, starting with acetaminophen and NSAIDs, and progressing to opioids for severe pain. Use of transdermal fentanyl is recommended only if oral administration is not possible.<br /><br />Other key areas of focus include the management of common symptoms such as dyspnea and cough, and complications like bone metastases and hemoptysis. For dyspnea, comprehensive evaluation of treatable causes is crucial, while cough may be addressed with specific therapies depending on the underlying cause.<br /><br />Management of bone metastases typically involves radiation therapy, supplemented with bisphosphonates for pain relief. In cases of spinal cord compression, urgent high-dose dexamethasone and radiotherapy or surgery are critical. The guidelines also cover palliation of brain metastases through corticosteroids, SRS, and possibly surgery.<br /><br />Superior vena cava syndrome resulting from lung cancer may be managed with chemotherapy or radiation therapy, and stent placement is advised if other treatments fail.<br /><br />The guidelines stress the need for multidisciplinary care and recognize that supportive care, integrating psychologic interventions, is essential for managing depression, fatigue, and insomnia in lung cancer patients. Ongoing monitoring and individualized treatment plans are recommended throughout the patient's illness. The guidelines point out the necessity for training healthcare professionals in managing lung cancer symptoms to support and improve patient care effectively.<br /><br />Overall, the ACCP guidelines aim to improve symptom management in lung cancer, leveraging evidence-based practices to enhance the quality of life for affected patients.

Keywords

lung cancer

symptom management

pain management

dyspnea

bone metastases

palliative care

multidisciplinary care

psychologic interventions

WHO analgesic ladder

patient quality of life