Symptom assessment in patients with advanced lung cancer at the in-patient palliative care unit and at home palliative care

Introduction: Symptom assessment in patients with advanced lung cancer (ALC) is an important issue in palliative care. The aim of the study was to assess pain and other symptoms intensity in ALC patients treated at in-patient palliative care unit and at home.
Material and methods: A prospective study of 50 consecutive patients cared at in-patient palliative care unit (IPU, 25 patients) and at home hospice (HH, 25 patients). The following instruments were used: visual analogue scale (VAS) for pain, EORTC QLQ C 30 and LC 13 for other symptom assessment. Measurements were performed twice with 10 day interval in each patient group. The NSCLC and SCLC were equally frequently diagnosed in both groups.
Results: The most frequent symptoms in both patient groups were as follows: dyspnoea (over 90% of patients), fatigue (90%), weakness (80%), constipation (60%) and anorexia (50%). At the second evaluation weakness intensified at IPU, dyspnoea and dyspnoea at rest were more intense in HH, haemoptysis was less intense at IPU. The intensity of alimentary symptoms did not change in both groups but loss of appetite was more intense in HH. Pain intensified at IPU (mean VAS 6.4 and 7.12), and was stable at HH (mean VAS 5.44 and 5.72) at the first and at the second assessment respectively.
Conclusions: The intensity of pain was significant in both patient groups and intensified at IPU. The symptomatic management of patients with ALC should incorporate more intense treatment of dyspnoea, fatigue, weakness, constipation, loss of appetite and above all pain.