Early palliative care and metastatic non-small cell lung cancer: potential mechanisms of prolonged survival

Chron Respir Dis. 2013 Feb;10(1):35-47. doi: 10.1177/1479972312471549.


Patients with advanced cancer experience a significant burden of physical symptoms and psychological distress at the end of life, and many elect to receive aggressive cancer-directed therapy. The goal of palliative care is to relieve suffering and promote quality of life (QOL) for patients and families. Traditionally, both the public and medical community have conceptualized the need for patients to make a choice between pursuing curative therapy or receiving palliative care. However, practice guidelines from the World Health Organization and leadership from the oncology and palliative care communities advocate a different model of palliative care that is introduced from the point of diagnosis of life-threatening illness. Early palliative care has been shown to provide benefits in QOL, mood, and health care utilization. Additionally, preliminary research has suggested that in contrast to fears about palliative care hastening death, referral to palliative care earlier in the course of illness may have the potential to lengthen survival, particularly in patients with advanced nonsmall-cell lung cancer. This review summarizes the literature on potential survival benefits of palliative care and presents a model of how early integrated palliative care could potentially influence survival in patients with advanced cancer.

Publication types

  • Review

MeSH terms

  • Adaptation, Psychological
  • Carcinoma, Non-Small-Cell Lung* / mortality
  • Carcinoma, Non-Small-Cell Lung* / pathology
  • Carcinoma, Non-Small-Cell Lung* / psychology
  • Carcinoma, Non-Small-Cell Lung* / therapy
  • Clinical Trials as Topic
  • Cost of Illness*
  • Disease Progression
  • Family Health
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / psychology
  • Lung Neoplasms / therapy*
  • Meta-Analysis as Topic
  • Palliative Care* / methods
  • Palliative Care* / organization & administration
  • Palliative Care* / psychology
  • Quality of Life / psychology
  • Survival Analysis
  • Terminal Care