Oncology Care in Non-Small Cell Lung Cancer—Personalizing the Treatment Plan

With potentially curative targeted and immunotherapies for non-small cell lung cancer, long term survival of at least 5 to 10 years is increasingly possible. A personalized, holistic, and multidisciplinary home healthcare treatment plan can help cancer patients transition from acute to chronic disease management. Factors to be considered include the patient's goals, treatment-related risks, the degree of metastasis, acute symptom management needs, and the desire and ability to participate in the treatment plan. The case history illustrates how genetic sequencing and immunohistochemistry testing guide treatment decisions. Strategies for pharmacological and nonpharmacological management of acute pain related to pathological spinal fractures are discussed. Care coordination that includes the patient, home care nurses and therapists, the oncologist, and the oncology nurse navigator is essential to transition the patient with advanced metastatic cancer to the highest possible functional status and quality of life. Discharge teaching should include early recognition and intervention for adverse effects of medications and signs or symptoms that may signal disease reoccurrence. The use of a written, patient-driven survivorship plan is important to assure diagnostic and treatment information is summarized, follow-up tests and scans are scheduled, and screening tests for other types of cancer are included.