Palliative care (ASCO plenary)

Despite significant advancements in treatments for lung cancer, many patients still face challenging side effects, including anxiety, depression, and overall declines in quality of life. Recognising the need for comprehensive care, the American Society of Clinical Oncology has developed guidelines recommending the integration of early palliative care for patients with advanced cancers, especially lung cancer. However, the availability of specialty-trained clinicians to provide such care is limited, creating a resource burden.

In response, the Massachusetts General Hospital team explored novel models of delivering early palliative care that are more efficient and scalable, particularly through telehealth using video visits. This idea emerged before the pandemic, at a time when the effectiveness of telehealth was not fully established. The primary question the team sought to answer was whether video-based palliative care could be as effective as in-person care in improving patients’ quality of life.

To address this, the study mirrored the structure of previous trials that involved monthly in-person palliative care visits. Participants were assigned either to monthly in-person visits or to video visits, with the video group beginning with an initial in-person visit to establish rapport before transitioning to video.

The results were promising. Both care models—whether delivered in person or via video—demonstrated equivalent effects on patients’ reported quality of life. This was measured using the Functional Assessment of Cancer Therapy Lung Scale, which assesses various aspects of well-being and lung cancer-specific symptoms. The study also found no significant differences between the two groups in other outcomes, such as mood symptoms, satisfaction with care, caregiver quality of life, and patient coping strategies. This suggests that video-based palliative care can effectively support patients with advanced lung cancer, offering a viable alternative to traditional in-person care.