Once the histology and stage of the tumour
have been established, it is important that the
patient’s fitness to undergo treatment is more
thoroughly assessed. This assessment is based
on a combination of measurable physiological
parameters such as lung, cardiac and renal
function, and also on functional capabilities
as described by the patient (Khoshbin and
Kirk 2008, Lim et al 2010). The patient’s
functional ability is graded using the Eastern
Cooperative Oncology Group performance
status (ECOG PS) (Oken et al 1982) (Table 1).
The findings of the assessment are used to help
the clinician determine the most appropriate
treatment, predict the chance of the patient coping with the side effects of treatment and
ensure that the benefits of such treatment
outweigh any risks.
Shared decision making between the patient
and healthcare professionals is essential.
The patient’s wishes must be considered and
each individual will have different views
about treatment outcomes and what he
or she is willing to accept in terms of side
effects (D’Addario et al 2010, NICE 2011).
The lung cancer specialist nurse can provide
accurate and timely information to patients
and their carers, and assess the individual’s
physical, social and emotional needs to ensure
appropriate support is available.