ASCO 2023: Surviving and Thriving with Lung Cancer 

By Brittney Nichols, MPH, RN-BSN, Science and Research Specialist, GO2 for Lung Cancer 

New treatments, developments, and scientific breakthroughs are always one of the most exciting aspects of the annual American Society of Clinical Oncology (ASCO) conference, but this year they weren’t the only highlight. People with lung cancer, survivors, and dedicated providers took the stage to share both stories and studies, with the aim of improving life. Not just extending it–but improving the quality of it to make life with and after cancer better and brighter.  

Accessibility of care  

We live in an era of non-stop innovation. But these innovations will not benefit people with lung cancer if they’re unable to access them. This issue was addressed in multiple ways at ASCO this year.  

Several presentations covered the concept of Social Determinants of Health (SDOHs), which is how factors such as residence, finances, and education (among others), combined with racial and identity demographics, affect our health and the care we receive. Healthcare research teams are starting to search for new ways to confront this by using technology.  

A recurrent theme throughout these discussions was trust. A person who is in a safe and trusted environment will be able to share with their oncologist what their specific needs are, and providers who create and engage in these safe spaces with their patients will then be able to address their unique situation in the best way possible.   

Affordability of care  

A recent buzzword that’s used to describe the impact of the costs of care is “financial toxicity.” At ASCO, both patients and professionals weighed in on how to navigate this growing area of need. Financial toxicity is more likely to affect people with cancer than with other conditions and can have negative health and quality of life outcomes.  

One study presented found that 64% of people with cancer were concerned about being able to pay their bills. Fortunately, the perspective is changing, with providers and health researchers recognizing that A) financial toxicity needs to be regarded as a negative side effect of cancer care and B) that financial toxicity is not limited to just the price of medications, but the impact that it has on the other aspects of a person’s life.  

Hospitals have started looking into solutions to fight financial toxicity. New resources include patient navigators trained to help people understand available resources and transportation related assistance to ensure they can make it to their clinic visits. Price transparency has also been advocated for, giving people the ability to identify what the best option for their medical and financial situation will be. Several studies like this are taking place all over the country to help reduce the burden of financial toxicity.  

A key takeaway is that providers and their patients should engage in shared decision making, a model that allows for both parties to discuss the potential benefits, harms, and real word implications of any treatment options, and together decide what the best option is to match each person’s lifestyle, values, and goals.  

Tolerability of care  

A key goal for many people living with lung cancer is to maintain a high quality of life while undergoing treatment. There are many side effects from cancer and treatments, but one of the most highly damaging is cancer-therapy associated hair loss. In fact, a presentation on scalp cooling and hair loss found that up to 50% of people reported that hair loss was the most traumatic side effect from their treatment journey. Fortunately, this study also showed that scalp cooling (wearing a hat filled with cool gel) is an effective means of reducing hair loss and maintaining or improving a person’s feelings about their image. The downsides noted in this study include limited efficacy in people of color and a lack of coverage by insurance, prompting both further studies and advocacy efforts.  

Integrative medicine was another subject discussed to improve quality of life during treatment. Integrative medicine encourages the provider to focus on the whole person within the treatment relationship and discuss all appropriate, evidence-based options that may be of benefit. This may include nutrition, psychology, mind-body approaches, and others. Some of these interventions have even been incorporated into national palliative care guidelines for cancer. Mind-body modalities have been increasing in popularity due to lack of medication induced side effects. Yoga and meditation have been studied closely and have been recognized to have significant impacts upon stress, depression, and anxiety.  

If you find yourself struggling with symptoms and side effects, make sure to address these with your care team, as the options available are expanding, and through open communication you can work to find which one will best fit your needs and your life.   

Quality of care  

Goal concordant care focuses on meeting a person’s values and priorities in life during their treatment. This is just one of the many building blocks comprising high quality cancer care. Care that is culturally appropriate and understandable is also key.  

Studies show that people who receive care in a language they have difficulty understanding have overall poorer health outcomes compared to those who receive care in their native language. Researchers are working to make sure that their education surrounding care, treatment options, and clinical trials meets the literacy and linguistic needs of those served. They’re also working to engage bilingual and/or bicultural staff so that people with lung cancer in these centers can interact with someone who they perceive as being like them, helping to build sustainable trusting relationships.  

Shared decision-making is yet another marker for quality care in cancer. This model can be especially beneficial to people with cancer when they are facing many different treatment options, when there is uncertainty surrounding the benefits vs. harms of a potential therapy, and when making high impact decisions. There are several decision aid tools available, with more being developed, that patients and physicians can use together when navigating care.   

Advocacy for and engagement in care  

Being active and engaged in care team decision making can feel intimidating but it is important to make sure that your care is best suited for you. Family members or caregivers are also often a part of this process and can help gather information, ask questions, and offer support.  

While shared decision making is an important part of engaging in care, there are other ways to become more engaged as well. Participating in research gives people the chance to be part of new breakthroughs in treatment, diagnosis, and complementary therapies–to name a few. Deciding if you want to be in a research study is an important decision, and one that has many factors to consider. Despite the benefits, many people aren’t fully educated by their providers on participation or aren’t even asked if they’re interested. Plus, trials aren’t always designed to be accessible for older adults, making it harder for them to join a study.  

Several speakers at this year’s conference discussed the importance of inclusion and advocacy of older people with cancer, survivors, and caregivers in developing research for this age group. Advocates are an important part of the research process, and their stories and voices help to improve the care of people with cancer across the world. 

The personal stories shared at 2023 ASCO conference were incredibly impactful and uplifting. While we continue to search for a cure for cancer, researchers are hard at work to ensure that people with cancer can live longer, better lives in the meantime.