This
study examined physicians’ views on palliative care and assisted dying and assessed
non-small cell lung cancer (NSCLC) patients’ symptoms and quality of life (QOL)
during chemotherapy.

Finnish
physicians expressed uncertainty about the management of end-of-life (EOL)
situations and advanced cancer symptoms. Additional training needs were recognized.
At the time the survey was carried out, 10% of oncologists and 19% of other
physicians supported the legalization of euthanasia. Most physicians believed
that proper palliative care might reduce requests for euthanasia.

A
six-month symptom survey was conducted among NSCLC patients receiving chemotherapy.
The patients had several comorbidities, most frequently cardiovascular diseases
and lung diseases. The most severe symptoms were pain, cough, dyspnea, fatigue
and insomnia. The lowest scores for functional scales were at the baseline for
physical and role functioning. The patients' global QOL was relatively low at
the baseline. Women had a better QOL and suffered less from pain than men
during the study. Pain intensity increased during the study, especially in men,
and physical functioning deteriorated. A high level of pain and low social and
role functioning predicted poorer survival. The Edmonton Symptom Assessment
Scale (ESAS) was found to be a reliable tool to accomplish frequent symptom
assessment for real time use.

In
conclusion, symptom assessment and control and quality-of-life issues are an important
focus in the treatment of advanced lung cancer. The quality of care could be
improved with better training of health care professionals, and symptom assessment
could improve the awareness and recognition of the symptoms.