Thesis (Ph.D.) - Cairo University - National Cancer Institute - Department of Anesthesia and Pain Relief

Background: Metastatic non small lung cancer is one of leading cause of deaths attributable to malignancies. Patients with advanced and metastatic NSCLC often present with pain, dyspnea, cough, fatigue, and loss of appetite. These symptoms all can adversely affect quality of life and become progressive during the terminal stages of the disease course. It is therefore necessary to provide earlier palliative care services in the course of NSCL cancer. The aim of the study is to evaluate the effect of early palliative care integrated with standard oncologic care compared with standard oncologic care only on improvement of quality of life in patients with metastatic non small cell lung cancer. Patients and methods: In this prospective comparative study;30patients diagnosed within 8 weeks as non small cell lung cancer were included and randomized to two groups, the study group received standard oncologic care plus early palliative care in form of Oral megestrol acetate (Megace 160mg tablet ,DEVA company) plus oral olanzapine (olapex 5mg tablet, Apex company) once neightly for management of anorexia and cachexia syndrome and nebulized morphine sulfate 5mg (0.5ml with 4ml normal saline) every 6 hours for management of dyspnea and management of pain according to severity of pain by using WHO ladder for cancer pain management. The control group Patients received standard oncologic care with management of cancer pain according to severity of pain by using WHO ladder for 8weeks. Measures of health-related quality of life and mood were obtained using the Functional Assessment of Cancer Therapy-Lung (FACT-L), follow up appetite by appetite visual analogue scale (VAS) and measuring body weight in kg, assessment of dyspnea by modified borg rating scale and oxygen saturation and assessment of pain by pain VAS

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