Navigating advanced lung cancer care, patient–physician alliance, cancer stigma, and psychosocial support in Asia-Pacific: perspectives from patients, caregivers, and physicians

Factors influencing holistic lung cancer care among advanced/metastatic non-small cell lung cancer (NSCLC) patients in Asia-Pacific are understudied. We identified gaps in lung cancer care from patients, caregivers, and physicians in Australia, Japan, Mainland China, South Korea, and Taiwan. Qualitative interviews and quantitative surveys were conducted among NSCLC patients with limited targeted treatment options, caregivers, and physicians. Patient-caregiver paired interviews (<i>n</i> = 15) were analyzed narratively and thematically; survey findings (70 patients, 106 physicians) were summarized descriptively. Descriptive analyses were performed with no formal hypothesis testing. While patients (53–66%) felt able to care for their condition, 47% were unaware of genetic mutations and 46% perceived delays in diagnosis (41–44% were unaware of symptoms/severity). Most physicians (78–90%) prioritized treatment discussions, 51% decided for patients, and 69% encouraged patient-led decisions. Patients (61–77%) relied on physician decisions; 71–76% prioritizing reduced recurrence and minimal side effects over physician recommendations (53%). Although patients (66%) felt cared for by their doctors, 24–31% felt their mental/physical well-being was not proactively addressed. This study identified significant gaps in lung cancer care, including patients’ suboptimal disease and treatment knowledge, limited patient-physician shared decision-making, cancer stigma, and inadequate psychosocial support; underscoring the need for tailored interventions in Asia-Pacific. Lung cancer is the most commonly diagnosed cancer and is the leading cause of cancer-related deaths globally. Non-small cell lung cancer (NSCLC) is the most common form of lung cancer and is frequently diagnosed at late stages. Managing lung cancer is complicated because not all of them are the same with different genetic variations, making it challenging to treat and predict its response. Cancer diagnosis is a highly stressful event and forces the patient (and family) to make life-changing decisions as they navigate the various diagnostic tests and treatment options. This study found that patients and caregivers lacked comprehensive understanding about lung cancer symptoms, diagnostic tests, genetic mutations, and treatment options. This could arise from insufficient communication between patients and physicians, as well as inadequate psychosocial support to manage the patients’ mental well-being. Overall, this could impact informed choice and shared decision-making when making a choice on which treatment to undertake. Providing information on the disease, diagnosis, treatment and available psychosocial support may help patients navigate the stressful event of the cancer care journey.