Patient experience and advocacy¶
TL;DR¶
- LUSC is lived as uncertainty, breathlessness, cough, fatigue, stigma, repeated waiting, and changing dependence—not only as stage and scan response.
- Smoking-related blame is clinically harmful. Stigma is associated with depression, poorer communication, and delayed help-seeking; every person deserves timely, evidence-based, compassionate care regardless of tobacco history.
- Information needs change across the pathway. At diagnosis, people need an intelligible map and a named contact; during treatment, they need symptom and toxicity plans; at surveillance or progression, they need uncertainty acknowledged and choices explained in absolute terms.
- Care partners perform medication, transport, monitoring, advocacy, and emotional labour. Their sleep, mental health, work, finances, and preparedness are treatment outcomes too.
- Financial toxicity includes direct bills, travel, accommodation, lost work, disability, caregiver time, and the administrative burden of obtaining care. Asking once is insufficient because costs accumulate and treatment changes.
- Early palliative care, patient-reported symptom monitoring, specialist nursing, cessation support without blame, peer connection, rehabilitation, and practical navigation are components of high-quality cancer care.
Scope and limits¶
Most patient-experience research combines lung histologies and stages. LUSC-specific qualitative evidence is sparse; this page therefore uses lung-cancer and NSCLC evidence and flags the LUSC features likely to intensify experience: central-airway symptoms, haemoptysis, cavitation/infection, COPD, smoking stigma, and limited targeted-therapy narratives. Population averages never define an individual's values.
This is a synthesis of measured experiences and advocacy resources, not invented first-person testimony. The companion patient-voice layer preserves themes, uncertainties, and source provenance without presenting composite prose as a quotation.
The pathway from first symptom to diagnosis¶
People may normalize cough or breathlessness as smoking, age, COPD, infection, or poor fitness. Symptoms can fluctuate, initial radiographs may be unrevealing, and repeated appointments can produce self-doubt. A qualitative study of diagnostic delay found that symptom interpretation, interactions with primary care, and system processes all shaped time to diagnosis ([PMID 18197868](https://pubmed.ncbi.nlm.nih.gov/18197868/){target="_blank" rel="noopener"}). A later regional pathway study similarly identified patient and carer experiences across referral, testing, communication, and transition to treatment ([PMID 36710377](https://pubmed.ncbi.nlm.nih.gov/36710377/){target="_blank" rel="noopener"}).
| Moment | Common experience | Better service response |
|---|---|---|
| New cough/dyspnoea | “This is my usual chest problem” | Clear persistence/change thresholds and safety-netting |
| Haemoptysis | Fear, shame, or minimization | Urgent assessment instructions without moral framing |
| Abnormal imaging | Long uncertainty before tissue diagnosis | Named navigator; visible test sequence and expected dates |
| Bronchoscopy/biopsy | Fear of bleeding, pain, anaesthesia, or a nondiagnostic result | Procedure-specific preparation and contingency plan |
| Waiting for pathology | Belief that no news means neglect or catastrophe | Agreed result channel/date; contact for deterioration |
| Staging scans | “Scanxiety” and fear that each test means bad news | Explain what each test answers and why order matters |
| First oncology visit | Cognitive overload and unfamiliar vocabulary | Written stage/biomarker summary; permission to record or bring support |
Delays should be measured in intervals—symptom-to-presentation, first-contact-to-imaging, imaging-to-biopsy, biopsy-to-complete pathology, staging-to-decision, decision-to-treatment—because interventions differ.
Stigma is a care-quality problem¶
Lung-cancer prevention messages can become blame after diagnosis. Patients may be asked “Did you smoke?” before “How can I help?”, anticipate judgment, hide the diagnosis, or believe they deserve less research and care. Stigma is a defined construct with consequences for patients ([PMID 32721137](https://pubmed.ncbi.nlm.nih.gov/32721137/){target="_blank" rel="noopener"}). It occurs in people with and without a smoking history, though its content differs ([PMID 31942920](https://pubmed.ncbi.nlm.nih.gov/31942920/){target="_blank" rel="noopener"}).
Measured associations include:
- greater stigma and depressive symptoms, supported by validation of the Lung Cancer Stigma Inventory ([PMID 30779396](https://pubmed.ncbi.nlm.nih.gov/30779396/){target="_blank" rel="noopener"});
- delayed medical help-seeking ([PMID 24769603](https://pubmed.ncbi.nlm.nih.gov/24769603/){target="_blank" rel="noopener"});
- altered patient–provider communication ([PMID 26553030](https://pubmed.ncbi.nlm.nih.gov/26553030/){target="_blank" rel="noopener"});
- racial differences in experienced stigma ([PMID 35415934](https://pubmed.ncbi.nlm.nih.gov/35415934/){target="_blank" rel="noopener"}); and
- stigma extending across patient and caregiver social networks ([PMID 29981928](https://pubmed.ncbi.nlm.nih.gov/29981928/){target="_blank" rel="noopener"}).
Healthcare trainees also show stigmatizing beliefs, so professional education cannot assume empathy emerges automatically ([PMID 38836527](https://pubmed.ncbi.nlm.nih.gov/38836527/){target="_blank" rel="noopener"}). Multilevel intervention is needed across public messaging, clinical language, research funding, and policy ([PMID 29800746](https://pubmed.ncbi.nlm.nih.gov/29800746/){target="_blank" rel="noopener"}).
Interventions do exist, but the evidence is immature. A 2024 systematic review found 11 empirical lung-cancer/COPD stigma interventions, mostly pilots; most improved at least one stigma measure, but larger randomized and societal-level evaluations are still needed ([PMID 39197098](https://pubmed.ncbi.nlm.nih.gov/39197098/){target="_blank" rel="noopener"}). A 30-clinician Nigerian pilot found empathic-communication training feasible and associated with improved provider-reported empathy, attitudes, and blame, but it did not test patient outcomes or diagnostic and treatment intervals ([PMID 38836528](https://pubmed.ncbi.nlm.nih.gov/38836528/){target="_blank" rel="noopener"}).
Language audit¶
| Avoid | Prefer | Reason |
|---|---|---|
| “Smoker” as identity | “Person who currently/formerly smoked” | Separates person from exposure |
| “Self-inflicted” | Name tobacco dependence, industry, occupational, environmental, and biological risks | Causation is complex; blame has no therapeutic value |
| “Failed to quit” | “Has not yet been able to stop” | Tobacco dependence is relapsing and treatable |
| “Noncompliant” without context | Describe the treatment not taken and the barrier | Makes the problem actionable |
| “Only palliative” | “Treatment focused on comfort, function, and/or disease control” | Palliative care is active care |
| “Nothing more” | “No further anticancer treatment with a favourable balance; these supports remain” | Prevents abandonment |
GO2 for Lung Cancer explicitly frames stigma as a barrier to screening, help-seeking, treatment, and hope, and offers navigation and peer support (GO2 stigma resource).
Symptom burden and function¶
Lung-cancer quality of life is shaped by breathlessness, cough, chest pain, fatigue, appetite/weight loss, sleep, anxiety, depression, and loss of role. Emotional problems, symptom burden, and quality of life are interdependent ([PMID 28412094](https://pubmed.ncbi.nlm.nih.gov/28412094/){target="_blank" rel="noopener"}). Long-term survivors can retain substantial symptom burden years after treatment ([PMID 22134070](https://pubmed.ncbi.nlm.nih.gov/22134070/){target="_blank" rel="noopener"}).
LUSC adds distinctive fear around central-airway events:
| Symptom | Lived meaning | Clinical task |
|---|---|---|
| Breathlessness | Panic, loss of independence, fear of suffocation | Treat reversible causes; breathing strategies, fan, rehabilitation, medication, oxygen when indicated |
| Haemoptysis | Visual shock and fear of catastrophic bleeding | Provide quantity/urgency thresholds and emergency plan |
| Persistent cough | Sleep disruption, rib pain, embarrassment, social withdrawal | Identify obstruction, infection, reflux, drug effect; targeted palliation |
| Stridor/wheeze | Fear and rapid functional decline | Urgent central-airway assessment, not routine follow-up |
| Fatigue | Reduced concentration and identity; “invisible” disability | Screen anaemia, sleep, mood, nutrition, endocrine toxicity, deconditioning |
| Weight loss | Worry that eating failure caused cancer progression; conflict with family | Cachexia-aware nutrition and goals; avoid coercive feeding |
| Neuropathy | Falls, driving/work limitations, difficulty with buttons and phones | Grade function, alter taxane exposure, rehabilitation and safety aids |
Patient-reported outcome measures are capable of detecting symptoms not elicited in routine visits; a systematic review found heterogeneous instruments and implementation but supported their clinical role ([PMID 29110842](https://pubmed.ncbi.nlm.nih.gov/29110842/){target="_blank" rel="noopener"}). In a multicentre randomized postoperative trial, PRO-based symptom management improved the monitoring pathway compared with usual care ([PMID 34995100](https://pubmed.ncbi.nlm.nih.gov/34995100/){target="_blank" rel="noopener"}). A score only helps if severe or worsening responses trigger accountable action.
Making decisions under uncertainty¶
Shared decision-making is not handing over a menu. It requires stating the decision, viable options, expected absolute benefits and harms, uncertainty, time horizon, and what matters to the person. Qualitative work shows that patients and clinicians use the term inconsistently ([PMID 31745852](https://pubmed.ncbi.nlm.nih.gov/31745852/){target="_blank" rel="noopener"}). Recent personalized-care scholarship emphasizes repeated decisions as biology and preferences change ([PMID 40500650](https://pubmed.ncbi.nlm.nih.gov/40500650/){target="_blank" rel="noopener"}).
A usable decision conversation¶
- “We need to decide whether to add chemotherapy to immunotherapy.”
- “The realistic options are A, B, and supportive care without anticancer treatment.”
- “For people in the trial, the median and absolute outcomes were…, but people with your health condition were underrepresented.”
- “The main burdens are clinic time, neuropathy, marrow suppression, infection, immune toxicity, and uncertainty.”
- “Which outcome are you most trying to protect—length of life, breathing, cognition, independence, a near-term event, or time away from treatment?”
- “Here is what would make us stop or change the plan.”
- “Please tell me in your own words what you understand; that checks my explanation, not you.”
Survivors and caregivers may value treatment outcomes differently, so both voices should be heard without allowing the caregiver to replace a capacitous patient's preference ([PMID 31998820](https://pubmed.ncbi.nlm.nih.gov/31998820/){target="_blank" rel="noopener"}).
Care partners¶
Care partners often coordinate appointments, medications, transport, oxygen, meals, benefits, symptom triage, and communication while absorbing uncertainty. Burden can change over time after diagnosis and treatment ([PMID 29476636](https://pubmed.ncbi.nlm.nih.gov/29476636/){target="_blank" rel="noopener"}); after early-stage surgery it remains linked to patient function and care demands ([PMID 35869414](https://pubmed.ncbi.nlm.nih.gov/35869414/){target="_blank" rel="noopener"}). In advanced lung cancer, patient and caregiver anxiety, depression, and sleep disturbance can be coupled ([PMID 32253349](https://pubmed.ncbi.nlm.nih.gov/32253349/){target="_blank" rel="noopener"}).
| Care-partner need | Minimum service response |
|---|---|
| Preparedness | Written symptom and medication plan; teach-back |
| Permission and privacy | Document what may be shared; speak with patient alone when appropriate |
| Respite | Ask who can substitute and connect to practical services |
| Emotional health | Screen distress, sleep, anxiety, depression, and anticipatory grief |
| Work/financial strain | Social work, leave/disability, transport and lodging resources |
| Emergency role | Clear thresholds and numbers; do not make family diagnose toxicity |
| Bereavement | Proactive follow-up rather than abrupt service withdrawal |
Multidisciplinary care can improve patient and caregiver satisfaction relative to serial care models ([PMID 37451932](https://pubmed.ncbi.nlm.nih.gov/37451932/){target="_blank" rel="noopener"}). Integrative care paths that explicitly include caregivers are feasible and address a need conventional tumour visits miss ([PMID 33902316](https://pubmed.ncbi.nlm.nih.gov/33902316/){target="_blank" rel="noopener"}).
Financial toxicity and access¶
Financial harm can alter treatment even when a nominally effective option exists. In a prospective lung-cancer cohort, financial toxicity changed longitudinally rather than remaining fixed ([PMID 33555936](https://pubmed.ncbi.nlm.nih.gov/33555936/){target="_blank" rel="noopener"}). Patients with advanced lung cancer report medical debt, work loss, travel costs, and difficult trade-offs between care and ordinary expenses ([PMID 38775918](https://pubmed.ncbi.nlm.nih.gov/38775918/){target="_blank" rel="noopener"}). Survivors report persistent financial toxicity alongside unmet needs and impaired quality of life ([PMID 38630475](https://pubmed.ncbi.nlm.nih.gov/38630475/){target="_blank" rel="noopener"}).
Equity is not achieved by offering the same list to everyone. Qualitative work among low-income and minority people with lung cancer identified informational, practical, emotional, and access needs that services must actively address ([PMID 35696628](https://pubmed.ncbi.nlm.nih.gov/35696628/){target="_blank" rel="noopener"}). Clinical-trial accrual is limited by eligibility, physician/site factors, logistics, and patient barriers ([PMID 18650170](https://pubmed.ncbi.nlm.nih.gov/18650170/){target="_blank" rel="noopener"}; [PMID 22591607](https://pubmed.ncbi.nlm.nih.gov/22591607/){target="_blank" rel="noopener"}). Rural–urban differences further affect participation burden ([PMID 35451964](https://pubmed.ncbi.nlm.nih.gov/35451964/){target="_blank" rel="noopener"}).
Ask repeatedly¶
- What will transport, parking, accommodation, food, childcare, and lost work cost?
- Has anyone delayed a scan, prescription, or visit because of cost?
- Is internet, phone, language, literacy, hearing, or mobility limiting access?
- Who is doing unpaid care, and what are they giving up?
- Would a local standard treatment be preferable to a marginally different distant regimen?
- Can trial travel, lodging, and companion expenses be reimbursed?
Palliative care, rehabilitation, and survivorship¶
Early palliative care alongside oncology improved quality of life and mood, reduced aggressive end-of-life care, and was associated with longer median survival in metastatic NSCLC ([PMID 20818875](https://pubmed.ncbi.nlm.nih.gov/20818875/){target="_blank" rel="noopener"}). It should be triggered by needs—symptoms, difficult decisions, caregiver strain—not prognosis alone.
In KEYNOTE-407, adding pembrolizumab to chemotherapy improved survival without worsening average quality of life; at week 18, the between-group global health/QoL difference was 4.9 points (95% confidence interval 1.4–8.3) ([PMID 31751163](https://pubmed.ncbi.nlm.nih.gov/31751163/){target="_blank" rel="noopener"}). Group averages still conceal severe individual toxicity and survivor attrition.
Survivorship includes fear of recurrence, chronic dyspnoea, pain, neuropathy, cognitive change, employment, sexuality, identity, second-primary risk, and smoking cessation. A systematic review linked unmet supportive-care needs to worse quality of life ([PMID 34729855](https://pubmed.ncbi.nlm.nih.gov/34729855/){target="_blank" rel="noopener"}). Physical activity is feasible for some survivors but must be adapted to pulmonary and cardiac reserve ([PMID 21113768](https://pubmed.ncbi.nlm.nih.gov/21113768/){target="_blank" rel="noopener"}).
Advocacy priorities derived from the evidence¶
| Priority | Concrete measure |
|---|---|
| End stigma | Audit language; train staff; measure reported discrimination and help-seeking delay |
| Diagnose earlier | Track diagnostic intervals and missed safety-net follow-up; expand equitable LDCT access |
| Make pathology usable | Report histology, PD-L1 assay/TPS, molecular adequacy, and turnaround visibly |
| Protect urgent pathways | Same-day route for haemoptysis, stridor, obstruction, febrile neutropenia, and immune toxicity |
| Represent real patients | Include older adults, ECOG 2, COPD, autoimmune disease, rural and under-served groups in research |
| Value lived outcomes | Make breathlessness, cough, function, cognition, caregiver burden, and time toxicity core endpoints |
| Reduce financial harm | Screen repeatedly; publish travel/time burden; fund navigation and trial participation |
| Support cessation | Offer pharmacotherapy and counselling without blame; never condition dignity on abstinence |
| Share results | Return plain-language trial results, including negative studies, to participants |
| Sustain survivorship | Provide rehabilitation, second-primary prevention, mental health, and caregiver/bereavement support |
Current support and advocacy resources¶
Availability and eligibility should be checked directly; these organizations do not replace emergency or local medical services.
| Organization | Resource type | Link |
|---|---|---|
| GO2 for Lung Cancer | US help line, peer support, trial navigation, stigma and policy advocacy | GO2 support |
| LUNGevity Foundation | Patient and care-partner education, biomarker gateways, virtual support and survivorship | LUNGevity patient/care-partner hub |
| Roy Castle Lung Cancer Foundation | UK practical/emotional support and helpline | Roy Castle |
Open questions¶
- Which stigma interventions change clinician behaviour, time to presentation, and treatment uptake—not only attitudes?
- What LUSC-specific symptom measure best captures central-airway fear and haemoptysis burden?
- Can routine caregiver screening improve both patient outcomes and caregiver health?
- How should treatment time and financial toxicity be incorporated into comparative-effectiveness trials?
- Which models reliably return understandable negative and positive trial results to participants?
Related pages¶
- Central-airway biology and presentation
- Screening and early detection
- Systemic therapy
- Clinical-trials landscape
- Red flags and safety concerns
References¶
- Maguire R, Lewis L, Kotronoulas G, McPhelim J, Milroy R, Cataldo J. Lung cancer stigma: A concept with consequences for patients. Cancer Rep (Hoboken). 2019;2(5):e1201. PMID 32721137
- Williamson TJ, Kwon DM, Riley KE, Shen MJ, Hamann HA, Ostroff JS. Lung Cancer Stigma: Does Smoking History Matter? Ann Behav Med. 2020;54(7):535-540. PMID 31942920
- Ostroff JS, Riley KE, Shen MJ, Atkinson TM, Williamson TJ, Hamann HA. Lung cancer stigma and depression: Validation of the Lung Cancer Stigma Inventory. Psychooncology. 2019;28(5):1011-1017. PMID 30779396
- Carter-Harris L, Hermann CP, Schreiber J, Weaver MT, Rawl SM. Lung cancer stigma predicts timing of medical help-seeking behavior. Oncol Nurs Forum. 2014;41(3):E203-10. PMID 24769603
- Shen MJ, Hamann HA, Thomas AJ, Ostroff JS. Association between patient-provider communication and lung cancer stigma. Support Care Cancer. 2016;24(5):2093-2099. PMID 26553030
- McDonnell KK, Webb LA, Adams SA, Felder TM, Davis RE. The association between lung cancer stigma and race: A descriptive correlational study. Health Expect. 2022;25(4):1539-1547. PMID 35415934
- Occhipinti S, Dunn J, O'Connell DL, Garvey G, Valery PC, Ball D, et al. Lung Cancer Stigma across the Social Network: Patient and Caregiver Perspectives. J Thorac Oncol. 2018;13(10):1443-1453. PMID 29981928
- Studts JL, Deffendall CM, McCubbin SL, Hamann HA, Hoover K, Brymwitt WM, et al. Examining evidence of lung cancer stigma among health-care trainees. J Natl Cancer Inst Monogr. 2024;2024(63):20-29. PMID 38836527
- Hamann HA, Ver Hoeve ES, Carter-Harris L, Studts JL, Ostroff JS. Multilevel Opportunities to Address Lung Cancer Stigma across the Cancer Control Continuum. J Thorac Oncol. 2018;13(8):1062-1075. PMID 29800746
- Tod AM, Craven J, Allmark P. Diagnostic delay in lung cancer: a qualitative study. J Adv Nurs. 2008;61(3):336-43. PMID 18197868
- Otty Z, Brown A, Larkins S, Evans R, Sabesan S. Patient and carer experiences of lung cancer referral pathway in a regional health service: a qualitative study. Intern Med J. 2023;53(11):2016-2027. PMID 36710377
- Morrison EJ, Novotny PJ, Sloan JA, Yang P, Patten CA, Ruddy KJ, et al. Emotional Problems, Quality of Life, and Symptom Burden in Patients With Lung Cancer. Clin Lung Cancer. 2017;18(5):497-503. PMID 28412094
- Yang P, Cheville AL, Wampfler JA, Garces YI, Jatoi A, Clark MM, et al. Quality of life and symptom burden among long-term lung cancer survivors. J Thorac Oncol. 2012;7(1):64-70. PMID 22134070
- Bouazza YB, Chiairi I, El Kharbouchi O, De Backer L, Vanhoutte G, Janssens A, et al. Patient-reported outcome measures (PROMs) in the management of lung cancer: A systematic review. Lung Cancer. 2017;113:140-151. PMID 29110842
- Dai W, Feng W, Zhang Y, Wang XS, Liu Y, Pompili C, et al. Patient-Reported Outcome-Based Symptom Management Versus Usual Care After Lung Cancer Surgery: A Multicenter Randomized Controlled Trial. J Clin Oncol. 2022;40(9):988-996. PMID 34995100
- Melzer AC, Golden SE, Ono SS, Datta S, Crothers K, Slatore CG. What Exactly Is Shared Decision-Making? A Qualitative Study of Shared Decision-Making in Lung Cancer Screening. J Gen Intern Med. 2020;35(2):546-553. PMID 31745852
- Wieland J, Hoppe BS, Rausch-Osian SM, King JC, Sierra A, Hiemenz JW, et al. Survivor and Caregiver Expectations and Preferences Regarding Lung Cancer Treatment. Int J Part Ther. 2019;6(2):42-49. PMID 31998820
- Lee YH, Liao YC, Shun SC, Lin KC, Liao WY, Chang PH, et al. Trajectories of caregiver burden and related factors in family caregivers of patients with lung cancer. Psychooncology. 2018;27(6):1493-1500. PMID 29476636
- Zhu S, Yang C, Mei W, Kang L, Li T, Li J, et al. Caregiver burden for informal caregivers of patients after surgical treatment of early-stage lung cancer. J Clin Nurs. 2023;32(5-6):859-871. PMID 35869414
- He Y, Sun LY, Peng KW, Luo MJ, Deng L, Tang T, et al. Sleep quality, anxiety and depression in advanced lung cancer: patients and caregivers. BMJ Support Palliat Care. 2022;12(e2):e194-e200. PMID 32253349
- McLeod H, Perlman AI, Salinas MG, Abu Dabrh AM. Caring for Caregivers-A New Integrative Care Path for Advanced Lung Cancer Patients and Their Caregivers. J Altern Complement Med. 2021;27(5):377-378. PMID 33902316
- Friedes C, Hazell SZ, Fu W, Hu C, Voong RK, Lee B, et al. Longitudinal Trends of Financial Toxicity in Patients With Lung Cancer: A Prospective Cohort Study. JCO Oncol Pract. 2021;17(8):e1094-e1109. PMID 33555936
- Takemura N, Jia S, Lin CC. Financial hardship experience in middle- and older-aged patients with advanced lung cancer. Support Care Cancer. 2024;32(6):372. PMID 38775918
- Hsu ML, Boulanger MC, Olson S, Eaton C, Prichett L, Guo M, et al. Unmet Needs, Quality of Life, and Financial Toxicity Among Survivors of Lung Cancer. JAMA Netw Open. 2024;7(4):e246872. PMID 38630475
- Patel MI, Agrawal M, Duron Y, O'Brien D, Koontz Z. Perspectives of Low-Income and Minority Populations With Lung Cancer: A Qualitative Evaluation of Unmet Needs. JCO Oncol Pract. 2022;18(8):e1374-e1383. PMID 35696628
- Temel JS, Greer JA, Muzikansky A, Gallagher ER, Admane S, Jackson VA, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010;363(8):733-42. PMID 20818875
- Mazieres J, Kowalski D, Luft A, Vicente D, Tafreshi A, Gümüş M, et al. Health-Related Quality of Life With Carboplatin-Paclitaxel or nab-Paclitaxel With or Without Pembrolizumab in Patients With Metastatic Squamous Non-Small-Cell Lung Cancer. J Clin Oncol. 2020;38(3):271-280. PMID 31751163
- Cochrane A, Woods S, Dunne S, Gallagher P. Unmet supportive care needs associated with quality of life for people with lung cancer: A systematic review of the evidence 2007-2020. Eur J Cancer Care (Engl). 2022;31(1):e13525. PMID 34729855
- Jones LW. Physical activity and lung cancer survivorship. Recent Results Cancer Res. 2011;186:255-74. PMID 21113768
- Curran WJ Jr, Schiller JH, Wolkin AC, Comis RL, Scientific Leadership Council in Lung Cancer of the Coalition of Cancer Cooperative Groups. Addressing the current challenges of non-small-cell lung cancer clinical trial accrual. Clin Lung Cancer. 2008;9(4):222-6. PMID 18650170
- Horn L, Keedy VL, Campbell N, Garcia G, Hayes A, Spencer B, et al. Identifying barriers associated with enrollment of patients with lung cancer into clinical trials. Clin Lung Cancer. 2013;14(1):14-8. PMID 22591607
- Mudaranthakam DP, Gajewski B, Krebill H, Coulter J, Springer M, Calhoun E, et al. Barriers to Clinical Trial Participation: Comparative Study Between Rural and Urban Participants. JMIR Cancer. 2022;8(2):e33240. PMID 35451964
- Shao H, Faris NR, Ward KD, Chen W, McHugh L, Smeltzer M, et al. Lung Cancer Patients' and Caregivers' Satisfaction With Multidisciplinary Versus Serial Care in a Community Healthcare Setting: A Prospective Comparative-Effectiveness Cohort Study. Clin Lung Cancer. 2023;24(7):e267-e274. PMID 37451932
- Sridhar A, Adjei A, Montori VM, Leventakos K. Shared decision making for personalized lung cancer care. Lung Cancer. 2025;206:108614. PMID 40500650
- Yamazaki-Tan J, Harrison NJ, Marshall H, Gartner C, Runge CE, Morphett K. Interventions to Reduce Lung Cancer and COPD-Related Stigma: A Systematic Review. Ann Behav Med. 2024;58(11):729-740. PMID 39197098
- Banerjee SC, Asuzu C, Mapayi B, Olunloyo B, Odiaka E, Daramola OB, et al. Feasibility, acceptability, and initial efficacy of empathic communication skills training to reduce lung cancer stigma in Nigeria: a pilot study. J Natl Cancer Inst Monogr. 2024;2024(63):30-37. PMID 38836528