Palliative Care Perceptions and Needs Among Total Cancer Care Patients Undergoing Immunotherapy: A Mixed Methods Study

Immunotherapies are increasingly used in advanced cancers, including lung, head, and neck cancers, and may contribute to misconceptions about reduced palliative care (PC) needs due to prolonged survival. This convergent mixed-methods study examined patients' knowledge, perceptions, and PC-related needs. A survey (n = 33) and semistructured interviews (n = 16) were conducted with patients from 5 Western United States. Quantitative data were analyzed descriptively, and qualitative data underwent thematic analysis. Participants had a mean age of 66.1 years, and 65.2% were male. Most perceived their treatment as aimed at controlling disease progression. The majority (81.8%) reported inadequate knowledge of PC, and 45.5% identified physicians as responsible for initiating PC discussions. Key emotional and spiritual needs included preparedness for the future (M = 4.85, SD = 1.9), emotional support for patients (M = 4.27, SD = 2.2) and families (M = 4.06, SD = 1.9), and spiritual support (M = 3.91, SD = 2.2). Qualitative findings highlighted themes related to treatment expectations, PC awareness, unmet needs, and timing of integration. Proactive education and early PC integration are essential to improve the quality of life, symptom management, and psychosocial and spiritual support for this population.