Navigating advanced lung cancer: Insights for nurses

Advanced lung cancer remains the leading cause of cancer mortality in Canada, with most patients diagnosed at late stages and experiencing limited survival. Despite advances in precision oncology, fewer than 10% of patients benefit from actionable mutations, reinforcing the need for comprehensive supportive care. This paper examines a patient-centred, nursing-led approach to advanced non-small cell lung cancer (NSCLC), emphasizing early integration of palliative care alongside disease-directed therapy. The illness trajectory for individuals with advanced non-small cell lung cancer is marked by worsening symptom burden, particularly dyspnea, cough, pain, and psychological distress, which significantly impairs quality of life. Oncology nurses play a pivotal role in addressing multidimensional needs related to these symptoms through early assessment, patient education, symptom management, and coordination of care. This review highlights evidence-based pharmacological and non-pharmacological interventions for key symptoms these lung cancer patients experience. Multidisciplinary and nurse-led strategies, such as breathing techniques, psychosocial support, opioid use for refractory dyspnea, and structured pain management, are essential to reducing patient distress and promoting self-management. Furthermore, effective communication and shared decision-making ensure alignment of care with patient values and realistic expectations of palliative-intent therapies. A palliative approach to nursing care in NSCLC requires proactive identification of clinical decline, structured communication, and coordinated interdisciplinary care. Ultimately, integrating early palliative care, optimizing symptom management, and strengthening nurse-led models are critical to improving outcomes, enhancing quality of life, and addressing persistent gaps in care for patients with advanced lung cancer. Keywords: advanced lung cancer, non-small cell lung cancer (NSCLC), palliative care, oncology nursing, symptom management