Social Support in Older Lung Cancer Patients

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Age is the single most important risk factor for cancer, and social support is important for health outcomes and survival among cancer patients. Measures of social network are often used in studies about older cancer patients. However, little is known about qualitative aspects of support, such as Instrumental or Emotional types and Directive or Non-directive styles, which might be important during treatment and recovery of older cancer patients and amenable to intervention. Older cancer patients may require more support or different kinds of support than younger patients to achieve positive outcomes, such as improved quality of life (QOL) and less-depressed mood. Older adults may have impaired functioning due to co-morbidity or limitations in activities of daily living (ADLs); impaired physical functioning is associated with poorer Q0L and depression. This study seeks to describe aspects of support received by patients with primary, inoperable, non-small cell lung cancer (NSCLC) during and after chemotherapy, assess differences in support, quality of life, and depressed mood between patients in two age groups (45-64 vs. greater than or equal to 65 years), and identify aspects of social support associated with Q0L and depressed mood during and after treatment. The sample will include patients greater than or equal to 45 years old with primary, stage IIIb or stage IV NSCLC receiving chemotherapy at first- line treatment at Barnes-Jewish Hospital in St. Louis. Clinical data will include co-morbidity, TNM stage, type of treatment, and response to therapy. Interviews at 4-6 weeks into therapy and at 4-6 weeks after treatment ends will assess qualitative aspects of support, perceived availability of support, support satisfaction, social network, size, Q0L depressed mood, and ADLs. Age differences in predictor and outcome variables will be tested using analysis of variance. Hierarchical regression will test the predictive effects of each social support variable on both QOL and depressed mood during therapy and at follow-up, controlling for important covariates. Findings will add to the knowledge of social support's relationship with QOL and depressed mood in older patients with stage IIIb or stage IV NSCLC and may lead to ways to improve their Q0L.