Barriers are a common challenge in lung cancer treatment that affect patient care and outcomes. While geographic and financial limitations are often the most recognized obstacles, knowledge gaps and communication issues can also significantly hinder patients’ access to care.
Debra Montague, President of Lung Cancer Europe (LuCE), addressed these gaps during the session Balancing Cost, Care and Patient Choice in Real World Journey and Research at the 2025 World Conference on Lung Cancer (WCLC) in Barcelona.
Balancing Cost, Care and Patient Choice in Real World Journey and Research
WCLC 2025 attendees can still watch Debra Montague and other experts explore the role of global advocacy and international collaboration to advance equitable access to care with on-demand access to the session. Learn More
During her presentation, Ms. Montague shared data from the 9th LuCE Report on Lung Cancer,1 an annual initiative led by LuCE to raise awareness of key challenges faced by individuals affected by lung cancer. The report included self-reported data from 1,432 patients and 608 caregivers across 34 countries in the World Health Organization (WHO) European Region.
“Previous studies had revealed gaps in lung cancer knowledge, and there were issues in accessing information and shared decision-making. So the aim was to understand how community preferences and knowledge impacted those decisions,” Ms. Montague said.
The self-filled online survey was available in 20 languages during a period of 6 weeks. Incomplete surveys and non-European responses were removed as part of quality control.
The findings revealed that nearly two-thirds of participants (65.1%) delayed seeking medical advice after experiencing symptoms. This delay was attributed to not recognizing symptoms associated with lung cancer in nearly half of participants (46.5%).
Additionally, 40% of participants misattributed symptoms to other conditions, 22.2% reported being unaware of biomarkers, and 24.2% didn’t fully understand the disease prognosis.
“When we looked at access to information, 40.2% lack sufficient information, and of those that did access it, 28.9% didn’t understand it,” Ms. Montague said.
Data show the barriers were related to information processing (39%), insufficient information (32.9%), and unclear information (32.5%), she said.
Overall, 85.5% of participants reported lacking some form of support or information. Challenges associated with accessing information included limited consultation time (50.9%), poor communication skills of healthcare providers (41.7%), and the use of complex information or terminology (25.3%).
While 70.2% of patients felt their opinion was very important in deciding treatment, only 49.3% reported feeling highly involved in the process, and only 55.9% felt that their opinion was being considered.
Participants identified complex information (49.2%) and poor communication (37.6%) as major obstacles to achieving meaningful participation in the decision-making process. Regarding treatment decisions, 63.7% of participants equally valued both quality and length of life, while one in three prioritized quality over length of life.
“Communication issues were common across all themes, [highlighting] the need for stakeholder collaboration on awareness and risk reduction,” Ms. Montague said. “Healthcare providers must support shared decision-making, and enhanced communication strategies are vital for person-centered care.”
So, how can clinicians and their teams implement better communications training moving forward? Ms. Montague suggested beginning with medical students during their training to include communication skills development.
It doesn’t all come down to the clinician, though; patient care involves a multidisciplinary team, Ms. Montague noted.
“I think that’s the problem with communication: it isn’t always that the information wasn’t shared. I think the question is whether patients understood it,” Ms. Montague said. “They may nod, but you still don’t know if they understood when you leave the room.”
This is true not only regarding treatment but also when it comes to clinical trial enrollment and the language used.
“I think that’s bound to impact enrollment in clinical trials, because it’s easier to say no than to keep asking questions if you don’t understand,” Ms. Montague said. “It has a real impact if patients don’t understand what’s going on; it’s important across the spectrum.”
At a time when the field is witnessing incredible promise for novel treatments, there is also tension regarding misinformation about vaccines and therapies. The emergence of non-evidence-based data about vaccines and treatments makes it critical for clinicians to balance drug development with patient concerns about new trials and treatments.
“I think it really comes down to communication, and I think it’s important to discuss the elephant in the room: what patients may be thinking but haven’t verbalized,” she said.
She noted that many clinicians are beginning to recognize the value of patient advocacy organizations in addressing misinformation, rather than relying on information published online.
“We’re seeing more and more patients being referred to patient advocacy groups, and that gives me hope that patients are getting more accurate information that they can then spend time disseminating and also meet other patients in the same boat,” Ms. Montague said. “There’s nothing like talking to another patient with the same condition.”
References:
- 1. Lung Cancer Europe. 9th LUCE Report on Lung Cancer: Empowering voices: Knowledge and decision-making among people impacted by lung cancer in Europe. Lung Cancer Europe; November 2024. Accessed September 29, 2025.
