The problem with the FACT-L is that it mostly covers lung cancer-related symptoms and not the treatment-related symptoms. The most important feature of the FACT-L is that it measures the relative weight of importance attached to the components of quality of life. Diastolic Filling
However, both the LCSS and the FACT-L have been validated and show a high level of reliability and validity, including good internal consistency, content validity, and responsiveness.
The EORTC QLQ-LC13 is a tumor-specific questionnaire supplementary to the EORTC quality of life cancer questionnaire (QLQ-C30). It is a 13-item measure of lung cancer-related symptoms and treatment side effects, including the following: coughing (1 item), hemoptysis (1 item), dyspnea (3 items), sour mouth or tongue (1 item), trouble swallowing (1 item), tingling hands and feet (1 item), hair loss (1 item), experience of pain (3 items), and pain medication (1 item).
A recent publication by the EORTC Study Group on Quality of Life concluded that the results from international field testing, yielding a database with >700 lung cancer patients, lent support to the EORTC QLQ-LC13 as a clinically valid and useful tool for assessing disease- and treatment-specific symptoms in lung cancer patients, when combined with the EORTC core quality of life questionnaire. All symptom and toxicity scores changed significantly over time, with disease symptoms declining and treatment toxic reactions increasing during the treatment period. In a few cases, however, the questionnaire module could benefit from further refinements. In addition, its performance over a longer period still needs to be investigated.
However, these are the most useful instruments and can provide information additional to the clinical data. With such a relatively good number of measures, it appears that there is no excuse for not measuring quality of life in lung cancer patients. Such information has an important role in clinical decision-making and ensuring effective care for lung cancer patients.