University of South Carolina College of Nursing


South Carolina is a relatively small state with almost five million residents, but it has the 12th highest incidence of lung cancer in the nation, with an estimated 4,500–5,000 new lung cancer cases diagnosed in the state. Although the five-year survival rate for non-small cell lung cancer (NSCLC) is increasing, excessive symptom burden during survivorship remains an extremely prevalent and complex problem for survivors and their family members. Long-term symptoms are associated with increased stress, poorer functional status, lower quality of life (LQOL) and higher mortality. 

Up to 80% of long-term lung cancer survivors report smoking-related comorbidities such as chronic obstructive pulmonary disease and heart disease. After curative surgery, survivors describe persistent physical and psychological symptoms negatively affecting their QOL. The prevalence of depressive and anxiety symptoms among lung cancer survivors ranges from 20% to 47%. Compared to survivors of other cancer types, survivors of lung cancer report the highest rates of distress resulting in a LQOL.


Advancing Quality Lung Cancer Survivorship in South Carolina has two major objectives:

  • Develop a statewide network of community and clinical stakeholders with an interest in lung cancer, referred to as the Partners in Quality Lung Cancer Survivorship (PIQ), to maximize community involvement and build capacity for survivorship care support services.
  • Adapt and test the Breathe Easier intervention in a face-to-face format and as an interactive mobile application. The intervention consists of breathing retraining exercises, mindfulness-based meditation and yoga for varying skill levels.

The intervention will be tested at two American College of Surgeons ACOS-approved cancer centers (Palmetto Health Cancer Centers, Columbia; Greenville Health System [GHS] Cancer Institute, Greenville). The long-term goal of this research is to improve clinical outcomes for survivors of localized lung cancer and their family members. 

Project Leader

Karen McDonnell,