Category: Mesothelioma
A Necessary Discussion: End-of-Life Options for Mesothelioma Patients
The COVID-19 pandemic has been a frightening time for all of us. The uncertain nature of the disease and number of people affected brings the importance of what we want at the end of our lives to the forefront. With hospitals and skilled nursing facilities limiting visitors and the inability of some to travel, it is necessary to discuss what we wish to happen at the end of life with our loved ones.
We all know that when one person within our family or group of friends gets diagnosed with a severe illness like malignant mesothelioma, it affects all of us. Uncomfortable conversations need to be had. However, navigating these complex and potentially life-altering conversations can be done in a reflective, thoughtful way.
As nurses, we have long heard our peers state that they would never have chosen the treatment that a particular patient went with, only to confront a health challenge themselves and choose the same treatment option.
Our relationships are the most important connections that we have. What we value and who we love are all individual decisions. Once we self-reflect on what we value and how we would like to live our final days, we need to let others know. To ensure your wishes are carried out, they must be shared with those who care about us: a spouse, partners, friends, and so on. Your medical team needs to know your desires, but more important than anything is that you and your loved ones know them.
Having essential conversations regarding our end-of-life wishes should be done by all of us, ideally before a health crisis. But unfortunately, it is easy to put off these conversations.
There is guidance and help on where to start thinking and planning about our wishes. Ellen Goodman, one of the co-founders of the Conversation Project, sums up their goal: “Conversations about what matters to you, not what is the matter with you.”
There are workbooks to help clarify your values and wishes. What do you value? Do you want to be home when you die? With who will you share your wishes?
In this complex world, sometimes we need to get back to basics and accept that we all are mortal. Talking and planning will not hasten our end of life but enable some peace when it does come. Ensuring that what you as an individual value and the decisions you want are honored can offer some peace of mind for both you and your loved ones.
Your Mesothelioma Diagnosis is the Start of a Journey
Being diagnosed with malignant mesothelioma will most likely change your perspective about life. The things you put emphasis on will no longer hold the same value. The relationships and everyday things you paid little or no attention to will now seem important. Our value system as you know it changes, our viewpoints will change without any conscious awareness.
Most likely you will learn more about yourself than you ever thought. You will begin to understand what makes you tick. When recovering from mesothelioma you will learn to understand your body. A whole new relationship will form. All of a sudden you will have certain hours of the day that you will perform better than others. There will be foods that give you energy, while others that once provided comfort will now be less appealing. You will learn the art of compensation and the art of acceptance.
You may not like the limits mesothelioma has placed on you but you will learn to figure it out. Some days will be very difficult while others will go by with more ease.
Having a rare disease like malignant mesothelioma is not easy on any level. Most medical professionals will paint the worst case scenario, and then the real experts of this disease will give you all scenarios. These will range from the very best to the very worst. Some of this will be up to you.
Of course, your disease is there. The type and the extent are facts. Taking a step back after the initial shock takes place may be the best thing you can do. Picking and choosing the things or situations that you are in charge of may be helpful.
Remember the things that made you smile yesterday are still there. Make a list of the things you can do while treating Mesothelioma. Pull every positive aspect you can and write it down. Being overwhelmed can interrupt your thought process. If you can only think of a couple of items that you are in charge of then just write them down. Keep the notepad handy.
Another thing you can do is think of the things you are grateful for. It is a difficult time to feel grateful but just make the list. When you are feeling not so well some day you can go back and reflect upon these ideas. Your mesothelioma journey will take you to a place where your life will change, you will meet people and you will learn to smile again with your loved ones and your new friends.
An Update on Malignant Mesothelioma from Dr. Raphael Bueno and CureMeso
The Mesothelioma Applied Research Foundation has a series hosted by their Executive Director, Mary Hesdorffer N.P., that interviews experts in malignant mesothelioma. This month the guest was Dr. Raphael Bueno, Chief Division of Cardiac and Thoracic Surgery at Mass General Brigham Hospital in Boston, Massachusetts.
Dr. Bueno reviewed the progress that has been made. In the not too distant past it was believed that anyone diagnosed with malignant mesothelioma was handed a death sentence. Today, malignant mesothelioma has many options to offer for treatment. The knowledge of malignant mesothelioma has evolved like many other cancers and therefore treatment options have as well.
Dr. Bueno reviewed that in order to understand mesothelioma, we need to understand the genomics of the disease. Genomics is the biology of the structure, function, and evolution of the tumor. Basically it’s understanding the fingerprint of the tumor. Once it is understood how it can react in certain settings, we can treat it. This does sound pretty basic but it has taken a long time to figure this out. Each malignant mesothelioma tumor is unique like one’s own fingerprint.
Another treatment that has been found to be equal or better was the pleurectomy. In previous years, many more extra pleural pneumonectomies (also known as EPP removal of the lung) were performed on patients. It has been found that removing one’s lung in someone that is 70 years or greater can create other issues. Pleurectomy has become the surgical choice. It has also found that instilling IOHC, Intra-Op Heated Chemotherapy, was key in attacking any microscopic cancer cells that could not be detected with the eye. This has also improved survival.
It has also been discovered that everyone should not have chemotherapy. Some patients do not respond to chemotherapy and their tumor continues to grow and they lose the option of becoming a surgical candidate. Chemotherapy is effective for 23-25 percent of the population for a 5 year survival.
As the talk went on, Dr.Bueno spoke about local recurrence. He educated the audience about how local recurrence is not metastatic disease, it is just what it is: local. There are options to remove this growth. Ablation or surgical removal of the tumor can be as simple as a day procedure or an overnight hospitalization. Ablation is similar to burning a wart off.
Dr. Bueno’s closing remarks were about the future and what will help cure this disease. Malignant mesothelioma does not have to be a death sentence. This is an aggressive disease but there are many who are still living beyond five years. He believes staging is critical. Dr.Bueno spoke about getting the mesothelioma patient to a Center of Excellence. He explains we do not have a cure but we certainly offer better outcomes. A Center of Excellence can offer hope to a patient that has been diagnosed.
Progress to a cure continues!
Mesothelioma Patients Can Benefit from Time Outside this Summer
Staying positive and maintaining your overall health to the best of your ability is key for your journey with malignant mesothelioma. This is a difficult time but there are some basic things you can do that will help you. Simply going outside is a positive step.
Going outside can do so much for your outlook or mental state and your overall health. In the United States, according to the EPA, the average American spends 90 percent of their time indoors. Going outside can boost your mood – no special equipment or membership required, just the great outdoors.
Another positive benefit of spending time outdoors is an increase in your Vitamin D. Vitamin D is beneficial to your bones, blood cells, and immune system. It can also help with the absorption of calcium and phosphorus. With decreased levels of Vitamin D a person is more likely to get colds and the flu. Also, if a person gets sick with pneumonia with decreased levels of Vitamin D, the outcome can be more serious. Sunlight can keep your serotonin levels up if you go outside as well. This will help raise your energy levels and keep your mood positive.
Just by going outside, there is a chance you may connect with people in your community. Human contact can be important to your mental health. Sometimes being inside we tend to get lost in our own thoughts and this is not always positive. Getting outdoors can distract those thoughts inside your head for even just a few moments. In fact, studies show that time in nature can boost your problem solving skills. If you are feeling frustrated or down, the outside world may change your thinking for even just a short time.
Depending on the weather there may be precautions you should take. Stay well hydrated if the weather is warm. Apply sunscreen, wear a hat, or bug spray if necessary. Also bring a phone in case you need to be in touch with someone, or may need a ride back.
Mesothelioma is a complex disease. Each case is unique, similar to one’s fingerprint. Medical centers continue to push for more knowledge and treatments. Although there are many interventions, ideas, and thoughts on how we treat symptoms, some therapeutic ideas are just basic like going outside. The good news: you don’t need to travel and it costs nothing.
Mesothelioma Patient on Importance of Staying Positive During Treatment
Once a person is diagnosed with malignant mesothelioma and decides on a treatment plan, the anticipation for treatment to begin – and the reality of when it does begin – can be a challenging time.
Recently while talking with a patient, he offered his perspective on the difference between day 1 and day 2 of beginning treatment. For him, when treatment was going to be initiated, he found his mind in a unique spot. As he took in the new faces, new information, and new surroundings, new hope was born. The anticipation of the day was finally reality, and his body and mind were going down separate paths. This experience – whether it be chemotherapy, radiation, immunotherapy or surgery – is new, a road never traveled. Although education was provided prior to his intervention it is overwhelming to say the least. This first day is like no other day of your journey.
For this patient, the second time he had treatment it was no longer a new experience. For him, the reality of what he was going through was met with dread and fear. The anticipation of treatment and hope was met with growing uneasiness. Familiar faces are not new and side effects are expected and can produce anxiety. How does one deal with these days ahead, days that once provided hope and now are filled with anxiety and fear?
Wrapping your mind around the positive and trying to focus on the ultimate goal is key. These experiences are trying times and everyone masters these situations differently. Many choose to surround themselves with their most positive support team, others surround themselves with thoughts of a brighter future. Whatever way you choose is yours, and entirely up to you.
Prior to day 2 of your journey, try to focus on the part of treatment that you found positive. Experiences like treating mesothelioma bring many new possibilities. A relationship of any kind may be positive, or a certain person may have provided a warm smile which may be all you need at that very moment.
Perhaps writing in a journal as you travel this new path will bring peace to help when you reflect back on some of your symptoms and how they are improving. When people are facing their biggest adversities, sometimes there are strong positive ideas, relationships, or experiences that may change your perspective.
Receiving a diagnosis of mesothelioma is not like any other challenges that you may have faced. As we continue to see our waiting rooms filled with new faces, we are aware of the struggles that you are facing and are here for you. If there is something that you need or have questions about, please ask. The Mesothelioma Centers of Excellence are striving for a brighter future for all who have been affected by this disease one patient at a time.
Free Mesothelioma Patient & Treatment Guide
We’d like to offer you our in-depth guide, “A Patient’s Guide to Mesothelioma,” absolutely free of charge.
It contains a wealth of information and resources to help you better understand the condition, choose (and afford) appropriate treatment, and exercise your legal right to compensation.
Download Now