Nurse Explains Mesothelioma Treatment Decision Points Used at Brigham and Women’s Hospital

• Lisa Hyde-Barrett
• Nurse's Corner

Deciding which path to choose in the treatment of mesothelioma can be confusing and overwhelming. The available options are often individualized and tailored to the patient based on the stage of the disease, lymph node involvement, and the patient’s functional status. Using this information and the patient’s desires, the mesothelioma team and the patient will work together to determine the best plan for the patient.

Some questions for the patient to ask him/herself include: Is the chance of living longer worth going through surgery, chemotherapy, and more tests? How do I make a decision when the stakes are so high? Do I understand all the options presented by my oncologist?

Dr. Raphael Bueno, Director of the International Mesothelioma Program, Brigham and Women’s Hospital, talks about three factors that he and his team, and the patient, consider when deciding on a treatment plan for mesothelioma.

Dr. Bueno’s first step is to determine how advanced the cancer is. Is it actually mesothelioma? Is the mesothelioma localized or has it spread to the lymph nodes? Is it amenable to surgery? Is chemotherapy a better option than surgery? These questions emphasize why it is so important to go to a treatment center with mesothelioma experts. They can give you the benefit of their experience in treating patients with mesothelioma that other less experienced teams cannot.

The second factor that Dr. Bueno uses is the patient’s physical condition. Functional status is the term used to describe what the patient is able to do to meet their daily needs, fulfill usual roles, and maintain health and well-being. Is the patient debilitated? Can he/she walk or are they bed bound?

The third factor is, “What does the patient want?” This is where you have to look deep inside yourself and ask yourself, “Is this what I want?” Do you want to turn over every stone and fight aggressively? Is what you are  feeling the right path for you?

This is a brief, simplified outline of a very involved multidisciplinary process involving many experts. However, I hope that it does give you some questions to contemplate, and shows you that your mesothelioma treatment is not dictated by the medical team but is a collaborative decision.

The decisions that go into determining your mesothelioma treatment plan are not easy, but support is available. Remember that progress is being made, and there is hope!

If you have questions about your mesothelioma treatment or any aspect of your mesothelioma care, please email me at [email protected].