NCCN Guidelines for Patients
: Malignant Pleural Mesothelioma
Part 7: Accepting a treatment plan
Talking with your doctor about your prognosis can help
with treatment planning. If the cancer can’t be cured,
a care plan for the end of life can be made. However,
such talks often happen too late or not at all. Your doctor
may delay these talks for fear that you may lose hope,
become depressed, or have a shorter survival. Studies
suggest that these fears are wrong. Instead, there are
many benefits to advanced care planning. It is useful for:
• Knowing what to expect,
• Making the most of your time,
• Lowering the stress of caregivers,
• Having your wishes followed,
• Having a better quality of life, and
• Getting good care.
Advanced care planning starts with an honest talk between
you and your doctors. You don’t have to know the exact
details of your prognosis. Just having a general idea will help
with planning. With this information, you can decide at what
point you’d want to stop cancer treatment, if at all. You can
also decide what treatments you’d want for symptom relief.
Another part of the planning involves hospice care.
Hospice care doesn’t include treatment to fight the cancer
but rather to reduce symptoms caused by cancer. Hospice
care may be started because you aren’t interested in more
cancer treatment, no other cancer treatment is available,
or because you may be too sick for cancer treatment.
Hospice care allows you to have the best quality of life
possible. Care is given all day, every day of the week. You
can choose to have hospice care at home or at a hospice
center. One study found that patients and caregivers had
a better quality of life when hospice care was started early.
An advance directive describes the treatment you’d want
if you weren’t able to make your wishes known. It also
can name a person whom you’d want to make decisions
for you. It is a legal paper that your doctors have to
follow. It can reveal your wishes about life-sustaining
machines, such as feeding tubes. It can also include
your treatment wishes if your heart or lungs were to stop
working. If you already have an advance directive, it may
need to be updated to be legally valid.
Getting a 2nd opinion
The time around a cancer diagnosis is very stressful.
People with cancer often want to get treated as soon as
possible. While cancer can’t be ignored, there is time
to think about and choose which treatment plan is best
for you. You may wish to have another doctor review
your test results and the treatment plan your doctor has
recommended. This is called getting a 2nd opinion.
Copies of all test results need to be sent to the doctor
giving the 2nd opinion. Some people feel uneasy asking
for copies from their doctors. However, a 2nd opinion is
a normal part of cancer care. What’s more, some health
plans require a 2nd opinion. If your health plan doesn’t
cover the cost of a 2nd opinion, you have the choice of
paying for it yourself.