NCCN Guidelines for Patients
Malignant Pleural Mesothelioma, Version 1.2014
Parts of a treatment plan
treatment. The plan will include the role of your
doctors and how you can help yourself. A treatment
plan often has the following parts:
Cancer can greatly differ even when people have a
tumor in the same organ. Test results that describe
the cancer are reported in the treatment plan. Such
test results include the cancer site, mesothelioma cell
subtype, and cancer stage.
Your treatment team
Pleural mesothelioma should be treated by
a multidisciplinary team with experience in
mesothelioma. Your treatment team may include
a radiation oncologist, thoracic surgeon, medical
oncologist, diagnostic imaging specialist, and
pulmonologist. Your primary care doctor can also
be part of your team. Besides doctors, you may
receive care from nurses, social workers, and other
health experts. Ask to have the names and contact
information of your health care providers included in
the treatment plan.
There is no single treatment practice that is best for
all patients. There is often more than one treatment
option. Treatment planning takes into account many
factors, such as:
• The cancer stage and cell subtype,
• Location of the cancer,
• Your general health,
• Treatment side effects,
• Costs of treatment, and
• What you want from treatment.
The cancer treatment that you decide to have should
be reported in the treatment plan. It is also important
to note the goal of treatment and the chance of a
good treatment result. In addition, all known side
effects should be listed and the time required to treat
them should be noted.
Your treatment plan may change because of new
information. You may change your mind about
treatment. Tests may find new results. How well
the treatment is working may change. Any of these
changes may require a new treatment plan.
Stress and symptom control
Cancer and its treatment can cause bothersome
symptoms. You may also have symptoms from the
stress of having cancer. Such symptoms include pain,
sleep loss, and anxiety. There are ways to treat many
symptoms, so tell your treatment team about any
symptoms you have so they can help.
Financial stress is common. You may be unemployed
or miss work during treatment. You may have too little
or no health insurance. Discuss these issues with
your treatment team and they will include information
in the treatment plan to help you manage your
finances and medical costs.
Advance care planning
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 advance 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.