mesothelioma info

10 Chapter 4 – Active anti-cancer treatment Clinical practice points Page f: A multidisciplinary team with sufficient experience should provide advice on the suitability of patients for trimodality therapy and the ongoing treatment strategy adopted. 50 g: Patients whose MPM progresses despite induction (neoadjuvant) chemotherapy should not be offered cytoreductive surgery followed by hemithoracic radiotherapy. 51 Chapter 5 – Palliative and supportive care Clinical practice points Page h: Patients with malignant mesothelioma should be referred to a palliative care specialist in a timely manner, and on the basis of their needs. 57 i: The WHO principles of cancer pain management for patients with malignant mesothelioma should be followed. 57 j: A specialist palliative care physician should be involved early as part of the multidisciplinary oncology team for patients with refractory or unresponsive pain. 57 k: Palliative radiotherapy should be considered for patients with painful chest wall infiltration or nodules. 57 l: In order to tailor information to a person’s individual needs at a particular point in time, it is necessary to: • give clear information specific to the individual • repeat and summarise important information • encourage questions • actively check the person’s understanding, and provide additional written/ audiovisual information. 59 m: Patients should be screened for psychological distress and unmet needs. 61 n: Patients and carers should be referred to appropriate counseling services when required. 62 o: Information, guidance and emotional support should be provided for carers. 62 p: Consultations should be provided with specialist nurses trained in the care of patients with malignant pleural mesothelioma. 63 q: Practitioners dealing with MPM patients should be aware that legal remedies are available and the patient should be advised of this upon diagnosis. 63