We are all goal-oriented in some way, although some more so than others. When patients are diagnosed with mesothelioma, their goals of care are discussed. No one wants the mesothelioma patient, or their family, to suffer with interventions that are not effective. The goals of therapy are individual and are, ideally, made jointly with the mesothelioma team. While goals established in a business environment usually have a timeline and benchmarks attached, for mesothelioma patients, it is not that clear cut.
When first diagnosed with mesothelioma, many people are determined to fight. They make it their mission to learn all about the disease: where to go for treatment, clinical trials, what can do they, what can their family do. Unfortunately, for many diagnosed with mesothelioma, disease progression can be rapid.
A patient I cared for this week had been diagnosed over two years ago. He and his supportive family have fought mesothelioma aggressively. Together they had been a force. Their goal was always to keep going, don’t give up. The patient had enjoyed some good times with his family and made some memories, but time and disease progression had taken its toll. He had lost weight, did not feel well, was in pain, had no appetite and was continually nauseous. He had also changed, he was accepting and quiet. His family was not. They continued to use their resources and energy to encourage the patient to keep fighting aggressively.
As the patient’s disease had progressed, the options for his therapy became limited. At this point it, it was time to take all that energy and redirect the goals of his care. Just as the family and patient had been a force of nature fighting the disease, it was now time to become a force to fight the pain and the nausea, and to make him comfortable.
People with mesothelioma all have a unique story to tell. Unfortunately, there is not a cure at this point in time. Goals should be set with the mesothelioma team, and as the individual’s disease progresses, the goals should be re-established, as needed.
My patient and his family did re-direct their goals. Now, he is comfortable, home, and they have had conversations that they never had while fighting the disease. Conversations that will become memories as time goes on.