Pleural mesothelioma: management updates and nursing initiatives to improve patient care

Abstract

Malignant pleural mesothelioma is a relatively rare but aggressive malignancy that is primarily associated with occupational asbestos exposure. While treatment options for mesothelioma have expanded, the disease carries a poor prognosis, with a median of 8 months to 1 year of survival postdiagnosis. This article synthesizes current disease-management practices, including the diagnostic workup, treatment modalities, emerging therapies, and symptom management, and identifies comprehensive nursing strategies that result in the best care based on updated evidence. Multidisciplinary coordination, palliative care initiation, survivorship, and end-of-life care are discussed. Findings may be applied in clinical environments as a resource to help nurses better understand treatment options and care for patients facing malignant pleural mesothelioma. Recommendations for future research are made to move nursing science forward and to improve patient well-being and health-related quality-of-life outcomes for patients and their family members.

Living with mesothelioma: a systematic review of mental health and well-being impacts and interventions for patients and their informal carers

“…24 48 Four reviews took other approaches: meta-ethnographic, 6 selective, 57 scoping 27 and unidentified. 58 Overall, the review studies had clearly stated questions, with appropriate inclusion criteria, search strategies and synthesis methods. They all used the reported data to make recommendations for policy and/or practice and to specify directives for new research.…”

“… 33 37 38 54 63 64 Patients and carers often mourned their previous life 63 and experienced anticipatory grief. 58 …”

Caring for Patients with Malignant Pleural Mesothelioma in Japan: Evaluation of a Palliative Care Educational Program

“…Mitsuhashi and Toda (2011) reported that quiet terminally ill patients were often in extreme spiritual pain; MPM patients with such pain kept away from health care staff and family members . The care of patients with spiritual pain is difficult and causes suffering among nurses (Lehto, 2014). reported that nurses experienced strong distress when attempting to communicate with patients with MPM who could not accept their disease and prognosis.…”

“…reported that nurses experienced strong distress when attempting to communicate with patients with MPM who could not accept their disease and prognosis. In addition, improving the relationship between patients with MPM and their family requires sensitivity in fully understanding the multiple causal factors together with the ability to empathize and use appropriate communication skills to facilitate reconciliation (Lehto, 2014). In conducting programs in the future, an additional module on communicating with patients in spiritual suffering and managing nurses' compassion fatigue (Lombardo and Eyre, 2011) should be considered.…”

“…For successful symptom management, it is advisable to introduce palliative care in the early stage of this incurable disease (Ibrahim et al, 2013) by a multidisciplinary care team (Lehto, 2014) including appropriately trained specialist nurses in the care pathway for the patient and the family throughout the course of the illness and who are able to provide a strong liaison between hospital services and primary care and can enable access to specialist palliative care services as required. (National Comprehensive Cancer Network, 2012).…”