Patient-Centered Care: Helping Sarah Navigate Treatment Choices
Panelists discuss the importance of vigilant, patient-centered monitoring for metastatic melanoma patients with high disease burden on immunotherapy, emphasizing clear communication about variable treatment responses, proactive symptom tracking, differentiation of true progression from pseudoprogression, and integration of clinical assessments with biomarkers like lactate dehydrogenase and circulating tumor DNA to guide optimal care.
Patients with metastatic melanoma and high disease burden starting immunotherapy require careful and continuous monitoring to assess treatment response and manage symptoms. It is crucial to set clear and realistic expectations from the outset, explaining that responses to treatment can vary widely. Some patients may experience rapid improvement, while others might initially seem worse before getting better. There is also the possibility that the disease progresses despite therapy. Using relatable analogies helps patients and their support systems understand the unpredictable nature of immune-based treatments, fostering better communication and engagement throughout the care process.
Regular clinical evaluations and close communication play an essential role in managing these patients. Monitoring focuses on symptom changes, especially those affecting energy levels, breathing, and daily functioning. Patients are encouraged to track and report symptoms promptly, using simple scales or checklists to benchmark their status. This proactive approach ensures timely identification of potential complications or disease progression. Additionally, health care providers remain vigilant for immune-related adverse effects and inflammatory responses, such as pseudoprogression, where imaging may temporarily show tumor enlargement despite effective treatment. Differentiating between true progression and such phenomena requires combining clinical judgment, symptom assessment, and diagnostic information.
Laboratory markers and emerging tools further support treatment monitoring, providing objective data to complement patient-reported outcomes. Blood tests, including lactate dehydrogenase (LDH) levels, help gauge disease activity and organ function. More advanced methods like circulating tumor DNA analysis are increasingly used to track tumor burden and detect subtle changes earlier than imaging might reveal. Ultimately, the combination of scientific data and a strong, trusting patient-provider relationship ensures optimal care. Being responsive to patient concerns and maintaining open lines of communication are as important as any diagnostic test in guiding treatment decisions and supporting patients through their cancer journey.
Oncology Nurses Provide Patients an Avenue to Supportive Care
November 12th 2019Palliative care is often associated with a patient entering end of life treatment and giving up on their treatment, but that isn't the reality of what id can do for patients. And oncology nurses can help guide patients to the right supportive care for them.
Hyman B. Muss Discusses the Importance of Nurses in Treating Pregnant Women With Breast Cancer
March 23rd 2016Hyman B. Muss, MD, professor of medicine at the University of North Carolina School of Medicine, discusses the vital roles that nurses play when it comes to treating pregnant women with breast cancer.
