Mesothelioma surveillance protocols are a series of medical tests. Surveillance is designed to detect and track cancer progression.
Surveillance protocols also check treatment effectiveness. And they provide patients with reassurance and hope.
A new study identified the effectiveness of mesothelioma surveillance protocols. This study focused on patients who have noncurative treatment intent.
Importance of Reassurance and Hope
Findings from nine different studies identified the need for reassurance and hope as part of surveillance. They also highlighted the importance of trust and relationships. Follow-up and surveillance models provide patients with continuity, reassurance, and updates on condition. Continuity ensured patients knew who to contact if they had a new symptom or concern.
Patient hopes for follow-up were for management of pain and management of hope. Follow-up should also address patient fears and provide support. Relatives and caregivers also reported that follow-up offered them peace of mind.
Yet, mesothelioma surveillance protocols also can cause anticipatory anxiety. Patients fear impending visits and diagnostic procedures. Patients reported feelings of vulnerability and uncertainty. Anticipatory anxiety around visits and computed tomography scans were common.
There was a marked lack of consistency and evidence around the frequency and method of surveillance models. The current standard of care suggests a surveillance model consisting of 3 monthly clinic visits. These visits take place in the hospital with a medical oncologist as the standard of care. Other models have been explored to understand better who could provide follow-up in a safe, acceptable, and timely way.
Current mesothelioma surveillance protocols are based on expert opinion. There is not enough concern about patient preferences or quality of life. The impact on anxiety and impact on survival outcomes needs more research. Quality of life and burden of care remain underexplored
Very little previous research has explored different ways of delivering surveillance. The traditional method is face-to-face clinic appointments. Patients reported the benefits of phone follow-up. This method includes no waiting times, no parking costs, and no negative impact on childcare or work release time. One patient-led, symptom-oriented, follow-up approach demonstrated up to 70% reduction in out-of-pocket costs.
The Role of Nurses
Nurses play a key role in managing mesothelioma surveillance protocols for noncurative lung cancer patients. Seventy-five percent of patients were happy to be included in a nurse-led protocol.
Results showed that the nurse-led protocol resulted in improved emotional functioning. Other benefits included less severe breathlessness and greater patient satisfaction. This was compared with conventional medical follow-up.
Questions remain around how often surveillance should occur for patients with noncurative disease. It is still unknown what tests and examinations should be conducted and how long mesothelioma surveillance protocols should be offered.
Anne Fraser, MEd ONP from the University of Auckland, reported, “Importantly, surveillance is not a singular exercise in detecting recurrence in the advanced lung cancer population. Symptom control, psychological support, strategies to improve quality of life, and management of hope are all important elements of surveillance for these patients.”
Fraser, A., & McNeill, R. (2022). Surveillance of Lung Cancer and Mesothelioma Patients With Noncurative Treatment Intent: A Narrative Review. Cancer Nursing, 45(1), 31-36. https://doi.org/10.1097/ncc.0000000000000880