Lindsey Lyle discusses the factors that should be considered when choosing a therapy.
Lindsey Lyle is a physician assistant at the University of Colorado Cancer Center, specializing in hematological malignancies with a subspecialty in myeloproliferative neoplasms (MPNs). More about this expert here.
When deciding about a treatment, it’s really important for the healthcare professional and the patient to discuss the patient’s goals.
The patient really is the key player here, and we as medical professionals are here to support the patient’s goals. So, what might work for one patient is not going to be necessarily the same treatment I would choose for a different patient. So, right off the bat, identifying the patient’s goals – and really, what are we trying to fix in one specific patient is going to look different from the next patient I see in that day.
For example, there are certain clinical manifestations of MPNs that need specific treatment approaches and maybe honing in on trying to help one clinical issue.
So, first of all, identifying the disease process – that’s No. 1. What is the diagnosis? No. 2: Coming up with a goals of care plan with the patient. What is causing them the most difficulty in their everyday life, and how are we going to fix that? That’s generally where I start.
Then, I discuss with the patients the different options for treatment, which either include therapies that are FDA-approved or enrolling in a clinical trial. And then, we really talk about pluses and minuses for each of these therapeutic decisions.
Patients may have different comorbidities, so they may suffer from different chronic diseases that may impact the treatment that is chosen with the patient and their provider, as well as discussing stem cell transplant, which we haven’t talked much about, but stem cell transplant is an option, and at this point, the only curative therapy for patients with myelofibrosis. And so, determining whether or not transplant is in the patient’s best interest is also a topic of discussion when deciding on therapy approach.