Tag Archive for: DLBCL treatment decisions

Dr. Nirav Shah: Why Is It Important for You to Empower DLBCL Patients?

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Dr. Nirav Shah: Why Is It Important for You to Empower DLBCL Patients? from Patient Empowerment Network on Vimeo.

 How can diffuse large B-cell lymphoma (DLBCL) care providers empower their patients? Expert Dr. Nirav Shah of the Medical College of Wisconsin explains methods he uses to help patients gain confidence and to create a relationship of collaboration and trust with patients.

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Transcript:

Dr. Nirav Shah:

So when I meet a new patient with diffuse large B-cell lymphoma, whether it’s in the frontline or in the relapsed/refractory setting, my main goal is to develop a partnership with them. Yes, I am the expert and the person who has knowledge on how to treat the disease, but the patient is a person going through it. And so what I try to do is educate them, review the options, and then guide them and try to help them come to a decision as to what is that best treatment there is, but again, with my educated guidance. And often patients need to make that decision themselves, especially our older patients who may have other values about how they want their life to be in their seventh or eighth decade.

And so what I try to do is have this collaborative discussion where I review the options and sort of say, “Well, this is what I think is best.” Why do I think that’s important? I think that patients today have access to a lot of information, and they’re going to be able to read a lot of things, and I think it’s important to be honest and up front that often there is more than one option for their disease, whether it’s frontline or relapsed, and then help them understand why I’m choosing a particular pathway for them and giving them that ability to make that final decision about, this is the way that I want to proceed.

By empowering them, I think it makes them a partner in their care, in the care that you’re providing them, it creates trust in a relationship between an oncologist and a patient, which is just so important to have because without having that trust it’s difficult to ask these patients to sacrifice their health, sacrifice sometimes important family events to be able to do the treatments that we’re prescribing. And so that’s sort of my approach, is through good education, review of information, through guidance, but ultimately allowing them to make that decision as to what they think is the best path among the options that I presented. 

How Can Your Diffuse Large B-Cell Lymphoma Care Team Help in Treatment Decisions?

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How Can Your Diffuse Large B-Cell Lymphoma Care Team Help in Treatment Decisions? from Patient Empowerment Network on Vimeo.

How can diffuse large B-cell lymphoma (DLBCL) treatment decisions be aided by your care team? Expert Dr. Nirav Shah from the Medical College of Wisconsin explains key factors that help guide treatment decisions and how some patient characteristics may alter dosing and treatment approaches.

Dr. Nirav Shah is an Associate Professor at the Medical College of Wisconsin. Learn more about Dr. Shah.

[ACT]IVATION TIP:

“..try to come up with an individualized treatment plan that meets the needs of your disease and your situation.”

See More from [ACT]IVATED DLBCL

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When Should CAR-T Therapy Be Considered for Relapsed/Refractory DLBCL Patients

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Transcript:

Lisa Hatfield: 

So, Dr. Shah, how do you work with your DLBCL patients in helping them make treatment decisions, and what should they consider when they are making their treatment decisions? 

Dr. Nirav N. Shah:

 It’s a great question, Lisa. I think that in the current area that we’re practicing, the term I use is one size doesn’t fit all. I really try to meet with the patient, understand number one, their disease, so the biology of their disease, what subtype or phenotype is it, what stage is it presenting in. Then I try to think about the actual patient characteristics, what are their goals of care, what is their age, and what are their comorbid conditions that may impact our ability to treat them and other factors, social factors. Do they have a support system? What is the distance that they’re driving to come here to be able to get treated here, and so I take all of this information together and try to come up with the best treatment option that is available for that patient.

Now again, the majority of people are going to get common regimen such as R-CHOP chemotherapy, which is one of the standard of care for diffuse large B-cell lymphoma, but even within them, there are different ways you can administer it if you’re a particularly older patient or have a lot of medical problems. And so I really believe in trying to individualize the treatment plan for the patient, because each one of us are different, and how we tolerate things and what our body has been through in the past is going to impact how we’re going to be able to handle a specific treatment. And so my activation tip to patients about this is to try to come up with an individualized treatment plan that meets the needs of your disease and your situation.

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Tips for Making Treatment Decisions WITH Your DLBCL Team

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Tips for Making Treatment Decisions WITH Your DLBCL Team from Patient Empowerment Network on Vimeo.

DLBCL expert, Dr. Jason Westin, explains shared decision-making and provides tips for engaging in your treatment decisions.

Dr. Jason Westin is the Director of Lymphoma Clinical Research in the Department of Lymphoma/Myeloma in the Division of Cancer Medicine at The University of Texas MD Anderson Cancer Center. Learn more about Dr. Westin, here.

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Transcript:

Katherine:                  

Lately, we’ve been hearing this term shared decision-making, which basically means the patients and clinicians collaborate to make healthcare decisions. And it can help patients take a more active role in their care. So, I’d like to get your thoughts on how best to make this process work. Are there questions that patients should consider asking about their proposed treatment plan?

Dr. Westin:                 

Definitely. And I think shared decision-making is something that we view to be critical. We want everybody on board to feel like they’ve got some sense of ownership of these decisions and that they’re involved in a way that’s meaningful. At the end of the day, the patients make the decisions about which treatments are right for them but they’re trusting their healthcare team to give them good advice. This is not something that patients have expertise in. This is often out of nowhere that somebody is newly diagnosed and this is not on their radar, not something that they ever thought that they’d be sitting in the chair talking about which type of therapy for this cancer.

And so, patients are often relying on the healthcare team to give them good advice. But it’s a fair question and it’s, I think, one that’s appropriate to ask. “Are there other treatment options that we should be talking about?” Basically, exploring, “Is this option you’re presenting the option or is this what you consider to be the best option.” Oftentimes physicians, and PAs, and nurse practitioners might filter information such that, “Yeah, there are other options but here’s why they’re bad. Here’s why they’re not right for you.”

But feeling that you have some clarity about why a treatment choice was made, I think, is often quite important. For first line DLBCL, there are less options to consider. But in the relapse space, there are lots of options. And those should be discussed. And sometimes the healthcare provider, a physician, might have their favorite that they have had good experience with treatment A and therefore they recommend treatment A to the next patient. But that may not always be the right treatment for a given patient.

There may be reasons to consider other treatments. And so, asking that question, “What else is out there? What other treatments are there? Anything else that we should be considering,” I think is a fair question to ask and an important one. And if the answer is, “No, there aren’t other treatment options. This is the one that we should choose,” at least you’re aware of that by asking that question. So, I think that’s an important one to clarify.