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Living with cancer· Appointment prep

Appointment sheet: Peritoneal mesothelioma

One page to bring and write on: your details, the questions for Peritoneal mesothelioma plus your own, the words you may hear, what to bring, the treatments the standard of care names, and room for the answers and agreed next steps. What you type stays in this browser. Print it or save it as a PDF. New to all this? Start with the first 60 days. Orientation, not medical advice.

Tick the questions to print

All of this cancer's questions start ticked. Untick what does not apply; ticks are kept in this browser. .

Your own questions

Shared with the prep pack, so questions you add there appear here too.

Print or save as PDF

Use (or Ctrl+P, Cmd+P on a Mac). To keep a copy, choose Save as PDF as the destination in the print dialog. Only the sheet prints; the controls stay on screen. Your typed notes print where you typed them; empty fields print as ruled lines to write on.

Appointment sheet

Peritoneal mesothelioma

Prepared with OnCo (onco.cc/prep/peritoneal-mesothelioma/). Orientation, not medical advice; your team knows your case.

My details

Name
Date of appointment
Hospital and clinician
Who is coming with me

What I know, what is unclear, changes to discuss

Saved in this browser
What I know so far
What is unclear to me
Changes since last time

My questions

14 on the sheet
Newly diagnosed
  1. 1.What is my exact diagnosis, stage, and grade, and which tests established them?
  2. 2.Which biomarkers have been tested on my tumour (for example Histology and peritoneal cancer index at laparoscopy, BAP1 loss, Ki-67, Completeness of cytoreduction score), and what were the results?
  3. 3.Which subtype is my cancer, and does that change the recommended treatment?
  4. 4.Is germline (inherited) genetic testing recommended for me or my family?
Diagnosis
  1. 5.For my situation (diagnosis), which of the standard options do you recommend and why?
Resectable epithelioid disease, fit patient
  1. 6.For my situation (resectable epithelioid disease, fit patient), which of the standard options do you recommend and why?
Unresectable or unfit
  1. 7.For my situation (unresectable or unfit), which of the standard options do you recommend and why?
  2. 8.Am I a candidate for Pemetrexed, Nivolumab, Ipilimumab or related drugs, and what side effects should I expect?
Indolent variants
  1. 9.For my situation (indolent variants), which of the standard options do you recommend and why?
Any stage
  1. 10.Are there clinical trials I could join, for example of Antibody-drug conjugates for mesothelioma: why they have failed so far and how they could work?
  2. 11.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
  3. 12.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
  4. 13.I read that “No randomised trial has compared surgery plus HIPEC with systemic therapy”. How does that affect my plan?
  5. 14.I read that “Selection for surgery relies on centre experience rather than validated criteria”. How does that affect my plan?

Tests and results to bring

Diagnosis: CT, laparoscopy with biopsy and scoring of disease extent; germline BAP1 testing when young or with a family history.

Biomarker results to ask for: Histology and peritoneal cancer index at laparoscopy, BAP1 loss (somatic and germline), Ki-67 (prognostic after surgery), Completeness of cytoreduction score.

Scans and tests linked to this cancer: Active surveillance.

Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.

The treatments I may be offered

  • Resectable epithelioid disease, fit patient: Cytoreductive surgery with HIPEC in an experienced centre; long-term survival in a substantial fraction. (HIPEC / PIPAC (intraperitoneal chemotherapy))
  • Unresectable or unfit: Platinum-pemetrexed chemotherapy; nivolumab plus ipilimumab or pembrolizumab combinations extrapolated from pleural trials and small peritoneal series. (Pemetrexed, Nivolumab, Ipilimumab, Pembrolizumab)
  • Indolent variants: Well-differentiated papillary and multicystic tumours: surgical removal and surveillance; systemic therapy rarely needed. (Active surveillance)

From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.

Answers and next steps

Saved in this browser
What I was told
Agreed next steps, dates and who to call