Physician Assistant Perspectives: Importance of Patient Shared Decision-Making and Multidisciplinary Team Approach in R/R FL
A panelist discusses how advances in follicular lymphoma treatments have expanded options beyond third-line therapy, emphasizing individualized, multidisciplinary care that integrates medical, psychosocial, and logistical support to address the complex needs of often older patients managing an incurable disease.
Over the past decade and a half, significant advances in follicular lymphoma treatments have provided numerous options beyond second and third lines, extending even to fourth- and fifth-line settings. This wealth of options allows for a collaborative decision-making process between provider and patient, emphasizing individualized care that fits each patient’s lifestyle and goals. Many patients with follicular lymphoma tend to be older, often retired, with active lifestyles that include travel and family time. When discussing treatment options, it’s important to consider efficacy, speed of response, toxicity, financial burden, and accessibility—especially since many patients face challenges such as limited transportation or support. Educating patients early about the incurable nature of follicular lymphoma and setting realistic expectations helps them feel more comfortable and engaged in treatment decisions as their disease progresses.
A multidisciplinary approach plays a critical role in managing relapse or refractory follicular lymphoma. In an academic center setting, patient cases are reviewed collaboratively by a team that includes hematologists, advanced practice providers, nurse navigators, infusion nurses, radiation oncologists, radiologists, and pathologists to ensure a comprehensive assessment. Beyond medical care, the team also integrates nutrition, psychosocial support, social work, psychology, and chaplaincy services to address patients’ holistic needs. Such support is particularly valuable as patients navigate complex treatment decisions and cope with the psychological impact of their illness.
Additionally, pharmacists and nurse navigators are essential team members who assist patients in managing medication interactions and coordinating care logistics. Pharmacists provide detailed medication reviews tailored to patients’ existing conditions and drugs, while nurse navigators ensure seamless scheduling of scans, labs, and treatment visits. This multidisciplinary model enhances patient comfort, supports shared decision-making, and helps deliver personalized, high-quality care throughout the patient’s treatment journey.
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