Mesothelioma can bring with it pain ranging from mild to severe, but people with mesothelioma and their loved ones should know that most cancer pain can be controlled effectively. Ninety percent of cancer patients find relief from cancer pain, often through a combination of drugs and methods of administering them. Mesothelioma patients should never have to cope with unmanaged pain.
Pain in mesothelioma patients may be caused by the tumor itself, the cancer treatment, or sources unrelated to the disease. Tumor pain results when a tumor presses on an organ, a bone, or nerves, and it varies by location. The size of the tumor may not have anything to do with the severity of the pain. Even a small tumor can cause severe pain if it presses right on a nerve. On the other hand, a large tumor that doesn’t impinge on a nerve, bone, or major organ may not be very painful at all.
Cancer treatments like radiation, surgery, and chemotherapy can cause pain. Pain from cancer treatments is more common in patients with compromised immune systems.
And people with mesothelioma cancer are subject to the same pains that occur apart from the cancer. Muscle strains, arthritis, and headaches can strike mesothelioma patients as well, but they can almost always be successfully treated along with cancer-related pain.
Pain management
Pain management for mesothelioma usually begins soon after the diagnosis. Up to 90% of mesothelioma patients have shortness of breath or pain as their first symptom. Fortunately, pain control techniques are constantly being upgraded, and more patients than ever before can get effective mesothelioma pain management along with treatment for their disease. Today there are even pain control devices that can be implanted that send pain relieving drugs straight to the central nervous system.
Mesothelioma pain can be effectively treated with such epidural anesthetics (which deliver medication directly to the spinal cord) and catheters, even in patients who have had trouble finding a pain management plan that is effective. These methods of pain relief are highly effective and have few side effects.
Most mesothelioma is pleural, or lung cancer, and one of the early symptoms may be a mild pain or vague discomfort in the back or chest. People who develop abdominal mesothelioma first may have pelvic pain or abdominal discomfort as a first symptom. With abdominal mesothelioma, the disease can cause bowel obstruction, which is a painful condition, though the pain can be treated effectively.
Fortunately, the early pain of mesothelioma usually responds to over-the-counter pain relievers like acetominophen, ibuprofen, and aspirin. When initial surgery, radiation, and chemotherapy are done, they can effectively fight pain by trying to halt the spread of the disease. But often the treatments themselves can be painful.
The mesothelioma survival rate is lower than other forms of cancer, and as mesothelioma progresses, it can destroy nerves and soft tissue and the mesothelioma pain intensifies. Eventually, when the cancer spreads to the chest wall, it impinges on ribs and muscles, and results in severe pain. Though this type of mesothelioma pain will become unresponsive to drugs taken by mouth, IV, and intramuscular injections, new mesothelioma pain management techniques with epidurals and catheters are able to effectively manage this pain.
Mesothelioma pain relief methods
Cancer treatment specialists often take a two-pronged approach to pain relief, treating both the physical mesothelioma pain and its psychological consequences. Pain itself is bad enough, but it also affects other quality of life issues by disturbing sleep, causing exhaustion and inability to work, depression, dampened appetite, isolation, and in some cases family and friends becoming exhausted by the demands of caregiving. Effective mesothelioma pain management is in the interests of not only the mesothelioma patient, but also his or her loved ones and medical team. Pain management can affect the mesothelioma survival rate, in the short term if not the long term.
Overwhelming pain can undercut a person’s ability to fight cancer by diminishing appetite and resulting in nutritional deficiencies, which further the cycle of exhaustion and pain, eventually sapping a patient’s will to fight the disease. Partaking of pain relieving measures is not a sign of weakness, but rather indicates a resolve to improve quality of life as much as possible and to be able to share one’s company with loved ones and avoid isolation and depression.
Most doctors, nurses, and health professionals who care for mesothelioma patients take treating mesothelioma pain very seriously. Their job is not just to help your body fight cancer, but to maximize the patient’s comfort and quality of life regardless of what stage cancer they have and what the mesothelioma survival rate is. This means helping the patient and his or her family cope with the emotional and psychological effects of the disease, and finding ways to minimize anxiety, fear, and depression.
In the top mesothelioma treatment centers, management of mesothelioma pain and the psychological effects of the disease are part of weighing treatment options, as is managing the pain of mesothelioma treatment. Every patient’s situation is unique, and every treatment plan must respect that.
Opiods for pain management
While there are many types of drugs used to treat mesothelioma pain, the ones most often used are opiods, also called narcotics. These medications do a very good job of controlling mesothelioma pain, but they do have side effects, including temporary nausea and vomiting. Fortunately, doctors have many effective ways of combating nausea and vomiting, so any patient experiencing this side effect should speak up about it.
Opioids also cause drowsiness and sleepiness, particularly at first. In most people, the side effect of drowsiness goes away after a day or two. Another side effect of narcotics is constipation, which can be managed by drinking plenty of water or juice, eating more fruit (with their skin), vegetables, and whole grains. Adding bran to food can also help, as can gentle exercise such as walking. If these measures don’t relieve the constipation, there are prescription medications that can help.
Another side effect of narcotics can be confusion, hallucinations, and nightmares. These effects typically do not go away with time, and in most cases the patient will be able to use another type of medication without experiencing those problems.
Classes of pain relieving drugs
When it comes to pain management, the World Health Organization groups pain relieving drugs into three classes:
1. Non-narcotics like acetominophen, ibuprofen, and aspirin
2. Weak narcotics like codeine and dextropropoxyphene
3. Strong narcotics like morphine and diamorphine
The WHO follows a “pain ladder” approach to treating pain, meaning that the patient should start with non-narcotics and only if they don’t work should he or she advance to weak narcotics. And only if the weak narcotics don’t work (the equivalent of 60 mg of codeine every 4 hours), should the patient use strong narcotics.
Breakthrough pain
Breakthrough pain is a clinical problem for cancer patients. It is defined as pain that occurs that “breaks through” medications that the patient uses to control chronic pain. For breakthrough pain, short-acting opioids like fast-release oral morphine may be given to relieve pain quickly while long-acting opioids are used for the chronic pain. Physicians and nurses take breakthrough pain seriously because it can seriously affect the patient’s quality of life.
These severe pain flares occur over a tolerable level of background pain that is treated with long-acting opioids occur in about half of patients taking narcotics for chronic pain. These episodes of breakthrough pain are mostly unpredictable, though patients can identify some triggers, such as movement, or the wearing off of pain medication. Mesothelioma patients who experience breakthrough pain often have greater pain-related impairment, low moods, and increased anxiety, mental conditions that make fighting cancer that much harder. In these cases novel ways of delivering pain medication may be used, such as catheters and epidurals.
Other approaches to pain relief involve the use of combinations of drugs. This often requires some trial and error, but it works often enough to be worth trying for many people. Sometimes the so-called non-steroidal anti-inflammatory drugs like ibuprofen can be used in combination with mild or strong narcotics and provide pain relief that neither drug on its own would provide. Sometimes steroids are found to relieve mesothelioma pain that results from nerve destruction.
Pain relief drug administration
Mesothelioma pain relieving drugs may be administered in a variety of ways, usually orally, in the form of a transdermal skin patch, by injection under the skin, by IV injection, intrathecally / epidurally (where medication is put directly into the fluid around the spinal cord or into the space around the spinal cord), or by immplantation wtih a computerized pump that the patient can control.
Patients who cannot tolerate oral narcotics due to nausea and vomiting or excessive drowsiness may be given these drugs by injection. Patients who require long-term drug administration may be given continuous subcutaneous (under the skin) infusion. The drug diamorphine is twice as potent when given by subcutaneous infusion or intramuscular injection than when it is given orally. Subcutaneous infusion is the delivery method of choice for patients who have advanced cancer.
For epidural pain medication delivery, the drug is delivered within the spinal canal, yet outside the dural membrane of the spinal cord. A thin catheter is placed under the skin, and fixed doses of the pain medication are programmed to flow through the tubing into the epidural area at preset times. The drugs attach to receptors directly in the central nervous system and block pain signals at the level of the nerve roots.
Not only do epidural implants control mesothelioma pain very well, they can reduce the need for in-hospital pain care. When patients can control their mesothelioma pain at home, they have more mobility and are usually much happier. Home healthcare technicians can monitor the operation of the device for problems.
It is extremely important for patients to speak up if a method of pain relief isn’t working because there are numerous options that can be tried. If the mesothelioma pain is not relieved, doesn’t respond within the time it is supposed to begin working, does not last as long as it should, results in breakthrough pain, or interferes with normal activities, there are many pain relief methods that are available, and it is likely that at least one will be effective, whether that’s a change in the medication itself or a change in the delivery method.
Mesothelioma pain is complex and unique, so each patient’s needs will be different. Doctors today take pain control seriously because they know that the quality of life of a person fighting cancer affects not only the patients, but his or her loved ones and caregivers as well.