Pain is a major problem faced by patients with mesothelioma. The mesothelioma tumor itself can be responsible for severe pain such as when the tumor presses on internal organs or nerves. Mesothelioma can also exacerbate other painful conditions like arthritis. Further, mesothelioma treatments often results in pain due to a number of reasons.
Pain can occur whether the mesothelioma is benign or malignant. Benign conditions that may cause pain include diffuse pleural thickening, folded atelectasis (collapse of part or all of the lung), pleural plaques and asbestosis.1
The primary sources of pain are peripheral neuropathy induced by chemotherapy, nerves in the chest wall invaded by tumors, postthoracotomy syndrome and dyspnea.2 these are certainly not the only sources of pain among mesothelioma patients though. Most mesothelioma patients will experience some type of pain. The early symptoms may include a mild pain in the chest, back or abdomen depending on the type of mesothelioma. Early mild pain can be treated with over-the-counter pain medications but as the disease progresses, the pain will get worse. Mesothelioma is an invasive disease that destroys tissue and nerves. The mild pain eventually gives way to more severe and chronic pain.
Luckily, there are many different pain management remedies available to patients and no patient should have to suffer through unreasonable pain because of mesothelioma. Pain may be treated at any stage of the disease also. Even as the disease progresses, palliative care may include pain management so that you can enjoy your life as much as possible even while dealing with the disease.3
Types of Pain
Mesothelioma pains are divided into three main types: acute, chronic and breakthrough. Acute pains may be very strong but they do not last for a long time. Chronic pain is constant and may be mild, very strong, or progressive. Breakthrough pain occurs in patients with chronic pain. It is when a very strong pain suddenly occurs and is not managed by the normal pain medications. Each of these different types of pain requires a different medical approach.
Problems with Mesothelioma Pain Medications
Treating chronic or breakthrough pain with medication can be very difficult because patients run the risk of becoming tolerant and/or dependent on certain drugs. Tolerance occurs when a patient’s body becomes used to the effects of a drug and the original dosage is no longer effective. Increasingly higher dosages of the drug will be needed to get the same pain-alleviating effects as during the start of treatment. Dependence is a physical need for a drug. When the drug is not taken, a patient can experience withdrawal effects. Dependency can lead to drug addiction.
Another problem with mesothelioma pain medications is that they can cause unpleasant or harmful side effects. The most common side effects of mesothelioma pain medications are fatigue, nausea, and constipation. While serious side effects are rare, they can include respiratory problems, fainting, and allergic reaction.
As mesothelioma progresses, the pain associated with it and its treatments typically also worsens. Patients may be offered increasingly larger doses of pain medications. While the medications can be very effective in relieving pain and discomfort, they may create severe lethargy which interferes with normal functioning and cognitive thinking. Many patients may choose to tolerate severe pain rather than submit to these debilitating side effects.
How Pain Medications are Administered
Most commonly, pain medications for mesothelioma are administered orally. If the patient is having troubles swallowing, the medication may be given in liquid forms or as an injection. Injections of pain medications may also be given for faster or more controlled results, such as before or after surgery. Other methods of administering pain medications include skin patches and pumps which administer the medications electronically when a button is pushed.
Alternative Pain Management Treatments
There are numerous palliative mesothelioma treatments which have proven very effective for alleviating pain. Of these, the most effective and popular include:
- TENS therapy
- Relaxation techniques such as meditating or yoga
- Message therapy
These alternative treatments can also be helpful for alleviating other symptoms associated with mesothelioma and its treatment, particularly stress, insomnia, nausea, and anxiety. Some alternative treatments are covered by health insurers, such as acupuncture and TENS therapy.
Choosing the Right Pain Treatment
The course of pain treatment varies greatly on a per-patient basis. Doctors will prescribe certain pain medications based on symptoms and also how the patient reacts to the medication. Largely, pain treatment is up to the patient; patients may decide whether or not to take certain medications depending on the risks and side effects and may opt to choose alternative treatments for pain. Patients should talk to their doctors about their options for pain management. Regardless of the situation, no mesothelioma patient should be forced to endure unnecessary amounts of pain from the disease or its treatment.
1 Allen, R. K., Cramond, T., Lennon D. and Waterhouse M. A retrospective study of chest pain in benign asbestos pleural disease. (Sept 2011) Pain Med, v12:9, 1303-1308, doi: 10.1111/j.1526-4637.2011.01209.x.
2 Abrahm, J. L. Palliative care for the patient with mesothelioma (Summer 2009) Semin Thorac Cardiovasc Surg, v 21:2, 164-171.
3 Ahmedzai, S.H. & Clayson, H. (2006). Supportive and palliative care in mesothelioma. In K. O’Byrne & V. Rusch (Eds.), Malignant Pleural Mesothelioma (403-434). Oxford: Oxford University Press.