There is no getting around the fact that mesothelioma is going to cause pain. As a vicious form of cancer, mesothelioma attacks healthy cells, produces tumors, and builds up fluid in the lining of the lungs (for pleural mesothelioma) or the lining of the abdominal cavity (for peritoneal mesothelioma). Mesothelioma pain management is the act of trying to mitigate the pain and other symptoms associated with the disease.
Treating pain is typically seen as a palliative measure (i.e., specifically designed to improve the quality of life and the comfort of the patient). But, pain management can also be curative in nature. Studies have shown that when pain is lower, prognoses become better. After all, a patient who is constantly in pain will likely not improve drastically.
It’s also just generally important to maintain quality of life so that patients do not get discouraged. The goal of mesothelioma symptom management is to make it seem as if life remained the same as it was prior to diagnosis. While the obvious nature of the disease makes this nearly impossible, there are measures that can help mesothelioma sufferers approach normalcy.
The Origin of Mesothelioma Symptoms and Pain
In the disease’s early stages, symptoms are usually hard to identify. The tumors in the body haven’t grown to a size that causes pressure, and the fluid buildup hasn’t accumulated so much that it’s causing swelling. Usually, pain and symptoms are minimal.
For pleural mesothelioma, early symptoms might include:
- Slight difficulty breathing
- Occasional chest pain
- Occasional lower back pain
This is why most early-stage mesothelioma symptoms don’t sound the alarm even for the individuals in question. For peritoneal mesothelioma, early symptoms may mimic the signs of irritable bowel syndrome. Again, this never seems like an urgent condition.
As the disease progresses, however, symptoms and pain become much harder to overlook. For pleural mesothelioma, fluid buildup, known as pleural effusion, in the lining of the lungs creates pressure as the lungs expand. This, in turn, causes increased trouble with breathing and more significant pain.
The same concept applies to peritoneal mesothelioma. Fluid buildup in the abdomen, known as ascites, creates swelling which can cause tightness and abdominal pain. The bloating can also put pressure on nearby organs and even the diaphragm or lungs causing shortness of breath.
Other symptoms associated with peritoneal mesothelioma include:
- Bowel blockages (and other bowel issues)
- Poor appetite
Another form of the disease called pericardial mesothelioma affects the lining of the heart sac (or pericardium). Pain and symptoms for that type of the disease include irregular heart rhythms and chest pain that is (again) caused by fluid buildup known as pericardial effusion.
All forms of the disease can also have tumors that grow in size and cause a variety of symptoms. Bigger tumors are more likely to impinge on other organs and tissues causing pressure and pain.
The disease can also metastasize (or spread) to other parts of the body which means that pain could theoretically be experienced anywhere. Tumors can even compress the esophagus making it difficult for some patients to swallow.
As mesothelioma symptoms progress, it’s not uncommon for patients to experience nerve pain. Tumors can even begin forming in nerve pathways causing strong neuropathic pain.
Occasionally, patients will develop nerve conditions like Horner’s syndrome (which causes the eye to malfunction) or laryngeal nerve palsy (which can cause the voice box to become paralyzed and the patient to become hoarse).
Treatment-Related Mesothelioma Pain and Symptoms
There are a variety of ways that mesothelioma pain and other symptoms may be treated. Pain and side effects associated with treatment also receive palliative care. Early on, doctors may suggest taking over-the-counter painkillers like ibuprofen, Aleve, or Tylenol. This is usually early on before pain has really started to set in. As pain becomes more unbearable, heavier painkillers may be prescribed.
While these drugs are usually successful at mitigating pain on a short-term basis, they are not really treating the underlying cause (unless they are used for pain associated with surgical procedures). The only way to manage mesothelioma pain and symptoms effectively is to attack the source of that pain.
The fluid buildup that causes tightness, pain, and discomfort can be removed via needle aspiration. There are several needle aspiration procedures, but they all draw fluid out of the body to reduce symptoms like shortness of breath and chest or abdominal pain.
These procedures include:
- Thoracentesis (removal of fluid buildup from the lung lining)
- Paracentesis (removal of fluid buildup from the abdominal lining)
- Pericardiocentesis (removal of fluid buildup from the heart lining)
Pain and discomfort associated with growing tumor sizes can also cause major problems to a patient’s quality of life. Despite their associated side effects, chemotherapy and radiation therapy can help shrink those tumors and relieve the pressure they are causing. Both forms of therapy can reduce the size of virtually any tumor anywhere on the body. They are also not as invasive as surgical procedures.
Of course, the best way to get rid of a tumor is to excise it completely via surgery. While the surgery will cause pain in the short term, the long term reality is that the tumors will not be causing as many problems for the patient. Cytoreductive surgery (also referred to as “debulking”) is one method of getting rid of tumors in multiple places throughout the body.
Cytoreductive surgery can also be combined with hyperthermic (heated) intraperitoneal chemotherapy (HIPEC). The relatively new chemotherapy procedure uses heated medications in a saline solution to essentially “bathe” the abdomen and tumors or cancer cells in the area. The procedure usually shrinks the tumors effectively while also providing a 5-year survival rate of 52%.
Other surgeries that can be palliative in nature include the pericardiectomy and pleurodesis. The pericardiectomy involves the removal of the lining of the heart sac. This helps the heart return to normal function (with no abnormal beats or pain) by prohibiting the continued buildup of fluid.
The pericardium may have also had tumors on it causing issues with abnormal heart rhythms. This procedure works for pericardial mesothelioma, but it may also be useful for other mesothelioma types that have metastasized to the heart.
Pleurodesis is a procedure that inserts talc (or another similar substance) into the pleural space. The talc irritates the lining of the lungs and the chest wall, causing both to fuse together eventually. This again permanently prohibits the buildup of fluid in that area and reduces symptoms like difficulty breathing, coughing, and some chest pain.
Other Methods for Mesothelioma Symptom Management
Nerve pain is a major issue with both mesothelioma itself and some of the methods used to treat the disease. For instance, tumors can invade nerves and nerve endings causing an enormous amount of pressure and pain. On top of that, incision sites after surgery can produce neuropathic pain, and chemotherapy is also known to produce nerve issues occasionally.
For these issues, doctors may prescribe medicines like:
In some cases, doctors may apply a nerve block, which is a combination of treatments that disrupt nerve signals and stop them from producing pain. A similar, albeit less intensive, procedure known as transcutaneous electrical nerve stimulation (TENS) therapy uses low voltage electricity to disrupt nerve signals and mitigate pain. The electricity is administered via electrodes that are applied to the skin.
Other mesothelioma pain management methods often involve the reduction of overall stress. Stress and anxiety can build up in the system causing pain and other symptoms to be more prevalent.
Procedures and activities that can help improve stress and anxiety include:
- Tai chi
- Therapeutic massage
- Anti-anxiety medications
- Chiropractic services
Mesothelioma is a difficult disease to deal with. Pain both physical and emotional can cause individuals to suffer in despair. But, there are always treatment options to help soothe physical discomfort and mental anguish. Mesothelioma pain management, in general, is a good way to improve one’s outlook on life simply.