Key takeaways: The pain associated with mesothelioma has several different causes, including pressure caused by fluid, nerve-based pain, and cancer-induced bone pain. There are different treatment modalities based on the cause of the pain, which is established by a doctor. Common pain management techniques include pharmacological interventions, surgery, radiotherapy, and physical therapy.
Why is mesothelioma accompanied by pain?
Mesothelioma is an aggressive cancer most commonly affecting the lining of the lungs and abdomen. Although relatively rare, mesothelioma is a.) extremely difficult to diagnose; b.) difficult to treat; and c.) is almost always fatal.
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When patients elect to receive treatment—and even before they receive treatment—they are likely to feel pain. This pain can be ascribed to many explanations:
- Growing tumors push up against other organs, sensitive nerves, or even other tumors. This results in neuropathic pain, in which the nervous system becomes damaged or “overworked.” This kind of pain is usually sharp or described as a stabbing feeling that usually is active and subsides cyclically. Oftentimes, it’s difficult for patients to pinpoint the locale of neuropathic pain, as it presents as deep and pervasive.
- Tumor metastasis—when tumors migrate from their original site of growth—can also cause pain. If mesothelioma tumors metastasize to bones or bone marrow, this can result in cancer-induced bone pain. This feels like persistent, achy pain that can’t be associated with a particular area. Although rare in mesothelioma patients, bone pain is still a real possibility.
- The fluid buildup associated with effusions is another cause of pain for mesothelioma patients. Besides effusion, fluid can build because of restricted blood and lymphatic vessel access, as a side effect of treatment, or because mesothelioma tumors are sites of prolonged inflammation. With no way to be processed and excreted by the body, this fluid can present painful challenges for patients.
How can patients and providers both manage pain?
Depending on the root cause of the pain—which a clinician can screen for and identify—there are different routes of treatment for pain.
- If deemed safe for patients, surgery can alleviate the pressure (and pain) associated with tumor growth. Although this kind of surgery doesn’t have a curative intent—meaning that it’s not intended to treat the growth of mesothelioma—it still provides relief.
- Pharmacological interventions are the most common forms of pain treatment for mesothelioma patients. These include anticonvulsants (manage neuropathic pain), morphine (oftentimes used in palliative care, meant to manage whole body afflictions), antidepressants (work on alleviating an overactive nervous system), and opioids, among other drugs.
- Similar to surgery in its goals to break down or alleviate tumor pressure, radiotherapy has proven useful in pain management for mesothelioma. Via ablation of the bulks of tumors, the pressure and pain exerted by the sheer size of tumors is relieved. For many patients, this is more feasible than surgery.
- Outside of formal treatment, patients can take measures that alleviate inflammation, like prioritizing physical movement and adjusting their diet. Oftentimes, treatment makes patients less physically active and/or has side effects that lend themselves to fatigue. By enrolling in physical therapy, patients receive the tools to adjust daily movements in ways that are both comfortable and accommodating to changes in activity levels.
Importantly, if you have pain, talk to your doctors and health care providers. From there, they can recommend different ways to manage your pain.
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