What Causes Mesothelioma Pain?
Mesothelioma tumors cause pain as they grow and push against sensitive nerves or vital organs. As mesothelioma cancer progresses, fluid buildup, particularly in the chest and abdominal cavities, can lead to pain with activity, breathing, coughing and eating.
Advanced or metastatic mesothelioma can cause bone or muscle pain as tumors spread throughout the body. At this stage, bone, joint and muscle aches become more likely. Doctors can ease these symptoms through palliative surgery or radiation therapy. If left untreated, severe or chronic pain is closely linked to feelings of anxiety and depression.
More than 60% of pleural mesothelioma patients report chest pain. Between 30% and 50% of peritoneal patients have abdominal pain. Mesothelioma pain can be more challenging to treat than pain from other types of cancer. Reporting all your mesothelioma symptoms, physical and psychological, to your doctor will help them prescribe the right treatments.
Specific mesothelioma treatments may also be a source of pain for some patients. For example, some chemotherapy medications, radiation treatments and surgeries can compromise or damage healthy tissue and create additional side effects or discomfort.
Common Symptoms of Mesothelioma Pain
While mesothelioma pain is a symptom of cancer, mesothelioma also causes additional symptoms, such as depression and changes in sleep and appetite, that can disrupt or impair quality of life.
- Loss in Appetite: Pain can cause nausea or digestive issues that hinder appetite, especially for patients with mesothelioma abdominal pain. Additionally, taste changes and dry mouth are common side effects of cancer treatment that can make eating seem less appealing.
- Sleep Disruption: It can be challenging to fall asleep or stay asleep when mesothelioma pain is high. Poor sleep can cause stress, depression, weight loss and more.
- Fatigue: Constant pain is exhausting and limits the amount of energy you have throughout the day. When pain is combined with poor sleep or appetite, the resulting fatigue can be debilitating.
- Physical Activity Difficulties: As pain impacts sleep and energy levels, it can be more challenging to perform physical activity, severely limiting your ability to exercise or perform daily chores and routines.
- Mood Changes: Managing constant pain often leads to feelings of anxiety, stress, depression and hopelessness. It’s essential to seek help for cancer’s social and emotional aspects, not just the physical symptoms.
Pain can create significant disruptions in daily life, especially as only one of many potential mesothelioma side effects. However, many treatment approaches for mesothelioma pain can ease your symptoms and improve energy and mood.
Mesothelioma Pain Treatments
Pain medication works for most cancer patients but does not work for everyone. Options such as palliative surgery or procedures can reduce pain without drugs. For example, if fluid buildup in the chest or abdomen causes pain, an outpatient procedure or minor surgery to drain the fluid can reduce pressure and pain.
Pain symptoms may also indicate issues with ongoing treatment. A 2021 report of a malignant mesothelioma patient with abdominal pain led to the diagnosis of another condition called adrenal insufficiency and pain as a side effect of nivolumab treatment. Talking to your doctor about pain management is integral to every mesothelioma treatment plan.
- Pain Medication: Doctors recommend starting with over-the-counter products such as ibuprofen (Advil) or acetaminophen (Tylenol) for mild pain. If pain is moderate, doctors may combine weak opioids, such as codeine, with medications such as anticonvulsants, anti-inflammatories or topical lidocaine patches. Doctors replace weak opioids with more potent opioids such as morphine when pain is severe.
- Regional or Local Anesthesia: Anesthesiologists can administer local and regional pain blockers or steroids via infusion or injection. While sometimes short-lived, these injections are repeatable and available at most pain management practices.
- Palliative Chemotherapy: Doctors can prescribe chemotherapy without the expectation of curing cancer. This treatment approach, called palliative care, focuses on shrinking tumors that cause pain to improve quality of life. Palliative chemotherapy is often a lower dose or given over a shorter period than traditional chemotherapy.
- Palliative Radiation: As a palliative treatment, radiation therapy is a pain management option for some pleural mesothelioma patients that can shrink tumors and limit pain. A 2016 study in the journal Pain Medicine reported that radiation therapy shrinks pleural tumors and provides pain relief in about half of patients.
- Palliative Surgery and Procedures: Mesothelioma specialists sometimes perform non-invasive palliative surgeries that focus on removing tumors responsible for extreme pain in one area, such as the lungs or kidneys. Palliative surgery helps make breathing easier or reduces back pain. Other procedures, such as thoracentesis, drain excess fluid to reduce pressure. A nerve block procedure can medically inhibit nerve pathways that carry pain signals to the brain.
- Complementary Approaches: Some techniques, such as breathing exercises, massage or electrical stimulation, complement pain medication and palliative procedures. Art and music therapy can distract patients from pain and help them find new hobbies or interests. These approaches do not eliminate pain on their own, but research supports their effectiveness in helping cancer patients better cope with pain.
- Psychological Techniques: Pain is linked to our thoughts. Emotions can limit us from working or participating in social activities, leading to feelings of isolation and loneliness. Anxiety and depression can worsen mesothelioma pain, and chronic pain can deepen those negative feelings. Look for distractions and find strategies to manage fatigue. You can also reach out to others for support, or seek help from a counselor in The Mesothelioma Center’s support group.
Some patients worry that taking prescription opioids will lead to addiction or over-sedation. However, pain relief from opioids often allows patients to resume their normal daily activities. In many cases, a cancer patient’s quality of life is better with opioids than without them. You can review the risks and benefits of opioid treatment with your healthcare provider.
Every mesothelioma cancer patient experiences pain in unique ways. There are multiple treatment options and delivery methods, such as a pain patch or oral pain medication, for patients to cope with mesothelioma pain. Ask for a referral to a pain management clinic if you feel overwhelmed by your pain.
Importance of Communication With Your Doctor
An essential part of pain management is communication. Keep your doctors informed of your pain medications’ effectiveness and side effects. A daily journal is a helpful tool for recording what you’ve tried and describing what’s working and what isn’t.
Pharmacists are also an excellent resource if you have questions regarding the safety of a particular pain management approach.
Mesothelioma pain disrupts life in many ways, by causing issues such as insomnia, stress, fatigue and feelings of anxiety and depression. Discussing these issues early with your mesothelioma specialist can limit pain before it becomes overwhelming.