Mesothelioma

Pain Management

Malignant mesothelioma is a particularly painful cancer, so that good pain management is essential for the comfort of its victims. It is important that someone suffering from malignant mesothelioma informs his physicians and caregivers about the characteristics of his pain, so that the best treatment can be offered. Pain characteristics include:

• Duration. Chronic (long-lasting), acute (lasting a short time, often sudden in onset) or breakthrough (episodes of more severe pain 'breaking through' a background level of pain)
  
  
• Severity. Mild, moderate, or severe

There are various methods of managing pain in malignant mesothelioma. Radiation therapy to the tumor area is often quite successful at relieving pain from tumor spread into the chest wall. It is given in lower doses than have been applied (with little success) to remove the tumor.

Many medications are available to relieve cancer pain. Mild pain may be treated with over-the-counter drugs such as acetaminophen (e.g. Tylenol) or non-steroidal-anti-inflammatory agents (NSAIDs, e.g. ibuprofen, Advil). These drugs may also be useful for treating breakthrough pain in patients receiving opioids. Opioids are narcotic drugs used to relieve moderate-to-severe pain; the most commonly used opioid is morphine. These drugs can be given in many different ways, such as:

• by mouth
• by intramuscular or intravenous injection
• by skin patch
• use of an intravenous pain pump
• by epidural catheter (a thin tube inserted near the spinal cord)

Opioids produce certain side effects; these should be discussed with the prescribing doctor.

Occasionally, patients may undergo neurosurgery to relieve pain; one such technique (percutaneous cervical cordotomy) severs the nerves from the spinal cord that carry pain sensation.

Pain may also be managed by many non-medical techniques. These range from physical methods (e.g. heat packs and massage) to psychosocial interventions (e.g. relaxation, massage, and support groups). For information about these and other pain management techniques, see:

• National Cancer Institute
• Cancer Pain.org (for the Association of Online Cancer Resources)