People are naturally fearful of experiencing pain. It’s vital to tell your treatment team if you are in pain. Pain can be a symptom of pleural mesothelioma, but can also be a side effect of treatment.
The pain caused by the mesothelioma itself is usually dull and generalised – it can be difficult to say exactly where it is coming from. If the cancer spreads and presses on bones or other organs, it may feel sharp and stabbing. A sharp pain in the chest can also be caused by a blood clot in the lungs (pulmonary embolism), so seek urgent medical attention if the pain is new. Chemotherapy or surgery can injure nerves and cause pain or numbness.
Learn more about:
- Pain medicines
- Procedures to manage fluid build-up
- Radiation therapy
- Debulking surgery
- Coping with pain
Pain medicines may be mild, like paracetamol; moderate, like codeine; or strong and opioid-based, like morphine. Pain-relieving drugs may be taken as tablets, oral liquids, patches, injections or intravenous infusions. Other drugs may also be prescribed, like non-steroidal anti-inflammatory drugs (NSAIDs) or drugs specifically for nerve pain.
To help find the right medicine for you, your doctor may prescribe different drugs, different doses or a combination of drugs.
Opioids, such as morphine or oxycodone, are the most common drugs used to control moderate to severe cancer pain. Morphine is available in quick-acting and long-acting forms.
Some people feel concerned that they might become addicted to morphine. However, pain specialists believe that this won’t happen if you take it as prescribed by your doctor to relieve pain. Morphine can be taken for a long time and in increasing doses, if needed. It doesn’t have to be kept for “when the pain gets really bad”. There are now many strong pain medicines that are similar to morphine, so if one does not agree with you, ask your doctor about other options.
A small percentage of people have difficulty in controlling their pain, and may need to try many medical and non-medical methods of relieving it. A palliative care specialist or pain specialist can help find the right combination for you.
Procedures to manage fluid build-up
Fluid build-up around the lungs can cause pain as well as breathlessness. There are various treatments that can help drain the fluid and try to prevent it building up again. These are described in Breathlessness.
This may be used to shrink mesothelioma that is pressing on body parts such as nerves, bones or major blood vessels and causing pain. Sometimes the mesothelioma can grow through the scar from VATS surgery and produce a lump in the skin. Radiation therapy can reduce the size of the lump and ease any associated pain. For more on this see Radiation therapy.
This can reduce the size of the mesothelioma that is causing the pain. See Chemotherapy for more on this.
If you are well enough and it is technically possible, surgery may be used to remove the part of the mesothelioma causing pain and other symptoms. This is known as debulking surgery.
Coping with pain
- Keep track of your pain in a symptom diary and try to describe it – what the pain feels like, how intense it is, exactly where it is, where it comes from and travels to, how long it lasts, and if it goes away with a specific pain medicine or with any other therapy, such as a heat pack.
- Allow a few days for your body to adjust to the dose of pain medicine/morphine and for the drowsiness to improve.
- Let your doctor know if you have vivid dreams, nausea or other side effects after taking a strong pain medicine such as morphine. Adjusting the dose may help, or you can try other methods of pain relief.
- Use a laxative regularly to prevent or relieve constipation from pain medicines.
- Take pain medicine regularly as prescribed, even when you’re not in pain. It’s better to stay on top of the pain
- For more on managing pain, call Cancer Council 13 11 20, or see Overcoming Pain.