Pain may be a symptom of 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 about these different ways to control pain:
- Pain medicines
- Procedures to manage fluid build-up
- Radiation therapy
- Debulking surgery
- Coping with pain
Different types and strengths of pain medicines may be used:
- mild, like paracetamol
- moderate, like codeine
- 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. Many people need a combination of medicines to achieve good pain control.
Opioids, such as morphine or oxycodone, are the most common drugs used to control moderate to severe mesothelioma 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 trying other options.
A small number of people have difficulty controlling their pain and a pain management specialist may need to consider several different medicines to find a suitable combination.
I could not believe how much better I felt after taking some pain relief. Everything seemed less stressful and I did not feel so angry and upset all the time.
Aside from breathlessness, fluid build-up around the lungs can cause pain. Various treatments can help drain the fluid and try to prevent it building up again. These are described here.
This may be used to shrink mesothelioma that is pressing on 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.
This can reduce the size of the mesothelioma that is causing the pain. Learn more about chemotherapy for pleural mesothelioma.
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. Talk to your doctor for more information.
- 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 and for any 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 or oxycodone. Adjusting the dose may help, or you can try other methods of pain relief.
- Ask your doctor if you need a laxative or stool softener prescribed to prevent or relieve constipation caused by 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.
- Ask your doctors to regularly review your pain management plan.
- See Pain and cancer, and listen to our podcast episodes on managing pain.
A/Prof Brian McCaughan, Cardiothoracic Surgeon, Chris O’Brien Lifehouse, NSW; Theodora Ahilas, Principal Lawyer, Maurice Blackburn Lawyers, NSW; Prof David Ball, Director, Lung Service, Peter MacCallum Cancer Centre, VIC; Shirley Bare, Consumer; Cassandra Dickens, Clinical Nurse Consultant, Cancer Care Coordinator – Thoracic Malignancies, Sunshine Coast University Hospital, QLD; Penny Jacomos, Social Worker, Asbestos Diseases Society of South Australia, SA; A/Prof Thomas John, Medical Oncologist, Senior Clinical Research Fellow, Austin Health, and Olivia Newton-John Cancer Research Institute, VIC; Victoria Keena, Executive Officer, Asbestos Diseases Research Institute, NSW; Penny Lefeuvre, Consumer; Jocelyn McLean, Mesothelioma Support Coordinator, Asbestos Diseases Research Institute, NSW; Prof David Morris, Peritonectomy Surgeon, St George Hospital and University of New South Wales, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Prof Anna Nowak, Medical Oncologist, Sir Charles Gairdner Hospital, and Professor of Medicine, School of Medicine and Pharmacology, The University of Western Australia, WA; Prof Jennifer Philip, Palliative Care Specialist, St Vincent’s Hospital, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, VIC; Nicole Taylor, Acting Lung Cancer and Mesothelioma Cancer Specialist Nurse, The Canberra Hospital, ACT. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. Previous editions of this title and related resources were funded in part by the Heads of Asbestos Coordination Authorities and a donation from Lyall Watts.
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