Pain Management and Dependency
A critical part of treatment and palliative care for mesothelioma patients is pain management. Pain may result from the cancer as it spreads to different organs, chemotherapy, radiation treatment, or atrophying muscles from inactivity. However, with every individual with mesothelioma, the level of pain and pain tolerance varies as with their experience.
Further, any cancer pain may be even more debilitating than the cancer itself. If the pain is uncontrolled and unmanaged, mesothelioma patients may succumb to depression or anxiety, which can severely affect overall health, vitality and potentially, recovery.
It is always a concern that with any chronic pain, an individual may develop a dependency on the prescribed pain medication. With proper pain management monitored by a primary care physician, mesothelioma patients can avoid this harmful side effect.
With cancer pain, it is imperative to assess what may cause the pain, whether the pain is chronic or intermittent and what may ease the pain. Chronic cancer pain can affect moods, emotions and ultimately may affect patient recovery. Depression and anxiety are common affects of chronic pain.
Assessing the origin of pain is the first, important step, in pain management. When did the pain start? Where is the pain coming from? Is it constant (chronic) or intermittent (acute)? Has the pain changed from intermittent to constant? What alleviates the pain?
Changes in pain may also signal changes in the mesothelioma cancer. If an individual starts with intermittent, yet manageable pain, and it changes into unbearable, chronic pain, it can signal the advancement of the cancer. Reporting any new pain or changes in pain to a primary care physician is important because it can affect treatment.
First, cancer pain may result from the cancer itself. As the cancer spreads and grows, it can cause considerable pain in the area.
For mesothelioma patients, pain can result from where the cancer is and how it is affecting nearby organs and structures. So far as pleural mesothelioma, the most common type of mesothelioma is concerned, pain may result from pressure on the pleura of the lungs. Pressure on the lungs may result in difficulty breathing, swallowing or general chest pain.
Pericardial mesothelioma pain results from the increased pressure the cancer places on the protective sac surrounding the heart. As the heart struggles to beat and regulate blood flow, an individual may experience chest pain. With peritoneal mesothelioma, pain results from the cancer spreading to the lining around the abdomen, radiating pain throughout the area.
Second, pain can result from the prescribed treatment, including surgery, chemotherapy and/or radiation. Monitoring this pain is critical to recovery, especially for individuals who underwent surgery. Pain medication may be prescribed to alleviate surgical pain. With chemotherapy, pain may be dull, intermittent or severe. Depending on the dose, treatment, type of mesothelioma and the individual, chemotherapy can be painful or manageable.
Third, pain may result from inactivity. With malignant mesothelioma or other advanced cancers, individuals may be unable to move well. This inactivity can result in body aches and muscle pain.
A useful and common practice is to keep a daily “pain journal,” where an individual tracks pain fluctuations, sources of pain and what eases the pain. This is an invaluable tool for both the individual and their primary care physician. A pain journal can be simple entries answering four main questions:
- Pain status: mild, moderate or severe
- Pain frequency: chronic or acute
- Pain location
- Pain treatment: medications or palliative care
With a pain journal, an individual’s primary care physician will be able to adjust prescribed medications or treatments.
For individuals with chronic pain from mesothelioma, dependency on pain medication can develop over sustained use of a given drug. However, if the patient and their primary care physician manage chronic mesothelioma pain properly, developing a medication dependency is rare.
Medication dependency stems from pain progression and an individual taking their own treatment into their hands. If pain increases, a physician may change the dosage of prescriptions or type of medication. It is not recommended for any individual to change their dosage without consulting their doctor first. The pain journal is a powerful tool to stave off dependency.
If an individual or a caregiver suspects a medication dependency, seek immediate medical attention. Individuals should consult with their primary care physician for other mesothelioma treatment options that may relieve any pain.
American Cancer Society. Pain Control. Accessed on November 20, 2010.
Memorial Sloan-Kettering Cancer Center. Causes of Cancer Pain. Accessed November 20, 2010.http://www.mskcc.org/mskcc/html/96735.cfm