A new study shows palliative care should be considered to relieve suffering in all disease stages of mesothelioma cancer, not just at the end of life. The charts and symptoms of mesothelioma patients in a home palliative care program located in Palermo, Italy were evaluated in the research.
In this program, the estimated survival time was about two months after being admitted. Epidemiological, pain, and analgesic characteristics; Karnofsky status; and Edmonton Symptom Assessment System (ESAS) were recorded.
Fifty-six of the 674 charts reviewed had the diagnosis of mesothelioma. Of those charts, about 75% had pain, with 18 patients with moderate pain and two with severe pain even though they had taken high doses of opioids.
Most pain was experienced in the chest and actually linked to taking the opioids. The most common, high-intensity symptoms were pain, weakness, loss of appetite, poor well-being, and dyspnea. Clinical problems included cough and pleural effusion. The global ESAS was about 40.
Pain management is an important component of a mesothelioma patient care plan. Pain may result from the cancer as it spreads to different organs or from chemotherapy, radiation treatment, or atrophying muscles from inactivity.
The pain may actually be more debilitating than the cancer itself. If left uncontrolled or unmanaged, mesothelioma patients may succumb to depression or anxiety, which can severely affect overall health, vitality, and recovery.
As of right now, in cases where a cure for mesothelioma is not likely, such as stage 4, palliative care may still be an option for pain. This type of care uses many techniques that focus on relieving the pain and suffering of the patient, rather than trying to eradicate the disease.
For example, one of the most debilitating symptoms of pleural mesothelioma is the build-up of fluid in the pleural space around the lungs. This collection of fluid makes it very difficult to breathe and also can cause severe pain.
The fluid build-up greatly impacts the quality of life for the patient and can make it difficult to do everyday tasks. The best way to relieve this discomfort is to have the fluid removed by means of pleurocentesis. Palliative care can also include pain medication.
“Patients were referred to palliative care late in the course of their disease, suggesting that earlier integration of palliative care should be considered to relieve suffering in all disease stages—not only at the end of life,” stated Sebastiano Mercadante, Lead Investigator at La Maddalena Cancer Center in Palermo.