Causes of Mesothelioma Pain
Pain is a very common mesothelioma symptom. Tumors and treatments may cause mesothelioma pain, which can be both physical and emotional. Each patient’s cancer and treatment are different, and everyone may have unique pain experiences. Experts often categorize pain in the following ways:
- Treatment-caused mesothelioma pain: Some mesothelioma treatments and diagnostic procedures can be painful. For example, pleurocentesis can cause discomfort. A surgery to remove a tumor may cause pain of varying intensity. Immunotherapy side effects include body aches and pains. Chemotherapy can cause mouth sores, headaches and more.
- Tumor-caused mesothelioma pain: Mesothelioma tumors can spread into, press on and damage healthy tissue and nerves. Pain from nerve damage may be intense and is sometimes described as shooting, burning or electric. Patients may also experience pain from inflammation and swelling.
Regardless of what causes the pain, mesothelioma patients do not need to suffer from it. The healthcare team has options to relieve pain, and they can adjust the pain management regimen as needed.
Types of Mesothelioma Pain
Doctors classify mesothelioma pain in various ways. Two ways of categorizing types of pain are by timing and physical sensation or cause. With timing, doctors consider how long the patients have had it or how quickly it came on. With physical sensation, doctors consider how patients feel the pain. These ways of classifying pain can help doctors discover its source and determine how to treat it.
Patients may experience more than one type of pain, but they can talk to their doctors about any discomfort they feel. Mesothelioma doctors can find solutions to help relieve the pain.
Mesothelioma Pain Types by Physical Sensation or Cause
Mesothelioma pain can come with different sensations and causes, including:
- Bone pain: Doctors may also call this somatic pain. Tumors spreading to the bone cause it, and patients often describe it as achy, dull or throbbing.
- Nerve pain: Patients may also hear this called neuropathic pain. Pressure on or damage to the nerves can cause it. Patients often describe the pain as burning or shooting. Some also say it feels like a tingling or the sensation of something crawling under their skin.
- Phantom pain: Doctors are not sure what causes phantom pain. But patients say it feels like it comes from a limb that has been amputated. Some say it feels unbearable.
- Referred pain: This type of pain feels like it’s coming from a different place in the body than the location of the actual cause. For example, an organ in the abdomen could push on a nerve that causes pain in the shoulder or lower back instead.
- Soft tissue pain: Doctors may call this visceral pain. Patients may describe it as achy, crampy, sharp or throbbing. The pain may feel like it comes from any soft tissue (organ, muscle or connective tissue).
Mesothelioma Pain Types by Timing
Doctors also classify pain by its timing. They consider how quickly the pain started and how long the patient has had it. The three most common types of mesothelioma pain by timing are:
- Acute: Doctors use this term to describe pain that starts suddenly, like from an injury. The pain may be short term or it can last for a while.
- Chronic: Chronic pain is long lasting. Patients may feel it long after treatment ends, and they may feel it all the time.
- Breakthrough: Doctors use this term for pain that “breaks through” medication that had been managing it. A previously successful medication no longer works against the pain.
Resources for Mesothelioma Patients
Mesothelioma Pain Management
Mesothelioma pain can be managed, and doctors can tailor pain management to each patient. It may include medications and other treatments, like radiation, or a more holistic approach in palliative care. Doctors choose pain management that is most effective in relieving the source of the pain.
Before choosing a pain management plan, the doctor talks to the patient to understand how it affects them. Some areas they focus on include the location and severity of the pain. Doctors also take the type of sensation into account. Pain-related disruptions to a patient’s life factor in as well.
Experts recommend that patients experiencing pain reach out to their healthcare teams for several reasons. If the patient experiences breakthrough pain, they should contact their team. Patients may also want to contact their doctors if they have side effects from medications used to relieve pain. Patients should also speak with their doctors if the medications don’t help at all.
In some cases, patients may need to enter hospice care. Hospice care has certain eligibility requirements, such as if treatments are no longer effective or the patient has chosen to end treatment. A healthcare team can help patients and caregivers understand this option and when to choose it.
Medications to Treat Mesothelioma Pain
Doctors may recommend medications to ease pain, and they have many medications to choose from. Doctors follow a general protocol to determine what type of pain medication to use. Each protocol level introduces different types of drugs for managing pain.
- Level 1: With lower levels of pain, doctors recommend non-steroidal anti-inflammatory drugs (NSAIDs). These drugs include aspirin, ibuprofen and others.
- Level 2: With more substantial pain, doctors add the option of a weak opioid, such as codeine or tramadol.
- Level 3: When a patient’s pain becomes severe, doctors generally prescribe stronger opioids. These drugs include morphine, oxycodone and fentanyl, among others. Cancer patients who take these medicines as directed have a low risk for addiction. Still, patients can discuss these concerns with their care team.
Doctors may supplement pain medications with other types of medicine, such as antidepressants and medications that help with epilepsy. For example, medicines like gabapentin and pregabalin reduce convulsions and can help manage nerve pain. Antidepressants like duloxetine and venlafaxine may help relieve pain from nerve damage.
Medical Procedures to Treat Mesothelioma Pain
Doctors also have medical procedures that may relieve pain caused by mesothelioma. These procedures include:
- Cervical cordotomy: This treatment involves purposely damaging nerves that carry pain signals. It is not widely available, but study results show it can be effective in reducing mesothelioma pain.
- Chemotherapy: Doctors may recommend chemotherapy for pain in some mesothelioma cases. For example, patients with a tumor compressing an organ may benefit from chemo that reduces the size of the tumor.
- Immunotherapy: Doctors may use immunotherapy drugs known as checkpoint inhibitors. For example, patients reported the Opdivo® (nivolumab) + Yervoy® (ipilimumab) combination was more effective at treating pain than chemotherapy.
- Nerve blocks: This treatment uses a numbing agent or other fluid to block pain signals. Doctors will inject the fluid to relieve pain temporarily.
- Radiation: In one study, roughly 50% of study participants reported a significant reduction in pain after receiving radiation. In part because of these results, doctors use radiation to help manage mesothelioma pain.
- Spinal cord stimulators: This treatment involves doctors placing a small device next to the spinal cord. The device stops pain signals from reaching the brain, helping relieve pain.
Patients can discuss these options with their care team to see if any may work for their pain.
Alternative Treatments for Mesothelioma Pain
Along with conventional medicines and medical procedures, patients may consider alternative treatments for pain. These treatments are meant to complement, not replace, traditional pain management options. Some alternative treatments patients may consider are:
- Acupuncture: This type of Traditional Chinese Medicine uses very thin needles inserted into the skin. Studies have shown it can help relieve insomnia and fatigue.
- Cannabis/marijuana: Evidence has shown that medicinal marijuana may help relieve pain symptoms. However, its use is not legal in all states. In states where it is allowed, doctors may suggest patients try it to see if it helps.
- Counseling: Not all pain is physical. Sometimes, mesothelioma and treatments can cause emotional pain, like anxiety, fear and worry. Counseling and therapy are meant to help people cope with these feelings.
- Massage therapy: Cancer massage may help with some physical pain. But it may also work to improve emotional pain.
- Relaxation techniques: By learning proper relaxation techniques, patients may be able to fall asleep more quickly and regain energy for their cancer treatments.
- Yoga: Gentle forms of yoga help patients stay active, an important piece of recovery. It can also help the patient relax, meditate and focus on breathing.
Patients should keep in mind that alternative treatments can interact with traditional treatments. You can discuss these therapies with the care team to make sure any chosen approaches complement the primary treatments.
Resources and Tips for Dealing With Mesothelioma Pain
Patients have resources for dealing with mesothelioma pain. It starts with maintaining good communication with your healthcare team. They have options available to help you manage physical and emotional pain.
When discussing your pain with any member of the care team, how you describe it may make it easier for them to help. The care team uses that information to find the best solution. They may ask many questions to fully understand what you are experiencing.
Experts recommend that patients keep a pain diary. The diary can include:
- A description of the pain (stabbing or throbbing)
- Anything the patient may have been doing before it started
- How long the pain lasted
- The date and time the pain started
- Where the pain was
Remember, a friend or family member acting as a mesothelioma caregiver can help the patient keep the diary updated.
Expert Pain Management Tips
Experts note it is important to follow a pain management regimen closely. Doing so may help reduce pain or keep it from getting worse. Specific tips include:
- Do not skip doses and take them as scheduled.
- Do not take old medicine prescribed for other conditions or injuries.
- Do not take someone else’s medicine because it may not be safe for you.
- For breakthrough pain, take prescribed medicines as directed and don’t wait for the pain to get worse.
- Keep your pain medicine prescriptions filled and avoid any delays in getting medicine.
- Only one doctor should prescribe pain medications to make sure you have no adverse interactions.
Common Questions About Mesothelioma Pain
- What kind of pain comes with peritoneal mesothelioma?
Peritoneal mesothelioma may cause abdominal pain in some patients, but it may not cause any pain. Some patients may feel it spread throughout the abdomen, but in some cases, it may feel like it is in one spot.
- What options do mesothelioma patients have for pain relief?
Mesothelioma patients have options for pain relief. Doctors prescribe different medicines to relieve the pain, like anti-inflammatory drugs or opioids. Medical treatments, including radiation or chemotherapy, can help qualified patients. Doctors may also suggest alternative treatments, like acupuncture or massage.
- What kinds of pain does mesothelioma cause?
Cancer can cause many different types of pain. Some people suffer physical pain from a growing tumor or cancer treatments. The pain can be sudden or long-lasting, and it can affect the bones, nerves or soft tissues. But cancer pain can also be emotional. Patients may have anxiety, fear or depression.
