Mesothelioma Palliative Care

What Is Palliative Treatment for Mesothelioma?

Palliative care aims to control pain and manage symptoms for patients with mesothelioma and other serious illnesses. It also provides treatment that addresses the whole person, not just their illness. Palliative therapy is an important component of mesothelioma treatment.

Palliative care has many synonyms. It may be referred to as:

• Comfort care
• Palliation
• Palliative therapy
• Supportive care
• Symptom management

Many people may think palliative care only applies to stage 4 cancer. However, it applies to every stage of cancer and its treatment. Mesothelioma patients can start palliative care at any time after diagnosis.

Palliative care for mesothelioma may aim to accomplish a few different things. These goals may include:

• Addressing psychological, social and spiritual problems
• Preventing and/or treating the side effects of mesothelioma cancer
• Preventing and/or treating the side effects of mesothelioma treatment

Palliative care can take many forms and may differ from patient to patient. Any treatment aimed at improving quality of life could be considered palliative care.

Palliative Care Providers and Locations

Mesothelioma patients can access palliative care by speaking with their treatment teams. Patients can receive palliation in multiple environments. Palliative care specialists often have extra training or certifications. With these diverse options, palliative care can be tailored to each individual.

Palliative care locations include hospitals, long-term care facilities, outpatient clinics and patients’ homes. Palliative care providers may be nurses, physicians, social workers and spiritual counselors or advisors.

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Palliative Treatments for Mesothelioma

Healthcare providers may tailor a mesothelioma palliative treatment plan to a patient’s specific situation. This plan may take into account several factors, including:

• Mesothelioma location
• Mesothelioma stage
• Other planned treatments
• Social factors
• Support network

Patients may receive traditional mesothelioma treatments in a palliative setting. For example, chemotherapy may be used to target certain cancer symptoms and side effects.

Breathing Interventions

Breathlessness is a common symptom of advanced cancers, including mesothelioma. Patients may be offered or coached on any of the following to address difficulty breathing:

• Breathing exercises
• Physical exercises
• Supplemental oxygen
• Use of a handheld fan

Patients may have difficulty breathing alongside other side effects such as a troublesome cough. Doctors may recommend medications or lifestyle adjustments for these side effects.

Constipation Treatments

Many cancer patients experience constipation-related discomfort. Laxatives may help prevent or treat constipation, even for patients taking opioids.

Cough Treatments

Some mesothelioma patients experience bothersome coughing. Palliative care providers may recommend cough suppressants or cough syrups to address this symptom.

Excessive Sweating Assistance

Mesothelioma patients may experience excessive sweating. Doctors may advise using a handheld fan and avoiding restrictive clothing.

Fatigue and Weight Loss Interventions

Fatigue and weight loss may occur as symptoms of mesothelioma. Patients may also experience fatigue and/or weight loss as side effects of treatment. Palliative providers may encourage such patients to eat small, calorie-rich meals. Doctors may also prescribe steroids to help improve appetite and nutrition.

Fluid Accumulation Treatments

Many patients experience abnormal fluid accumulation due to cancer. Pleural mesothelioma may cause fluid to build up in between the tissue surrounding the lungs. This condition is called pleural effusion. In peritoneal mesothelioma, fluid can build up in the tissue surrounding the abdomen. This creates a peritoneal effusion. When fluid accumulates in the lining around the heart, it causes pericardial effusion.

Abnormal fluid buildup can cause discomfort and breathing difficulties. Doctors can treat this accumulation of fluid in one of two ways. They can drain or remove the excess fluid. They can also try to prevent future fluid accumulation. These strategies are common in pleural and peritoneal mesothelioma palliative care.

Mental Health Therapies

Some mesothelioma patients report symptoms of anxiety and depression. Such psychological distress may worsen other physical symptoms. Doctors may recommend group or individual therapies to help alleviate anxiety and depression. Antidepressant medication may also help some patients.

In one study, 80% of cancer patients treated for depression and anxiety reported improved life satisfaction. Any patient struggling with anxiety or depression should discuss treatment options with a doctor.

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Palliative Care for Pain Management

Cancer patients may experience pain due to their illness. Mesothelioma patients commonly report chest pain and abdominal pain. This pain may stem from several things, including:

• Chemotherapy negatively affecting nerves or other healthy tissues
• Surgical treatments requiring substantial internal or external incisions
• Tumors pressing on or disrupting internal tissues

Mesothelioma pain may have physical and emotional components, which can negatively affect quality of life. Doctors will take these factors into consideration when creating a mesothelioma pain management strategy.

Palliative pain management for mesothelioma may include any of the following:

• Chemotherapy: Palliative chemotherapy may help shrink pain-causing tumors.
• Electrical devices: Some patients may receive electrical devices called transcutaneous electrical nerve stimulators (TENS). TENS devices use a gentle electric current to help relieve pain.
• Nerve blocks: Patients may undergo injections that help block pain. These injections deliver anesthetic to prevent a nerve from sending pain signals to the brain.
• Neurosurgery: Some patients may benefit from a type of surgery that prevents pain messages from reaching the brain. If the pain signal does not reach the brain, the patient will not perceive the pain.
• Over-the-counter (OTC) medication: Doctors may recommend OTC drugs for mild to moderate cancer pain.
• Prescription medication: For more severe pain, doctors may prescribe various drugs. Options include antidepressants, anti-seizure medications, opioids and steroids.
• Radiation therapy: Some patients may benefit from targeted radiation treatment. Doctors may use this approach to shrink tumors, thereby decreasing pain.
• Surgery: In eligible patients, doctors may be able to surgically remove the pain-causing tumor.

Mesothelioma patients have a variety of pain management options. Open communication with doctors and palliative care providers can help patients control their pain. Patients should discuss pain management concerns with an experienced mesothelioma doctor.

Benefits of Palliative Care for Mesothelioma

Palliative care takes many forms, each offering potential benefits. These may include physical, emotional and mental benefits, such as:

• Improved quality of life: In a study, patients who received early palliative care reported better quality of life than those who did not.
• Fewer depressive symptoms: Early palliative care has been linked to lower rates of depressive symptoms in cancer patients.
• Extended survival: In a study, patients receiving early palliative care lived longer than those who did not.

It is a common misconception that palliative treatment is only available for end-of-life care. Many people don’t realize palliative care can extend mesothelioma survival. However, palliative care has been tied to improved survival in multiple cancers. Lung cancer patients receiving early palliation lived about 2.5 months longer than those who did not.

Another study showed pleural mesothelioma patients also experienced improved survival with palliative care. Patients undergoing palliative pleurodesis lived about six months longer than those who did not.

Alternative Palliative Treatments for Mesothelioma

Palliative care for mesothelioma is not one size fits all. Some patients may benefit from alternative forms of palliation, including:

• Acupuncture: This form of Traditional Chinese Medicine places very thin needles at specific points. The placement of needles is designed to change the flow of energy in the body and encourage healing.
• Biofeedback: This approach uses measurements to help patients control certain body functions. Patients can learn to monitor and adjust vital processes such as breathing, heart rate and muscle tension. This may help with relaxation and pain management.
• Hypnosis: This technique attempts to induce a trance-like mental state. In this state, individuals may be aware of their surroundings but relaxed enough to accept suggestions. Such suggestions may help a patient alter their perception of pain and discomfort.
• Meditation: This approach uses various techniques to focus attention. A meditation habit may help alleviate pain, stress or depression.
• Tai Chi, Qi Gong and Yoga: These mind-body practices combine mental focus with physical movement. They may help alleviate stiffness and pain during treatment.

Mesothelioma patients interested in alternative palliation should discuss it with their care teams. A mesothelioma expert can help patients explore traditional and alternative palliative approaches.

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