Mesothelioma.com Resources for Patients and their Families

Pain Management and Dependency

Pain management is an important component of a mesothelioma patient care plan. However, certain kinds of pain medication can lead to medical dependency, which can have a deleterious effect on the patient’s treatment and recovery.

Everyone has a different level of pain and pain tolerance, and for some patients, the pain of cancer can be more debilitating than the cancer itself. As much as 90 percent of cancer patients experience some degree of pain, and in many cases this pain can be debilitating.

Managing Pain in Mesothelioma Patients

When a mesothelioma patient is experiencing pain, the most important thing is to find out what is causing that pain and whether the pain is acute, chronic, or intermittent. This assessment can often lead to a solution that will ease the pain, whether through drugs, physical adjustment, or some other type of care.

Whatever the case, leaving pain unresolved can lead to unwelcome outcomes. Chronic cancer pain can affect moods and emotions, and it may severely affect patient recovery. Depression and anxiety are common effects of chronic pain.

Assessing Mesothelioma Pain

The following steps should be taken when assessing pain:

  1. Determine the origin of the pain – When did it start? Where is it coming from?

  2. Understand the duration and intensity – Is it always (or almost always) there, or does it come and go? How strong is it?

  3. Note any changes – Has the pain gotten stronger over time? Did it change from intermittent to constant?

  4. Report your findings to your doctor.

Pain Journaling

It may be useful to keep a daily “pain journal” to monitor whether pain is increasing, decreasing, or changing in other ways. This journal can help your physician in assessing how best to treat pain and related symptoms.

Things to note in your pain journal may include:

  • Location of the Pain
  • Intensity (mild, moderate, severe)
  • Frequency (chronic or acute)
  • Treatment (medications or other care)

What Can Cause Mesothelioma-Related Pain?

Pain in mesothelioma patients can come from a variety of sources, including the cancer itself or from various types of treatment. Understanding the common causes of pain can help you assess the issue.

Common Causes of Mesothelioma-Related Pain
  • As a tumor grows and spreads, it can press on nerves, bones, organs, and other parts of the body, causing pain.
  • Secondary symptoms, such as fluid buildup, can cause discomfort and pain by creating pressure in the lungs, heart, or abdomen.
  • Treatments such as surgery, chemotherapy, and radiation can cause pain directly.
  • Side effects of treatment, such as nausea and vomiting, can cause pain and sensitivity throughout the body.
  • Inactivity due to fatigue, weakness, or other symptoms can lead to muscle atrophy, making it painful to move.

Pain Clinics

Many major cancer centers have pain management clinics designed to help patients learn effective pain management techniques and coping strategies. Pain clinics can treat both chronic and acute pain, as well as show patients how to manage pain themselves.

Typically, the patient will need to make an appointment with a pain specialist at the clinic. The doctor will take a full medical history, find out more about the pain, and complete any diagnostic tests necessary. From there, you will receive a pain treatment plan that may include visits to specialists from other areas of practice, such as neurology, psychology, and others.

Most pain centers will offer a combination of pain management strategies for the patient including prescription drugs, over-the-counter medicines, nerve blocks, and implants. Non-pharmacologic methods of alleviating pain may also be suggested, including complementary and alternative therapies.

Post-Operative Pain

While pain clinics are often used to address daily pain associated with cancer, they can also be used for more specific scenarios, such as to help combat post-operative pain associated with cancer surgeries. These surgeries, including pneumonectomy or pleurectomy for mesothelioma cancer, are usually quite serious and require a long recovery period during which pain is a major issue.

Many pain clinics will offer in-hospital or in-home consultations for those who are recovering from surgery. After an initial consultation and development of a pain management plan, they will check on the patient frequently to determine if or when adjustments need to be made and will help family members or other caregivers learn how to administer pain meds or otherwise manage any post-surgical pain.

Painkillers and Drug Dependency

Drug dependency is a growing concern in the United States, especially with opiate drugs that are highly addictive. Mesothelioma patients who have a high degree of pain may be at a high risk of developing a dependency on pain medications that they use over a sustained period of time.

Dependency often stems when a patient decides to take pain management into their own hands. If pain increases, talk to a physician before changing your dosage; never decide to increase the amount of painkillers you are taking on your own.

Sources

American Cancer Society. Pain Control. Accessed on November 20, 2010.
http://www.cancer.org/.../pain-control-what-i-need-to-know

Memorial Sloan-Kettering Cancer Center. Causes of Cancer Pain. Accessed November 20, 2010.http://www.mskcc.org/mskcc/html/96735.cfm

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