Pain

Many people are naturally worried about being in pain. It’s important to tell your treatment team if you are in pain. Pain may be a symptom of pleural mesothelioma, but can also be a side effect of treatment.

Learn more about:

• Overview
• Pain medicines
• Procedures to manage fluid build-up
• Radiation therapy
• Chemotherapy
• Debulking surgery
• Ways to cope with pain at home

Overview

Pain caused by mesothelioma is usually dull and generalised – it can be difficult to say exactly where it is coming from. If the cancer spreads and presses on bones or organs, it may feel sharp and stabbing. A sharp pain in the chest can also be caused by a blood clot in the lungs (pulmonary embolism), so seek urgent medical help if the pain is new. Chemotherapy or surgery can injure nerves causing pain or numbness.

Read below to learn about the several different ways to control pain and see our general section on Pain and cancer.

Pain medicines

Different types and strengths may be used:

• mild, like paracetamol
• moderate, like codeine
• strong and opioid-based, like morphine.

Pain medicines may come as tablets, oral liquids, patches, injections or intravenous infusions. Non-steroidal anti-inflammatory drugs (NSAIDs) or drugs for nerve pain may also be prescribed. Many people need a combination of medicines for good pain control.

Opioids, such as morphine or oxycodone, are the most common drugs used to control moderate-to-severe mesothelioma pain. Morphine is available in quick-acting and long-acting forms. Some people worry they might get addicted to morphine. Pain specialists believe this is unlikely if you take it as prescribed to relieve acute pain or for palliative care. Morphine can be taken for a long time and in increasing doses, if needed. It doesn’t have to be saved for when pain is very bad.

There are many strong pain medicines similar to morphine, so if one doesn’t work, ask your doctor for other options. A small number of people have difficulty controlling their pain, and a pain management specialist may help find a solution.

Procedures to manage fluid build-up

Aside from breathlessness, fluid build-up around the lungs can cause pain. Various treatments can help drain the fluid and try to prevent it building up again.

Radiation therapy

This may be used to shrink mesothelioma that is pressing on nerves, bones or major blood vessels and causing pain. Sometimes the mesothelioma can grow through the scar from VATS surgery and produce a lump in the skin. Radiation therapy can reduce the size of the lump and ease any associated pain.

Chemotherapy

This can reduce the size of the mesothelioma that is causing the pain. Learn more about chemotherapy for pleural mesothelioma.

Debulking surgery

If you are well enough and it is technically possible, surgery may be used to remove the part of the mesothelioma causing pain and other symptoms. This is known as debulking surgery. Talk to your doctor for more information.

Ways to cope with pain at home

	Keep notes on your pain Describe and track pain in a symptom diary – what it feels like, how intense it is, exactly where it is, where it comes from and goes to, how long it lasts, and if it goes away with a medicine or a heat pack, etc.
	Take it slow Allow a few days for your body to adjust to the dose of pain medicine and for any drowsiness to improve.
	Report side effects Let your doctor know if you have vivid dreams, nausea or other side effects after taking a strong pain medicine such as morphine or oxycodone.
	Watch for constipation Ask your doctor if you need a laxative or stool softener prescribed to prevent or relieve constipation (difficulty passing bowel movements) caused by pain medicines.
	Keep up your medicine Take pain medicine regularly as prescribed, even when you’re not in pain. It’s better to stay on top of the pain.
	Check your pain plan Ask your doctor to review your pain management plan regularly. If you have problems, adjusting the dose may help, or you can try other methods of pain relief.

I could not believe how much better I felt after taking some pain relief. Everything seemed less stressful and I did not feel so angry and upset all the time.

BILL

→ READ MORE: Managing constipation

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