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Malignant Pleural Mesothelioma and Shortness of Breath

Malignant pleural mesothelioma is a type of cancer caused by exposure to asbestos that occurs in the lining of the lungs, called the pleura.  It is an aggressive and irreversible cancer that often has painful and sometimes scary symptoms, such as making it difficult to breathe, fluid in the lungs, tightness in the chest, cough, and shortness of breath.

The symptoms of mesothelioma often make it difficult to maintain daily living activities.  As the cancer advances, the difficulty breathing can become severe, making it difficult to walk short distances or even painful to rest or lie down.  While there is no cure for mesothelioma, there are some measures that can be taken to treat the shortness of breath and ease suffering.

Some patients find having oxygen can alleviate the difficulty breathing, and this can be provided at home.  There are also a variety of drugs that can help open the lung passages and provide relief from shortness of breath.  As with most drugs, there are side effects so a treating physician should always be consulted.

Another technique that does not involve any medications is called chest physiotherapy (also referred to as cpt or chest physical therapy), and can be taught to a caregiver or family member.  With chest physiotherapy, the patient lies in special positions (sitting up, lying on the back, lying on the side) that help drain secretion away from smaller airways in the lungs to larger ones.  While the patient is lying down, percussion or tapping is applied on the back of the person with some strength, which helps to bring up mucus and phlegm and clear secretions from the respiratory tract.  Again, consult with a doctor or nurse for training and to see if physiotherapy is a recommended method given the particulars of your case.

Mesothelioma patients and caregivers often find it helpful to also know in advance that shortness of breath can lead to a sense of decreased alertness.  Knowing before that shortness of breath can also lead to feeling confused, odd behavior, and tremors in the hands helps to relieve anxiety when they do occur.  Anxiety will only exacerbate the problems with breathing, so anything to calm -such as meditation, music, prayer or guided imagery- can be very helpful.   Oxygen therapy is sometimes ordered to help lessen these symptoms as well.

Patients with mesothelioma can also experience quite a bit of pain, mostly located in the chest.  This is especially so if coughing is persistent and frequent, or if other illnesses such as cold or flu are present.  If the pain becomes severe, consult your physician for techniques and medications that can help address the cough and ease pain.

Because of the nature of mesothelioma and the side effects from treatments, it can be difficult to know just how close to death a patient is.  Over time, the ability of the lungs to function declines and the need for artificial respiration can occur.   Some patients would prefer that such measures not be taken.  If so, these wishes about end of life care must be written and clearly communicated while the patient is still of sound mind and able to speak on his own behalf, unless a health care durable power of attorney has been appointed.

To find out more about how to do this, read our article:   End of Life Care for Mesothelioma Patients.  We encourage our clients to have conversations about their preferences for treatments, hospitalizations, CPR, and ventilator use with their family early on.  If they wait until after they have been admitted to the hospital or the cancer has progressed too far, then they can lose that choice and the decisions will be made by the doctor and hospital staff.

Some of our clients have made the choice to stay at home once the cancer has progressed past the point where any treatments or hospitalizations can help.  For them, they focus on what will give the highest quality of life for the time they have left.  Hospice is or home care providers who are trained to provide oxygen, home treatments for pain, antibiotic therapy and medication are called in to help.

Dealing with all the symptoms of mesothelioma and mesothelioma treatments as well as coming to terms with having a terminal cancer can be very difficult at times.  We hope that some of the information we share here helps to ease that process.