Clapper, Patti, Schweizer and Mason

Pain Control Important in Treating Mesothelioma

Treatments for mesothelioma are designed to prolong lifespan, but this is only half the battle for our clients diagnosed with this fatal cancer caused by prior exposure to asbestos.  Two separate authors recently reached the same conclusion after examining the state of current mesothelioma treatments and discovering a disturbing lack of focus on the quality the patient’s life rather than just longevity.  Both authors agree that a significant opportunity for improvement of treatment methods exists in the area of palliative care and pain management for mesothelioma patients.

The first recommendation comes from a study by researchers at the University of Pennsylvania.   First published in the January-February edition of the Journal of Opioid Management, the study examined mesothelioma and lung cancer patients who were diagnosed between 2005 and 2008.  These patients filled out a self-report questionnaire that included 22 questions pertaining to their overall symptoms, their current approach to pain management, if any, and their own evaluation of pain levels they experience.

Ninety participants answered the questions, 8 of which suffered from mesothelioma.  Nearly half of all the respondents had undergone some form of surgical treatment for their cancers and 58% had suffered through at least one round of chemotherapy.  Another 44% had also been treated with radiation. 

While one of the most common symptoms of mesothelioma and other cancers is some type of pain, only 52% of the study participants attributed their pain to the disease itself.  A full 38 said they thought their pain was caused by the treatment instead. 

And of those that reported they were experiencing pain:

• 33% said that they took no medications to alleviate the pain. 
• 76% said they were worried about addiction or dependency
• 56% said they simply couldn’t afford the pain medication.

Imagine: a full third of these patients not doing anything to alleviate the daily pain associated with mesothelioma and other forms of lung cancer – and doctors not stepping in to help them.

The second recommendation comes from Aetna, one of the nation’s leading health insurance providers.

Stephanie Whyche, author of “Malignant Mesothelioma: The Challenge of Treating Pain,” acknowledged that “the pain that can accompany malignant mesothelioma — especially during the end-stage of the disease — is one of the major challenges facing patients and their doctors.”

She went on to say that 60 to 90 percent of mesothelioma patients report experience pain or shortness of breath as the first symptom of the disease.

But rather than approach pain the old fashioned way with addictive pills and outmoded treatments, Wyche says that advances in pain management have to be adopted in order to minimize the effect that mesothelioma has on those afflicted by the disease.

She cites one novel new treatment which includes implanting a device that can deliver pain medication directly to the nervous system, bypassing parts of the body such as the stomach, kidneys, and liver - all which can be damaged by pain pills.

Dr. Srdjan S. Nedeljkovic, an anesthesiologist at Brigham and Women’s Hospital in Massachusetts, one of the leading hospitals that specialize in mesothelioma, says that this radical new form of pain management is “the most effective analgesic pain therapy for the treatment of patients who have pain from mesothelioma."

He says this form of treatment has roughly a 90% effectiveness rate with few of the side effects that plague other forms of treatment.

Dr. Nedeljkovic went on to explain that mesothelioma pain is often periodic with spikes in pain sensation occurring seemingly at random.  These spikes can be unbearable and may be unresponsive to oral medications or even IV infusions or injections.

In addition to treating the physical symptoms, psychologists at Brigham and Women’s Hospital note that emotional or psychological pain stemming from a mesothelioma diagnosis and all of the attendant drama associated with it can make the actual pain feel much worse than it actually is.  That’s why they recommend a psychological approach to pain management in addition to traditional and non-traditional medicinal therapies.

Regardless of the approach to treatment of malignant mesothelioma, it’s clear that doctors must pay more attention to the pain their patients are experiencing.  Because mesothelioma is incurable and invariably fatal, a significant amount of time and effort go into merely prolonging the patient’s life.  However, as the research above clearly emphasizes, that may not be enough.  Mesothelioma patients shouldn’t have to choose between a longer life of pain and a comfortable one.

By combining successful palliative treatments with a comprehensive pain management plan which includes affordable medications, psychological assistance, and general preparedness, mesothelioma patients can not only have a longer life, they can enjoy the life they have left.