|
Managing Mesothelioma Pain
Pain is a chief symptom of malignant mesothelioma. Mesothelioma
pain is generally harder to treat than pain from other types
of cancer, because the disease is locally invasive and persistent.
The excruciating pain - especially during the end-stage of
the disease - is one of the major challenges facing patients
and their doctors. The emotional distress wrought by the illness
and its associated pain can have a significant impact on the
quality of life of patients stricken with this disease.
It's estimated that 60 to 90 percent of patients experience
pain or shortness of breath as the first symptom of their
mesothelioma. The mere diagnosis of mesothelioma can be so
devastaing that it increases the psychological perception
of pain. Emotional support and counseling can play a key role
in pain management. Improving a patient's mental health can
help minimize the fear, anxiety and depression that can make
physical pain feel worse.
When malignant mesothelioma originates in the pleural cavity,
the first symptom may be a nagging discomfort or mild pain
in the chest area or in the back. If it originates in the
lining of abdominal cavity, the first symptom is abdominal
or pelvic discomfort.
During this initial stage, pain can be eased with over-the-counter
analgesics, such as aspirin, acetaminophen, or ibuprofen.
Surgery, radiation and chemotherapy are aimed at stopping
the spread of the disease and thus easing the pain. But the
treatment themselves are not exactly pain-free.
As the disease progresses and destroys soft tissue and nearby
nerves, the patient experiences more discomfort.
The pain changes from mild, general and episodic to severe,
localized and chronic as the disease progresses. Usually,
severe pain is unresponsive to oral doses, intravenous infusions,
or intramuscular injections of analgesics or narcotics.
However, anesthesiologists and other health care workers
who specialize in pain control are providing more relief than
ever before, thanks to state-of-the-art pain management techniques,
including implanting devices which deliver pain-fighting drugs
directly to the central nervous system.
Epidural Implants
If a patient no longer attains relief taking the strongest
oral or intravenous analgesic medications, doctors may prescribe
a solution containing local anesthetics and opioid analgesics
that is delivered epidurally. This treatment means a fluid
is injected outside of the dural membrane of the spinal cord,
but still within the spinal canal.
The pain-management team surgically implants a thin catheter
beneath the skin. Precise doses of the pain-killing mixture
are programmed to flow through this tubing into the epidural
area of the spinal canal at preset amounts and times. The
drugs bind to receptors in the central nervous system and
at the level of the nerve roots, blocking pain signals.
In addition to controlling pain, the epidural implant reduces
the need for in-hospital pain care. By allowing pain to be
controlled at home, it offers maximum mobility for patients.
Doctors, in conjunction with trained technicians of a private
home-health care agency, provide the medication and monitor
the ongoing operation of the device.
|