- Mesothelioma treatments
- Mesothelioma treatments for Shortness of Breath
- Mesothelioma treatments for Fighting for Breath
- Mesothelioma Treatments for Pain
- Mesothelioma Treatments for Coughing
The way mesothelioma is treated will vary between each sufferer depending upon his/ her situation. Age, general level of health and fitness, other illnesses are all relevant and might affect the treatment options. The treating doctor will discuss the options with the sufferer and a plan will be made. There are three main mesothelioma treatments; radiotherapy, chemotherapy and in some case surgery. Symptom control will also form a part of treatment for all patients.
Radiotherapy uses high-energy x-rays to reduce the size of the cancer tumour or control symptoms. Treatment is given for a period of time in cycles. The number of cycles given will vary between each sufferer.
Radiotherapy can be targeted to the area of the body affected by the cancer. If non cancerous cells are treated they will recover to some extent.
If a sufferer has undergone a procedure that left a scar (for example in pleurodesis or drainage of fluid), the site of the scar can be treated with radiotherapy to prevent the cancer from spreading.
Radiotherapy can cause side effects including nausea, reduced appetite, vomiting. Side effects should be kept under review and discussed with the treating doctor. Side effects should resolve once the course of radiotherapy is completed.
Chemotherapy is the use of anticancer drugs to destroy or disrupt the growth of the cancer cells. In mesothelioma chemotherapy is used to reduce the size of the tumour or control symptoms, it is not intended to be used as a cure for mesothelioma but some doctors believe it can extend the lifetime of a sufferer.
There are a number of drugs used to treat mesothelioma and include; Cisplatinum, Carboplatin, Doxorubicin, Gemcitabine, Mitomycin, Pemetrexed (Alimta), Raltitrexed and Vinorelbine.
Chemotherapy drugs can be given by injection, through drip or pump and some drugs can be taken as a tablet, capsule or liquid.
The side effects of chemotherapy include lowering the normal blood cells in the sufferer, which can make him/ her more prone to infections and fatigue. Other side effects of the drugs include nausea, anorexia, hair loss or thinning, constipation, diarrhoea and fatigue. The symptoms should be carefully reviewed with the treating doctor.
In order to diagnose mesothelioma a biopsy is usually taken. This is an operation that can be performed under local anesthetic where fluid can be removed from the chest and samples of tissue taken. The fluid and tissue are analyzed to confirm if mesothelioma is present. If these tests do not rule out mesothelioma a surgical biopsy may be required later.
Mesothelioma treatments for Shortness of Breath
Shortness of Breath Caused by Fluid on the Lung.
The medical term for this is pleural effusion and is where fluid accumulates in the space between the two layers of pleural membrane. The majority of mesothelioma sufferers will experience this symptom. If large amounts of fluid collects it can cause severe breathlessness.
The presence of the fluid can be confirmed by taking a chest x-ray. Fluid can be drained to relieve the symptoms. These procedures will take place in hospital and as soon as the fluid is drained the symptoms will improve. Sometimes a tube will be left in place to allow any further fluid that may collect to immediately drain away.
Pleural effusions can often occur again once the fluid has been drained from the lungs. In some cases it can become difficult for doctors to drain the new fluid that collects as is can collect in pockets or become sticky.
A procedure called pleurodesis can be performed to prevent further fluid from collecting. This is where a sterile talc is used to make the two pleural membranes stick together. This means that there is no space between them where the fluid can collect again. The talc is inserted into the space between the two pleural layers using a tube or thoracoscope. A video camera is often used so the treating doctor can see inside the chest. This is called VATS (Video Assisted Thoracoscopy).
Other Causes of Shortness of breath
Lung Volume Loss
If the mesothelioma tumour grows large and it enters the lung space, it can affect the ability of the lung to do its job. It reduces the exchange of oxygen and carbon dioxide causing breathlessness. In some rare cases a radical surgical procedure called ‘Debulking’ can help. However this serious surgery is not often appropriate in most mesothelioma cases. The symptoms of lung volume loss can be controlled by the sufferer using the Symptom Control Techniques.
Chest Wall Mobility Loss
This can occur when a mesothelioma tumor becomes attached to the chest wall and causes the chest to become less flexible. This restriction on movement can make breathing more difficult. Pleural thickening can also cause this rigidity and cause the same symptoms. Currently there are no treatments that can cure this problem but is the sufferer can learn to control and pace his/her breathing this can help.
Mesothelioma treatments for Fighting for Breath
Breathlessness can be very frightening and can make a mesothelioma sufferer very anxious. This anxiety can make the sufferer tense and the breathlessness worse. In turn this causes more anxiety and muscular tension, and so a cycle can form. However, a sufferer can be empowered to learn breath control techniques to break this cycle and help reduce the number of breathlessness attacks.
Options can include relaxation exercises, self-hypnosis or visualisation and are often taught by complementary therapists. Ask the advice of physiotherapist, Macmillan nurse, lung cancer nurse or palliative care team. And try our Ten Tips for Easier Breathing.
Ten Tips for Easier Breathing
- If lying down try to sit as upright as possible. Adjust your bed or use pillows for support.
- If in a chair, lean forward with your elbows and forearms on your knees/ thighs for support.
- If sitting at a table, try resting your head on pillows or your arms
- Standing is better than sitting.
- If standing, lean forward with your hands/ arms on a stable surface for support. For example, a wall, chair or table.
- Standing upright, turn your back to a wall and lean into it with your hips and back.
- Try to sit or stand by an open window for fresh air.
- Try using a hand held or electric fan to blow cool air at your face
- In very severe cases causing anxiety a light sedative can be prescribed by your doctor, such as lorazepam or diazepam.
- See your physiotherapist, Macmillan nurse, or lung cancer nurses for help in breathing control techniques
Mesothelioma Treatments for Pain
Most mesothelioma sufferers experience pain as part of their illness. Pain can be very different and includes dull nagging pain or a sharp stabbing pain, however the pain can be controlled with effective medication.
Locations of pain can differ and can include the shoulder back or chest. Often movement or deep inhalations of breath can worsen it.
The first step is to use simple analgesics such as paracetamol and ibuprofen. If these are ineffective stronger opiates such as morphine can be prescribed. Morphine is started in a low dose and can then be increased as necessary. It is a safe drug when used as prescribed and normally does not cause addicition if used for pain relief. It is usually given in liquid form that is swallowed initially every 4 hours, and then a longer lasting preparation can be taken twice a day regularly.
Some sufferer can experience breakthrough pain, which is bursts of pain that occur even when the prescribed painkillers have been taken. If this occurs the short acting morphine can be taken. You should discuss your experience of pain in detail with your treating doctors, and if you continue to experience pain ask to be referred to a Palliative Care or Pain specialist.
In some cases the sufferer is unable to swallow pain relief, so a syringe driver can be used. This involves a small needle being inserted under the skin and connected via a tube to a small pump that will feed in the medication slowly. This method can be very effective and can be used at home as well as in hospital. Each day the nurse will check and renew the supply of medication.
Mesothelioma Treatments for Coughing
Mesothelioma sufferers can experience a troubling cough. It can be caused by variety of reasons including the tumour irritating surrounding tissue, the lungs needing to clear phlegm, or chest infections. (If a chest infection is found it can be treated with antibiotics.)
A dry cough can be helped by the following medication; codeine, pholcodine linctus, or oral morphine solution.
Sometimes it can be relieved by saline (salt water) via a nebuliser. If a sufferer is having difficulty clearing his/her lungs of thick phlegm an oral liquid medicine called carbocisteine can help by reducing the thickness and stickiness of sputum making it easier to bring up.
If the sufferer is experiencing the lungs producing excessive secretions there are some medications that can be prescribed to dry this. Occasionally steroids can assist in treating a cough
Changing position can help, especially propping the sufferer up on pillows to assist the coughing mechanics. Keeping the air moist or inhaling steam can help, as does ensuring the sufferer remains hydrated.