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For people with advanced mesothelioma, controlling symptoms is the main aim of treatment. Radiotherapy| and chemotherapy| can also be used to control symptoms.
Breathlessness| and pain when breathing may be a problem.
In mesothelioma, breathlessness is most commonly caused by a pleural effusion.
Mesothelioma can cause a build-up of the fluid between the two layers of the pleura (the membranes that cover the lungs). This is called a pleural effusion. The fluid can press on the lung making it difficult for the lung to expand fully. This can cause pain and breathlessness.
It’s treated by placing a small tube, connected to a drainage bag or bottle, between the two layers of the pleura and draining off the fluid. This is done under a local anaesthetic. You may need to have the fluid removed on a regular basis.
After the fluid from the pleural effusion has been drained it may be possible to seal the two layers of the pleura. This is called pleurodesis|. Your doctor can put sterile talcum powder (talc), or a particular chemical powder, into the pleural space through the tube. This causes the membranes to stick together. This helps stop pleural effusions happening again.
A pleural effusion View a large version of the image of a pleural effusion|
This may be used for some people, particularly if they are unable to have pleurodesis. The catheter is a soft flexible tube that can be inserted into the space where fluid collects. It can be left in position so that any fluid can be drained off whenever needed without you having a tube put in each time.
You’ll need to stay in hospital for a few days when the tube is put in. You can be taught how to drain the fluid yourself or the hospital staff can arrange for a district nurse to do this.
Other ways of helping breathlessness include using relaxation techniques and controlled breathing exercises. Your doctor can refer you to a physiotherapist who can help with any breathing problems.
Peritoneal mesothelioma can cause a build-up of fluid in the abdomen. This is called ascites. The abdomen can become distended, which can be uncomfortable and also cause you to feel breathless or sick. The fluid can be drained off and this can relieve the symptoms. A small cut is made in the abdominal wall under a local anaesthetic and a thin tube is inserted. The fluid is then slowly collected into a drainage bag. This can be done on a ward or in the x-ray department using an ultrasound to show exactly where the fluid is. You may need to have the fluid removed on a regular basis.
Your doctor may also prescribe a tablet called spironolactone. This is a water tablet (diuretic) that makes you pass urine more frequently. This helps stop the build-up of fluid in the abdomen.
Pain| is a common symptom of mesothelioma. There are many painkilling drugs available to treat different types and levels of pain. Other treatments such as surgery, radiotherapy and chemotherapy can also help reduce pain by removing or shrinking the tumour. Your doctor or nurse will aim to find the right painkillers| and other therapies to make sure that your pain is managed in the best possible way.
Giving your doctor or nurse as much information as you can about your pain will help them to assess it and plan treatments. You may want to think about:
If your pain is difficult to treat, your doctor may refer you to a doctor who specialises in pain control, or a specialist pain clinic. They may use other methods of pain control such as nerve blocks or transcutaneous electrical nerve stimulation (TENS). These methods can be effective on their own or in combination with painkillers.
Cancer and some cancer treatments can cause problems with eating and digestion. If your appetite is poor| you can add high protein powders to your normal food or you can replace meals with nutritious, high-calorie drinks. These are available from most chemists and can be prescribed by your GP. If you have lost your appetite, medicines such as steroids may be used to help improve it. You can also ask to be referred to a dietitian at your hospital. These are experts in assessing the food needs of people who are ill. They can advise you which foods are best for you and also whether any food supplements would help you. If you are at home your GP can arrange this for you.
Many people with mesothelioma feel tired and have less energy to do the things they normally do. This may be due to your illness or may be a side effect of treatment. Your body will tell you when you need to rest, but it’s important not to stop doing things completely, or to do too much. When you do feel like doing things, try to pace yourself. Start by setting yourself goals, maybe cooking a light meal or going for a short walk. Keeping a treatment diary can help you record your energy levels and plan activities for when you’re feeling stronger.
Find out more about coping with fatigue|.
Some people find that complementary therapies| can help them feel better and help reduce symptoms. It’s important to discuss your planned therapy either with your specialist or GP to check there are no reasons why you shouldn’t go ahead. Many doctors are now comfortable with medical and complementary therapies being used together.
Many hospitals and hospices offer complementary therapies. Treatments may include acupuncture, massage, aromatherapy and relaxation techniques.
Therapies such as gentle massage can be carried out by your relatives or carers and this can help them to support you.
For answers, support or just a chat, call the Macmillan Support Line free (Monday to Friday, 9am-8pm)
If you have any questions about cancer, need support or just want someone to talk to, ask Macmillan.