Supportive therapies for peritoneal mesothelioma

Possible symptoms of peritoneal mesothelioma include a swollen tummy, pain, night sweats, loss of appetite and tiredness. There are many things that can help these symptoms so it’s always worth telling your doctor or nurse about any problems you have.

Tummy swelling is caused by a build up of fluid. This is called ascites. A doctor can drain the fluid to relieve discomfort.

Painkillers are used to control pain. There are many different types for treating different types of pain. Pain that is more difficult to control may be managed at a specialist pain clinic.

If you have night sweats try keeping the temperature in the bedroom cooler and using lighter bedclothes made from natural fibres such as cotton. Your doctor can prescribe high calorie supplements if your appetite is affected. Some people are prescribed steroids to boost their appetite.

If you feel very tired tell your doctor as some causes of tiredness can be treated. Try to balance rest with some gentle activity.

Some people also use complementary therapies such as massage or relaxation techniques to help them to cope with symptoms.

Other treatments (supportive therapies)

For most people with mesothelioma, the main aim of treatment is to control symptoms. There are a number of drug treatments and other procedures that can be used to control the symptoms of peritoneal mesothelioma.

There are several people who can help you manage your symptoms, including your:

  • hospital consultant
  • nurse specialist
  • GP.

They may suggest referring you to a palliative care team. These teams specialise in managing symptoms and also provide emotional support for you and your family. Many palliative care teams have nurse specialists who can visit you at home.


Treating ascites

Peritoneal mesothelioma can cause a build-up of fluid in the tummy (abdomen) known as ascites. Your tummy becomes swollen and you may have pain, and feel sick and breathless.

Ascites can be treated by draining off the fluid from your tummy. This helps to relieve the symptoms. You will be given a local anaesthetic injection in your tummy to numb the area. A small cut is made in the skin and a thin tube is inserted. The tube is attached to a drainage bag and the fluid slowly drains out. The tube may be held in place with a couple of stitches and covered with a dressing.

The length of time that the tube needs to stay in place depends on the amount of fluid that needs to be drained off. Sometimes, a small amount of fluid can be drained in the outpatients’ clinic. But if there is a large amount of fluid, the procedure may need to be carried out in hospital under the supervision of the doctors and nurses. The drain may stay in place for up to 24 hours, although occasionally it may stay in longer.

It’s possible for the fluid to build up again, and you may need the fluid drained off more than once. If the fluid builds up again quickly, your doctor may put a tube into your tummy which can be left in place. When the fluid starts to build up it can be attached to a drainage bottle and drained off. The end of the tube is covered with a dressing when you’re not using it. Your doctor will be able to give you more information about this.

Side view of the abdomen showing draining of ascites
Side view of the abdomen showing draining of ascites

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Your doctor may also prescribe a tablet called spironolactone. This is a water tablet (diuretic), which makes you pass urine more often. This may help stop the build-up of fluid in the abdomen.


Pain

Pain is a common symptom of mesothelioma. Let your doctors or specialist nurse know if you have pain so that they can assess and treat it early on.

Painkillers

There are many painkilling drugs available to treat different types and levels of pain. They include: painkillers, such as paracetamol, codeine or morphine; and anti-inflammatory drugs, such as ibuprofen (Brufen®) and diclofenac (Voltarol®). Some people find that they have nerve pain (also known as neuropathic pain), which happens when the mesothelioma presses on nerves. This type of pain is best treated with specific painkillers that treat nerve pain such as gabapentin and pregabalin (Lyrica®).

Often, a combination of painkillers is needed to get the best pain control.

Other ways to control pain

Other general ways of relaxing and helping to reduce your pain include:

  • listening to relaxation CDs
  • having a long soak in a warm bath
  • having a massage to an area of your body that isn’t painful, such as your hand or foot.

Occasionally, if your pain is troublesome, your doctor or nurse may suggest a short admission to hospital or a hospice so that your pain can be controlled while you’re an inpatient. They may also suggest referring you to a doctor who specialises in pain control, or a specialist pain clinic. They may use other methods of pain control, such as specialised procedures to block nerves, if nerve pain is a problem.


Night sweats

Mesothelioma can cause some people to sweat a lot at night. This can be distressing, especially if you wake at night with damp bed clothes and bedding. Let your doctor know if this happens to you as they may be able to give you medicines to help. You may also find the following tips helpful:

  • Try avoiding drinks that contain caffeine before you go to bed or in the night.
  • Keep the room temperature cool or use a fan.
  • Avoid using duvets or blankets that make you too hot.
  • Lie on a towel so that you avoid getting your bedding damp.
  • Use cotton sheets and bed clothes, and have some spare so that you can change them in the night if you need to.


Loss of appetite

Mesothelioma and some cancer treatments can cause problems with eating and digestion. If your appetite is poor, try having smaller, more frequent meals. You can also 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 help improve it. You can also ask to be referred to a dietitian at your hospital. They can advise you which foods are best for you and also whether any food supplements would help you. If you’re at home, your GP can arrange this for you.


Tiredness

Many people with mesothelioma feel tired and have less energy to do the things they normally do. This may be due to the illness or it may be a side effect of treatment. It’s important not to do too much. Your body will tell you when you need to rest, but it’s important not to stop doing things completely. Try to balance rest with gentle activity, such as walking. Some people find it helpful to set goals to help them plan their daily activities. These goals may include cooking a light meal, going for a short walk or meeting a friend.

Some causes of tiredness can be treated, for example anaemia (low red blood cells) can be treated with a blood transfusion. Your doctor can take a blood sample from you to find out if you have anaemia.

If sleep problems are causing or contributing to your tiredness, then improving your sleep will help you feel better. You can read about ways of improving your sleep in our information about difficulty sleeping.

Tiredness is also a common symptom of depression. If you think you’re depressed, talk to your doctor or nurse. You and your doctor will be able to work out if what you’re feeling is depression or fatigue. Talking about your feelings with a professional counsellor can often help depression. Antidepressants may also help you feel better.


Managing bowel obstruction

Occasionally, peritoneal mesothelioma may cause the bowel to block. Symptoms may include pain, tummy bloating, sickness and constipation. If this happens, your doctors will give you medicines to control your symptoms. They may also suggest treatments that will help rest your bowel for a while and help with the blockage.


Complementary therapies

Some people find that complementary therapies, such as acupuncture, massage, aromatherapy and relaxation techniques, can help them feel better and reduce symptoms. Many hospitals and hospices offer these therapies.

If you’d like to try a complementary therapy, check with your cancer specialist or GP before using it. This is important because some complementary therapies should be avoided during, and for a short time after, cancer treatments.

Back to Treating

Making treatment decisions

Your doctors may tell you there are different options for your treatment. Having the right information will help you make the right decision for you.

Chemotherapy

Chemotherapy uses drugs to treat many different types of cancer. It is most commonly given as an injection into a vein or as tablets or capsules.

Surgery

Surgery involves removing all or part of the cancer with an operation. It is an important treatment for many cancers.

Clinical trials

Many people are offered a trial as part of treatment. Find out more to help you decide if a trial is right for you.

After treatment

After treatment you will have regular check-ups. If you have any problems, let your doctor know.