Treating mesothelioma symptoms

There are different treatments that can help control the symptoms of pleural mesothelioma.

Breathlessness is a common symptom of pleural mesothelioma. It is often caused by a build-up of fluid between the 2 layers of the pleura. The pleura are the linings (membranes) that cover the lungs. This build-up is called a pleural effusion.

Managing breathlessness

There are things you can do to help manage breathlessness. These include breathing techniques, relaxation and coping strategies. They can all help to reduce the distress of breathlessness and make breathing easier.

Even simple things can be helpful, such as how you position yourself when sitting or standing. Using a fan or sitting by an open window with cool air blowing on your face may also ease breathlessness.

Your doctor may give you medicines to help with breathlessness. This might be a low dose of a painkiller called morphine, or drugs to help the anxiety and panic that breathlessness can cause. Some people may benefit from using oxygen at home. Your doctor or palliative care nurse can organise oxygen at home if it is suitable for you.

Coughing is also common with mesothelioma. This can be difficult to cope with, as it can sometimes cause other symptoms such as pain, vomiting and tiredness.

Your doctor may be able to give you medicines, such as a low dose of morphine. You may also find it helpful to:

• sleep in a different position – such as propped up with pillows
• use steam inhalations or saline nebulisers – a nebuliser is a small machine that turns saline into a fine mist, so you can breathe it deep into your lungs.

Chest drain to treat fluid around the lung

If you have a build-up of fluid around the lung (pleural effusion), your doctor usually puts a tube in the side of your chest to drain the fluid. Before they do this, they clean the skin with an antiseptic. They then give you an injection of local anaesthetic to numb the area. You will not feel any pain during the procedure. Sometimes it is done under general anaesthetic, which means you will be asleep.

Your doctor makes a very small cut in the chest. They insert the chest drain into the space where the fluid is collecting. Sometimes they use an ultrasound scan to help guide the tube into the correct position. When the tube is in, they attach the chest drain to a bag or bottle for the fluid to drain into.

Pleural effusion with drainage

To help drain the fluid, you can have a small tube inserted into your chest. This is called an indwelling pleural catheter (IPC). It is usually put in under local anaesthetic. Sometimes it is put in under general anaesthetic.

The tube is soft and flexible. It is about the size of a straw. One end sits in the chest where the fluid collects. The other end passes through the skin. It has a valve that can be opened and closed.

The drain can stay in place when you go home. You can drain the fluid whenever it starts to build up again around the lung. This might be once a day or every few days, depending on how quickly it builds up. The tube can be connected to a bottle for the fluid to drain into. You can then disconnect the bottle and empty it. The nurses will show you how to use the drain. When you are not using it, the tube is not noticeable. It will be under your clothes and should not affect your daily activities.

Pain

Pain is a common symptom of mesothelioma. Tell your doctors or specialist nurse if you have pain so they can treat it early. There are different ways to manage pain depending on the cause. Your cancer team will assess the pain and usually give you painkillers to help.

Painkillers

There are many drugs available to treat different types and levels of pain. They include:

• painkillers, such as paracetamol, codeine or morphine
• anti-inflammatory drugs, such as ibuprofen and diclofenac
• other types of medication, such as steroids or patches to help numb pain.

Some people have nerve pain, which happens when mesothelioma presses on nerves. This type of pain is best treated with painkillers such as:

• gabapentin
• pregabalin (Lyrica®)
• amitriptyline.

You may need a combination of painkillers to get the best pain control. It can be helpful to keep a record of the painkillers you take, and when you have taken them.

Radiotherapy can also be used to help manage pain in some situations.

Sometimes, your doctor or nurse may suggest a short stay in hospital or a hospice to get your pain under control. They may also refer you to a doctor or nurse who specialises in pain control, or to a pain clinic. If you have nerve pain that has been more difficult to control, they may suggest other ways to control it. This might include a specialised procedure called a nerve block.

We have more information about managing pain.

Night sweats

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

• Try to avoid drinks that contain caffeine before you go to bed or during the night.
• Keep the room temperature cool or use a fan.
• Avoid using duvets or blankets that make you too hot.
• Use natural fibre bed sheets and nightwear, and have spare ones nearby so you can change them if you need to.

Loss of appetite

Mesothelioma and some cancer treatments can cause problems with eating and digestion. If you do not have much of an appetite, try having smaller meals more often. You can also add high-protein powders to your normal food. Or you can boost your meals with nutritious, high-calorie drinks. These are available from most pharmacies, or your GP may prescribe them for you.

If you have lost your appetite, medicines such as steroids may help. You can also ask your GP or nurse to refer you to a dietitian. They can advise you on which foods are best for you and whether any food supplements would help. If you are at home, your GP can arrange this for you.

Tiredness

Many people with mesothelioma feel tired and have less energy. This may be because of the cancer, or a side effect of treatment. It is important not to do too much. Try to balance rest with gentle exercise, such as walking. Some people find it helpful to set some goals. These goals could include:

• cooking a simple meal
• going for a short walk
• meeting a friend.

Some causes of tiredness can be treated, for example anaemia (low red blood cells). Your doctor can take a blood sample from you to check if you have anaemia. You may need a blood transfusion if you are very anaemic.

Some people may be tired because they have difficulty sleeping. This may be caused by some treatments, or by the emotional effects of cancer. We have more information about difficulty sleeping.

Tiredness is also a common symptom of depression. If you think you are depressed, talk to your doctor or nurse. Talking about your feelings with a professional counsellor can also help.

Complementary therapies

Some people find that complementary therapies may help them to cope with symptoms and side effects. These may include acupuncture, massage, aromatherapy, and relaxation techniques. Many hospitals and hospices offer these therapies.

If you would like to try a complementary therapy, check with your cancer doctor or GP first. This is important because you may need to avoid some complementary therapies during cancer treatments and for a short time after.