Other treatments (supportive therapies) to control symptoms of mesothelioma

For most people with mesothelioma, the main aim of treatment is to control symptoms. There are a number of drug treatments and minor procedures that can be used to control the symptoms of both pleural and peritoneal mesothelioma. On this page Treatments to control symptoms of pleural mesothelioma Treatments to control symptoms of peritoneal mesothelioma Treatments to control other symptoms of mesothelioma Loss of appetite Tiredness Complementary therapies There are also several people who can help manage your symptoms, including your hospital consultant, nurse specialist and 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. Treatments to control symptoms of pleural mesothelioma Back to top Breathlessness is a common symptom of pleural mesothelioma. It’s often caused by 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. Treating a pleural effusion A pleural effusion is 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. A pleural effusion A pleural effusion. View a large version of the image showing a pleural effusion. 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 and helps stop pleural effusions happening again. A pleurodesis may sometimes be carried out during a procedure know as video-assisted thoracoscopy. Your doctor will be able to tell you about this. Some people may have a pleural catheter put in, particularly if they’re 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 may have a catheter put in as a day-case procedure or you may need to stay in hospital for a few days. You can be taught how to drain the fluid yourself or the hospital staff can arrange for a district nurse to do this. We have more information available about managing a pleural effusion. Other ways to manage breathlessness These include breathing techniques, relaxation and coping strategies. These can all help to reduce the distress of breathlessness and make your breathing easier. Even simple measures, such as how you position yourself when sitting or standing, can be helpful. Using a fan or sitting by an open window with cool air blowing on to your face may also help ease breathlessness. Your doctor may also prescribe medicines to help with breathlessness, such as a low dose of the painkiller morphine, or drugs to help relieve 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 for you to have oxygen at home if it’s suitable for you. We have more detailed information available about managing breathlessness. Treatments to control symptoms of peritoneal mesothelioma Back to top Peritoneal mesothelioma can cause a build-up of fluid in the tummy (abdomen) known as ascites. When this happens, the tummy becomes swollen and it may cause you to feel sick and breathless. You may also have pain. Treating ascites Ascites can be treated by draining off the fluid from the tummy. This helps to relieve the symptoms. A small cut is made in the abdominal wall under a local anaesthetic, and a thin drainage tube is inserted. The fluid is then slowly collected into a bag. The length of time that the drainage 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. If there is a large amount of fluid however, 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 ascites to build up again, and drainage may need to be carried out more than once. If the fluid builds up again quickly, your doctor may insert a tube known as a catheter into the abdomen. The catheter is used to drain fluid from the abdomen and may be left in place for several weeks. Your doctor will be able to give you more information about this. Large version of the image of the abdomen showing draining of ascites Side view of the abdomen showing draining of the ascites. View a large version of the image showing the side view of the abdomen showing draining of the ascites. You may also be prescribed a tablet called spironolactone. This is a water tablet (diuretic), which makes you pass urine more frequently. This helps stop the build-up of fluid in the abdomen. We have more information available about ascites. 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. Treatments to control other symptoms of mesothelioma Back to top Pain Pain is a common symptom of mesothelioma. If you have pain, let your doctors or specialist nurse know 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 antiinflammatory 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 into 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. We have more information available about controlling cancer pain. 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 Back to top Mesothelioma 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 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. We have more information available about eating problems and cancer. Tiredness Back to top 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. Keeping a treatment diary can help you record your energy levels and plan activities for when you’re feeling stronger. 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. We have more information available about coping with tiredness in our section on coping with fatigue. Tiredness is 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. Complementary therapies Back to top 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. We have more information available about complementary therapies.