Mesothelioma Treatment Requires More Than Cancer Targeting Drugs
By Nancy Meredith
Mesothelioma is a serious, asbestos-caused cancer of the membranes that surround many of the body’s vital organs. The most common form is pleural mesothelioma, where the cancer attacks the tissue surrounding the lungs. There is no known cure for mesothelioma. However, with an early diagnosis and appropriate care, patients may get some relief from their symptoms.
Treatment for mesothelioma is complex and, depending on the stage of the disease, typically involves a multi-modal approach including surgery, radiation and chemotherapy. While these treatment options are vital for fighting the disease, they can come with pain and side effects and may deplete the body of much needed nutrients. As a result, additional medications must be added to the cancer-fighting arsenal to help the patient fight off infection and fatigue and keep them as comfortable as possible during the difficult treatment regimen.
The most common side-effects of chemotherapy treatment are nausea, vomiting and diarrhea. Fortunately, there are many drugs that a doctor can prescribe to prevent, lessen, or relieve the GI discomfort. The drugs can be given in pill form, through an IV, a patch, under the tongue, or even in a shot. In some cases the medicine is given via IV prior to receiving the chemotherapy treatment. Some common anti-nausea medicines include:
- aprepitant (Emend®)
- dolasetron (Anzemet®)
- granisetron (Kytril®)
- ondansetron (Zofran®)
- proclorperazine (Compazine®)
- lorazepam (Ativan®)
- metoclopramide (Reglan®)
- famotidine (Pepcid®)
- ranitidine (Zantac®)
The Multi-Uses of Steroids
Cortisol-type steroids are used to treat many conditions and symptoms that arise from cancer and the associated treatments. Prednisone is one of the most common steroids prescribed and can be used for any or all of the following:
- Shrink tumors and fight the cancer in addition to the chemotherapy;
- Relieve inflammation and reduce swelling;
- Reduce allergic reactions from chemotherapy and other infusions – often given via IV prior to the primary drug infusion;
- Reduce nausea associated with chemotherapy and radiation;
- Increase appetite and stimulate weight gain;
- Induce sleep.
Mesothelioma is a painful cancer and the pain associated with the disease varies from patient to patient and depends on the type of mesothelioma. Over half of the pleural mesothelioma patients suffer pain in the lower, back and sides of the chest. Sufferers of peritoneal mesothelioma may experience pain in the abdominal area, whereas pericardial mesothelioma patients experience the most pain with symptoms including chest pain, heart palpitations, shortness of breath, and constant and acute coughing.
Pain treatment varies depending on the severity.
- Mild pain is typically treated with over-the-counter drugs containing ibuprofen, aspirin, naproxen or acetaminophen.
- Moderate pain often involves the use of opioid medications that are sometimes used in combination with NSAIDs. Opioid products are hydrocodone, codeine, methadone or oxycodone.
- Severe pain is often experienced following surgery and is typically managed through “patient-controlled analgesia” where the patient can manage the dosage of the painkiller. Most often this is a morphine drip. Higher doses of the moderate pain relievers may be used or other drugs can be prescribed including morphine, fentanyl and hydromorphone.