Too many patients with malignant mesothelioma may be suffering more than they have to because they are not being offered palliative care earlier.
Cancer researchers in Italy reached that conclusion after evaluating the charts and symptoms of mesothelioma patients enrolled in a home palliative care program in Palermo.
Palliative care is the medical specialty focused on alleviating pain and other life-limiting symptoms. While palliative care is often associated with the end of life, the new study suggests that many mesothelioma patients could benefit from better symptom control earlier in their disease.
Evaluating Mesothelioma Symptoms
One of the most deadly aspects of malignant mesothelioma, an aggressive cancer caused almost exclusively by asbestos exposure, is that it often causes no symptoms at all for decades.
By the time early symptoms such as cough and fatigue do occur, pleural mesothelioma may already be advancing rapidly. Once a diagnosis is made, mesothelioma treatments can include chemotherapy, surgery, radiation or investigative therapies such as immunotherapy.
Although these treatments can slow it down, mesothelioma usually continues to progress, eventually causing more severe symptoms such as chest pain, shortness of breath, weakness, and poor appetite.
Palliative Care for Mesothelioma Patients
The new study focused on 56 patients with a diagnosis of mesothelioma. About three quarters of those patients said they had chest pain with their mesothelioma and more than a third found the pain to be moderate or severe, even with medium-high doses of pain medication.
Most importantly, their medical records showed that many of these mesothelioma patients were having significant pain as well as symptoms of advanced mesothelioma even before they were admitted to the palliative care program.
“Patients were referred to palliative care late in the course of their disease, suggesting that earlier integration of palliative care should be considered to relieve suffering in all disease stages – not only at the end of life,” writes lead investigator Sebastiano Mercadante with La Maddalena Cancer Center in Palermo.
Among the mesothelioma patients in the study, pain, weakness, poor appetite, poor well-being and shortness of breath were the most intense and bothersome symptoms. Many patients also suffered with cough and a buildup of fluid around the lungs.
Some studies have shown that effective symptom control can not only improve the quality of life for cancer patients, but may even help extend their lives. In the US, some types of palliative care treatments and medications are covered by Medicare Part B and many private insurance plans also provide coverage for palliative care. Mesothelioma patients and their families should discuss options for symptom management with their doctor.
Mercadante, S, et al, “Symptoms burden in mesothelioma patients admitted to home palliative care”, August 17, 2016, Current Medical Research and Opinions, Epub ahead of print